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German universities built over the years highly specialized book collections for use by faculty and graduate students. The German term,seminarbibliothek, is often applied to these types of collections, although examples can be found in universities across Europe. The purpose of this article is to examine a similar type of collection using ebooks in veterinary science and to compare this collection to the standard subject classified ebook collections. Most collection development in college and university libraries focuses on academic subjects. The type of collection being described here focuses on a mission. A mission-focused collection increases the use of library holdings and greatly benefits the stakeholders within the institution. This study looks at how such a collection might be formed and defined and what possible effects this might have on the use of collections of this type. [ABSTRACT FROM PUBLISHER]

Background:Prostate cancer (PrCa) is one of the most common diseases to affect men worldwide and among the leading causes of cancer-related death. The purpose of this study was to use second-generation sequencing technology to assess the frequency of deleterious mutations in 22 tumour suppressor genes in familial PrCa and estimate the relative risk of PrCa if these genes are mutated.Methods:Germline DNA samples from 191 men with 3 or more cases of PrCa in their family were sequenced for 22 tumour suppressor genes using Agilent target enrichment and Illumina technology. Analysis for genetic variation was carried out by using a pipeline consisting of BWA, Genome Analysis Toolkit (GATK) and ANNOVAR. Clinical features were correlated with mutation status using standard statistical tests. Modified segregation analysis was used to determine the relative risk of PrCa conferred by the putative loss-of-function (LoF) mutations identified.Results:We discovered 14 putative LoF mutations in 191 samples (7.3%) and these mutations were more frequently associated with nodal involvement, metastasis or T4 tumour stage (P=0.00164). Segregation analysis of probands with European ancestry estimated that LoF mutations in any of the studied genes confer a relative risk of PrCa of 1.94 (95% CI: 1.56-2.42).Conclusions:These findings show that LoF mutations in DNA repair pathway genes predispose to familial PrCa and advanced disease and therefore warrants further investigation. The clinical utility of these findings will become increasingly important as targeted screening and therapies become more widespread. [ABSTRACT FROM AUTHOR]

KEY POINTS AND PRACTICAL RECOMMENDATIONS: •  β-Blockers are appropriate treatment for patients with hypertension and those who have concomitant ischemic heart disease, heart failure, obstructive cardiomyopathy, or certain arrhythmias. •  β-Blockers can be used in combination with other antihypertensive drugs to achieve maximal blood pressure control. Labetalol can be used in hypertensive emergencies and urgencies. •  β-Blockers may be useful in patients having hyperkinetic circulation (palpitations, tachycardia, hypertension, and anxiety), migraine headache, and essential tremor. •  β-Blockers are highly heterogeneous with respect to various pharmacologic effects: degree of intrinsic sympathomimetic activity, membrane-stabilizing activity, β(1) selectivity, α(1) -adrenergic-blocking effect, tissue solubility, routes of systemic elimination, potencies and duration of action, and specific effects may be important in the selection of a drug for clinical use. •  β-Blocker usage to reduce perioperative ischemia and cardiovascular complications may not benefit as many patients as was once hoped and may actually cause harm in some individuals. Currently the best evidence supports β-blocker use in two patient groups: patients undergoing vascular surgery with known ischemic heart disease or multiple risk factors for it and for patients already receiving β-blockers for known cardiovascular conditions. [ABSTRACT FROM AUTHOR]

The Purdue University Libraries was an early implementer of purchasing books requested through interlibrary loan rather than borrowing the requested books. The service, called Books on Demand, began in January 2000. An analysis of the requests at the end of the first two years of service indicated that these patron-selected books were more likely to have repeat circulations than the books acquired through normal collection development processes. When the program reached its tenth year, the authors analyzed and compared the books purchased through Books on Demand with all other purchased books during the same period. Findings indicate that books acquired through this user-initiated program have higher circulation rates than books acquired through the normal selection channels. The difference is quite large, a mean of 4.1 compared to a mean of 2.4, when the first interlibrary loan use is included as a circulation. Therefore, the authors recommend that libraries investigate a service of purchasing books requested via interlibrary loan as a complement to other collection development efforts. [ABSTRACT FROM AUTHOR]

The article presents a study on meeting academic needs for information using a customer service approach. The study aimed to investigate whether academic libraries should seek to improve general satisfaction with their services or are services more relevant than others. The study asserted that faculty and students mainly want information services. It analyzed the LibQual+(trademark) data to identify which other resources contribute to information satisfaction among users. The results indicated that access mechanisms were very relevant predictors of information satisfaction and that library facilities and staff were negligible predictors.

The article talks about LibQUAL+, an assessment tool that can be used by libraries in assessing their services. The LibQUAL+ was developed by the Association of Research Libraries (ARL) which will be used in developing a survey that allowed local libraries to discover their particular strengths and deficiencies. LibQUAL+ enables libraries to compare their results with results of peer institutions and they can use a proved and tested survey instrument. Libraries can also use the new tool for help in strategic planning.

The feasibility of using the electrically evoked compound action potential (ECAP), measured with the NRT system (Neural Response Telemetry) and the NRT software (version 2.04), to quantify the longitudinal spread of neural excitation was examined in four subjects fitted with the Nucleus C124M cochlear implant. The ECAP and psychophysical forward-masking profiles were measured using stimulation on each of three electrodes, in basal, middle and apical positions. Spatial spread profiles derived from the ECAP measure produced broader functions than those derived from the psychophysical measure. These results, together with investigation of the change of ECAP spread pattern with stimulation current, suggest that functions derived from this 'simple' method were more influenced by the spread of electric field from excited neuron to electrode array than by breadth of the neural excitation pattern. The recently released NRT version 3.0 permits the masker and probe pulses to be delivered to separate electrodes, thus removing a fundamental limitation of version 2.04. Results from a pilot study, in which this capability was exploited, suggest that the spatial functions from this 'advanced' method may provide a better correlation with results from psychophysical forward masking. [ABSTRACT FROM AUTHOR]

A basic principle of information literacy programs is that skills needed to use computers and skills needed to find and evaluate information are two separate sets of skills. Outside the library this is not always the view. The claim is sometimes made that information skills are acquired by learning computer skills. This article uses data from a survey of computer and information skills to determine whether or not these skills are separate entities. The survey was given to incoming freshmen at Purdue University in West Lafayette, Indiana, in 1999 and 2000.

Summary:Allogeneic bone marrow transplant (BMT) with an MRD in complete remission (CR)1 is the preferred treatment for children with Philadelphia-positive (Ph+) ALL. The role of MUD BMT in CR1 is still controversial. We compared the outcomes of two treatment strategies: BMT using an MRD or MUD vs chemotherapy in children with Ph+ ALL in CR1. In total, 21 children were treated from 1985 to 2001. In all, 10 received chemotherapy and 11 received allogeneic BMT: four MRD, seven MUD. In the MRD group, one relapsed 12 months after BMT and died; the remaining three are long-term event-free survivors (median follow-up, 6.1 years). In the MUD group four died; the remaining three are long-term event-free survivors (median follow-up, 7.2 years). The 4-year event-free survival (EFS) for the BMT group was 53±15%. In the chemotherapy group, seven relapsed after a median period of 12.5 months and three remain in continuous CR (median follow-up, 2.4 years). Four chemotherapy patients received CR2 transplants; all died. The 4-year EFS for the chemotherapy and MUD groups was 33±17 and 35.7±20%, respectively. This difference was not statistically significant. We continue to support treating children with Ph+ ALL with MRD BMT in CR1. The effectiveness of MUD BMT vs chemotherapy merits further study.Bone Marrow Transplantation (2004) 33, 39-45. doi:10.1038/sj.bmt.1704319 Published online 20 October 2003 [ABSTRACT FROM AUTHOR]

Discusses the effect of bibliographic instruction on the demand for reference services. Purpose of the bibliographic program; Results of a research study on the topic using data from 83 Association of Research Libraries members; Impact of bibliographic skills instruction on library user.

Presents a study that examined the effectiveness of antiemetic prophylaxis in children receiving antineoplastic agents prior to undergoing bone marrow transplantation (BMT). Percentage of BMT patients who experienced nausea during the conditioning regimen; Components of BMT supportive therapy; Symptoms in women with breast cancer undergoing BMT.

Busulphan (BU) pharmacokinetic (PK) studies in children undergoing bone marrow transplantation suggest that individual BU dosing may be necessary to optimise BU systemic exposure. Optimising BU systemic exposure may improve outcome and decrease toxicity in BMT. Because of practical limitations in obtaining blood from children and for financial reasons, a limited sampling method (LSM) is needed. However, such methods for BU have not been validated in children. In the present study, we individualized oral BU dosing in 10 children to target an area under the curve of BU (BU AUC) of 900–1400 μ M/min based on BU AUC0–∞ calculated from nine serum BU concentrations performed after a BU test dose of 40 mg/m2. We validated a LSM using 3 BU concentrations to determine AUC. Six of nine patients studied (one patient non-evaluable), required their doses modified (3, lower; 3, higher). The mean percent dose change was 26.2% (range -33.3% to +45.3%). Our three sample LSM BU AUC0–∞ (1098 ± 344, mean ± 1 s.d.) correlated highly with our nine sample BU AUC0–∞ (1132 ± 389, Pearson r = 0.98, P = 0.0001) and was not significantly different by t-test (P = 0.3). The mean percentage difference between the three sample LSM AUCs and the nine sample AUCs in each of our patients was 7.5%, (range -10.99% to +9.4%). Trough levels correlated extremely well with AUC (r = 0.95, P = 0.0001). Individual BU dosing, based on AUC, is necessary in most children to achieve targeted levels of BU therapy. An LSM of three BU concentrations performed at 0.5 h, 1 h and 6 h post-BU test dose closely predicts the AUC calculated from nine sampling points. [ABSTRACT FROM AUTHOR]

The effect of three methods of root-end preparation. following apical resection, on the apical seal of root-end fillings, was studied in vitro. Root canals of 116 single- rooted teeth with mature apices were prepared chemo-mechanically and obturated with gutta-percha and sealer. The root ends were resected with a diamond but under water coolant and were prepared as follows: group I a size 010 round bur was used to prepare an apical cavity 2-3 mm down the long axis of the root; group H treatment as per group 1 followed by a 60-s rinse with a solution of 10:3 (10% citric acid: 3% Fe2Cl3); and group 111 an ultrasonic retrotip was used to prepare a 2-3 mm deep apical cavity. The root end was restored with an EBA cement. Apical leakage was determined using India ink after 7 days and 7 months. The teeth were demineralized, rendered transparent and linear dye penetration was recorded. Results showed that there was no significant difference in leakage between the groups at each time interval (P>0.05) but there was increased leakage after 7 months (P<0.01). Cracking of the root surface was seen most often with the ultrasonically prepared roots (P<0.001). [ABSTRACT FROM AUTHOR]

The effect on coronal leakage of the use of either a single gutta-percha cone or cold lateral condensation of gutta-percha, with a glass ionomer sealer cement was studied. In addition, the effect of the removal of the smear layer was also determined. Eighty-eight single-rooted teeth were prepared chemomechanically using hand files, with the balanced force technique. Lubrication was provided by either Hibiscrub (maintaining the smear layer) or an EDTA-containing paste (to remove the smear layer). Copious irrigation was carried out with 2.2% sodium hypochlorite. The teeth were allocated randomly to four groups of 20 teeth each, the remaining eight teeth served as controls. Two groups of teeth, one with and one without smear layer, were obturated with either a single gutta-percha cone or cold laterally condensed gutta-percha, with Ketac Endo as the sealer. The teeth were stored for 6 weeks, thermocycled, and the extent of coronal leakage determined for each group after immersion in India ink for 90h. The teeth were demineralized, dehydrated and immersed in methyl salicylate, which rendered them transparent. Linear measurement of maximum dye penetration was recorded. The mean depth (+ SD) of leakage for the groups in which the smear layer was left intact was 1.68mm (+ 0.38) for the single cone (A1) and 2.29 mm (+ 1.58) for lateral condensation (B1). When the smear layer was removed the mean depth of leakage for the single cone group (A2) was 2.04 mm (+ 0.73) and 2.37mm (+ 1.70) for the laterally condensed group (B2). There was no significant difference in coronal leakage between the groups (P>0.05). [ABSTRACT FROM AUTHOR]

The effect of post space preparation on the apical seal of teeth roots treated with the plastic-cored Thermafil was studied in vitro. Single rooted teeth with mature apices were prepared chemomechanically and obturated with alpha-phase gutta-percha, Thermafil, on plastic core-carriers and sealer, Scalapex. The teeth were divided randomly into four groups of 18 teeth each. In two of the groups post space was prepared by hand using a Parapost drill (diam. 1.25 mm) after gutta-percha removal with Peeso reamers in a slow-speed handpiece, one group immediately after canal obturation and the other after storage in 100% relative humidity at 37°C for 1 week; 5 mm of root filling was left intact. The time taken to remove the gutta-percha was recorded. Post space was not prepared in the control groups. Apical leakage was determined using black India ink. The teeth were demineralized, rendered transparent, and linear measurement of dye penetration was recorded. Results showed that there were no significant differences in leakage between any of the groups (P>0.05). There was no statistically significant difference in the time required to remove the gutta-percha from the root canals in both groups (P<0.05). It is concluded that under the conditions of this study post space preparation immediately after obturation, or after a delay of 1 week, does not affect the apical seal of Thermafil with plastic core-carriers. [ABSTRACT FROM AUTHOR]

The effect of the removal of the smear layer on coronal leakage of root fillings was studied using two sealer cements. Sixty single-rooted teeth with mature apices were prepared chemomechanically using a modified double-flared technique with non-cutting tipped files and copious irrigation with 2% sodium hypochlorite. The teeth were randomly allocated to four groups of 15 teeth each. Two groups were treated with 40% citric acid to remove the smear layer. Two groups of teeth, one with and one without smear layer, were filled by lateral condensation of gutta-percha with either Tubliseal or a resin-based glass ionomer, Vitrebond. The teeth were stored for 1 week, thermocycled, and the extent of coronal leakage determined for each group after immersion in indian ink for 90 h. The teeth were demineralized, dehydrated and immersed in methyl salicylate which rendered them transparent. Linear measurement of dye penetration was recorded. The mean depth (± SD) of leakage for the groups in which the smear layer was left intact was 4.26±1.53 mm and 6.83±1.65 mm for the Vitrebond and Tubliseal, respectively. When the smear layer had been removed, the mean depth of Leakage for the Vitrebond group was 1.13±0.29 mm, and 3.72±1.23 mm for the Tubliseal group. There was a statistically significant difference in leakage between the groups (P<0.001). With both sealers, those teeth in which the smear layer had been removed showed less leakage than the specimens in which the smear layer was left intact (P<0.001). The Vitrebond specimens leaked less than the teeth that were root filled using Tubliseal, both when the smear layer was intact and when It was absent (P<0.001). [ABSTRACT FROM AUTHOR]

The use of a resin-based glass ionomer as an endodontic sealer was studied in vitro. The root canals of extracted single-rooted human teeth with mature apices were prepared using a stepback technique. Subsequently, the smear layer was removed with 40% citric acid and the canals obturated using lateral condensation of cold gutta-percha and a resin-based glass ionomer as the sealer. The relationship between the sealer and the wall of the root canal was studied using scanning electron microscopy. The shear bond strength of gutta-percha to this glass ionomer was also determined. Finally, the uptake of fluoride into the wall of the root canal was studied using scanning electron microprobe analysis after storage for 2 weeks. 1 month and 3 months following root filling with gutta-percha and glass ionomer cement. The results showed that removal of the smear layer allowed the sealer to enter some of the dentinal tubules. This was observed most frequently in the middle third of the root canal, where there was good adaptation of the sealer. The shear bond strength of gutta-percha to the glass ionomer sealer was not significantly different from that obtained between gutta-percha and a proprietary zinc oxide-eugenol endodontic sealer. The concentration of fluoride in the dentine in the coronal part of the root canal increased after obturation with gutta- percha and the glass ionomersealer at every time interval. The increase in fluoride concentration varied widely between teeth. It is concluded that a resin-based glass ionomer cement may have potential as a root canal sealer. [ABSTRACT FROM AUTHOR]

Considerable preparation, planning and detailed organization are necessary if endodontic `hands-on' courses are to be stimulating and worthwhile for participant and teacher alike. Projection facilities, lighting, seating and working surface requirements must be checked immediately on arrival at the venue. The format, although flexible enough to allow for the wide range of knowledge and practical ability found within any one group, must adhere to and stress the current fundamentals in endodontic teaching. Not only can information and skill in diagnosis, root canal preparation and obturation be taught in a `hands-on' format, but rubber dam isolation techniques can also he practised very successfully. Tutors must be prepared to demonstrate personally their clinical ability and experience of principles and techniques taught during the course. Post-course feedback can be an extremely useful means of ensuring that `hands-on' courses are relevant, with the appropriate practical emphasis required by the general dental practitioner, as well as the necessary stress on endodontic principles. [ABSTRACT FROM AUTHOR]

The effect on the apical seal of root filling teeth with two sealer cements that reacted chemically with tooth structure was studied in vitro. In addition, apical leakage of teeth obturated with these materials and subsequently prepared to accept a post was tested. Ninety single-rooted teeth with mature apices were prepared chemomechanically by the stepback technique using files and copious irrigation with 2.5 per cent sodium hypochlorite. The teeth were then randomly allocated to six groups of 15 teeth each, Two groups were root filled by lateral condensation of gutta-percha and one of three sealer cements: Tubliseal, a radiopaque glass ionomer kiting cement, Ketac Cem, and a chemically active composite resin, Panavia Ex. Thirty minutes later, in one group for each material, a post space was prepared leaving 4-5 mm of root filling at the apex. The extent of apical leakage in each group was determined after immersion in Indian ink for 14 days. The teeth were demineralized, dehydrated and immersed in methyl salicylate, which rendered them transparent, and a linear measurement of dye penetration was recorded. No statistically significant difference in the extent of leakage was found between the sealers in those groups which were filled by lateral condensation and left intact. However, the degree of leakage increased after post space preparation with the glass ionomer and Tubliseal groups, but was reduced in the Panavia Ex group. [ABSTRACT FROM AUTHOR]

Temperature elevations of 10°C above body temperature, of duration >1 minute, may be sufficient to cause bone tissue injury. Temperature rises on the root surface in excess of 10°C have been shown in studies in vitro of thermoplasticized gutta-percha root filling techniques. To determine whether results in vitro at room temperature could be extrapolated to conditions in vivo, temperature elevations were recorded at the mid-point on the root surface of the canine tooth in the ferret during thermomechanical compaction of gutta-percha. The time taken for the temperature to return to normal was also measured. There was no statistically significant difference between temperature elevations recorded in vitro and chose measured in vivo. A linear extrapolation may therefore be made from results recorded at room temperature. Temperature elevations dissipated more rapidly in vivo than in vitro; this may be due to the cooling effect of the microvasculature of the periodontal membrane. [ABSTRACT FROM AUTHOR]

An in vivo investigation is described and a histological evaluation made of the effect of canal obturation by thermomechanical compaction of gutta-percha and sealer on the cementum on the lateral surface of the root and adjacent periodontal membrane and alveolar bone of the ferret canine after time intervals of 24 hours, 20 days and 40 days. These tissue reactions were compared with those in the roots of control teeth filled by lateral condensation of cold gutta-percha and sealer. Iatrogenic damage was apparent in a minority of the experimental specimens 20 and 40 days after obturation. [ABSTRACT FROM AUTHOR]

The leakage associated with restorative materials placed within the pulp chamber of maxillary and mandibular molars was studied in vitro. The root canals and pulp chambers of 69 extracted teeth were prepared chemomechanically and sealed with gutta-percha and Tubliseal using cold lateral condensation. The teeth were divided into five groups. Gutta-percha was removed from the pulp chambers of three of the groups of 15 teeth and filled with one of three materials, a glass ionomer cement, a cement or an amalgam. The gutta-percha was removed from the pulp chamber in the fourth group of nine teeth, which were left unfilled. The gutta-percha in the pulp chambers of the fifth group of teeth was left intact. The teeth were suspended in Indian ink, thermocyded for 24 hours and stored for a further 48 hours at 37°C. They were then demineralized and cleared and the degree of coronal leakage was assessed. Those teeth with no filling in the pulp chamber showed extensive leakage. The gutta-percha-filled group demonstrated rearer leakage than did the groups in which other restorative materials had been employed (P<0.01). No significant differences in leakage occurred between the other groups (P0.05). It is recommended that the pulp chamber of molars should be restored with a filling material following root canal treatment. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to assess the effect of compactor design, alterations in rotational speed and modification to the basic technique of thermomechanical compaction on the quality of the apical seal produced by gutta-percha and sealer cement. The integrity of the apical seal achieved using two different configurations of compactor, rotational speeds of 8000 and 16,000 rev/ minute and a hybrid technique which combined thermomechanical compaction with lateral condensation were compared with conventional lateral condensation. The same brand of gutta-percha and type of sealer were used throughout the investigation. A cleared tooth technique that allowed the three- dimensional assessment of Indian ink leakage was employed. Instrument fracture, a problem experienced in some other investigations, did not occur with either design of compactor used. Apical dye leakage was found to be a relatively frequent occurrence with each variation in obturation technique studied, including that of lateral condensation of cold gutta-percha and sealer. The results showed no significant difference in the mean degree of leakage for each of the groups or in the proportion of specimens that showed leakage (P>0.1). The advantages of the hybrid method of root canal obturation were discussed. [ABSTRACT FROM AUTHOR]

The angiotensin-converting enzyme (ACE) inhibitor trandolapril, a non-sulfhydryl prodrug which is hydrolysed into trandolaprilat, was studied in 322 hypertensives of African-American descent using a double-blind, randomised, placebo-controlled, parallel study design. Following 6 weeks of double-blind treatment with placebo or 0.25 to 16 mg/day trandolapril, an analysis of drug effect on trough blood pressure (BP) stratified by age, gender, weight, pre-treatment plasma renin activity, and trandolaprilat concentration was performed. Two mg was the lowest effective trandolapril dose, whereas doses above 4 mg did not significantly reduce trough BP. Reduction in BP did not correlate with trough plasma trandolaprilat concentration. Pre-treatment plasma renin activity was not a reliable indicator of anti-hypertensive response, as similar reductions in BP occurred even in patients with the lowest renin levels. There were no observable differences based on age, gender or measurements of the renin-angiotensin-aldosterone axis. In conclusion, neither age, gender or plasma renin activity influenced anti-hypertensive response to angiotensin-converting enzyme inhibition in African-Americans. [ABSTRACT FROM AUTHOR]

Abstract. Granulopoiesis was studied in 10 children with Shwachman's syndrome (chronic neutropenia and exocrine pancreatic insufficiency). Marrow proliferative activity assessed by determination of mitotic indices and tritiated thymidine uptake into granulocytic cells was normal. Assay of bone marrow granulocyte colony-forming cells (CFU-C) in a methylcellulose tissue culture system demonstrated normal CFU-C numbers in four patients and reduced numbers in five. The granulocyte colonies formed were indistinguishable from normal colonies morphologically. Production of colony-stimulating activity (CSA) from patients' peripheral blood leukocytes appeared normal when tested on control marrow. No serum inhibitors against CFU-C or CSA could be demonstrated using both control and autologous marrow, and co-culture of patients' peripheral blood lymphocytes with control marrow did not inhibit CFU-C growth. We conclude that in Shwachman's syndrome committed granulocytic stem cells are present, and the numbers detected in vitro vary widely as does the clinical neutropenia. The proliferative activity of recognizable granulocytic cells is normal and neither a deficiency of humoral stimulators nor the presence of serum or cellular inhibitors of granulopoiesis can be demonstrated. Pediatrics 64:515-519, 1979; granulopoiesis, neutropenia, Shwachman's syndrome, stem cells. [ABSTRACT FROM AUTHOR]

Comments on David Henige's criticism of library research.

The concept of ethnoracial ‘majority-minority’ was introduced to describe changing population demographics where racial or ethnic groups traditionally in the majority have become a numerical minority. Despite their increase in recent years, very little is known of how hidden curricula manifests in these settings. Hence, this study sought to interrogate the hidden curriculum of race at an Occupational Therapy school with a majority-minority student-educator population in London, England. We conducted a secondary analysis of qualitative data from a larger action research project. The main data source was derived from two group interviews involving 11 racially minoritised student participants, and thematically analysed through a hidden curriculum lens. Trustworthiness of the analysis was enforced through crystallisation. The hidden curriculum of race was identified as embedded within (1) formal learning, (2) the null curriculum, (3) the informal curriculum, and (4) administrative structure and functioning. It is underpinned by pervasive colour-evasive racial ideologies which perpetuate health and workforce inequities. This paper concludes that majority-minority population demographics are insufficient to mitigate the impact of wider societal norms of oppression on hidden curricula. Thus, concerted and collective efforts involving all professional stakeholders are needed to embed intersectional, critical race-conscious approaches throughout formal learning across the academic curriculum. [ABSTRACT FROM AUTHOR]

Myasthenia gravis and polymyositis are each a rare manifestation of immune dysregulation in chronic graft-versus-host disease (cGVHD). We report a 4-year-old boy with idiopathic acquired aplastic anemia who developed myasthenia gravis 22 months and polymyositis 69 months after an allogeneic BMT (5/6 matched, MLC-nonreactive). The occurrence of both syndromes in one patient is unique. Autoimmune dysfunction may be associated with the development of cGVHD as demonstrated by the high incidence of prior aplastic anemia in BMT patients presenting with myasthenia gravis and polymyositis. Recognition of these neurologic manifestations is important in the diagnosis and treatment of cGVHD. [ABSTRACT FROM AUTHOR]

We were tasked with creating best possible non-clinical workspace solutions for approximately 450 hospital staff across 11 departments encompassing medical, nursing, allied health, administrative and other support staff. We used a Human-Centred Design process, involving 'Hear, Create and Deliver' stages. We used observations, contextual enquiry and role-specific workshops to understand needs, key interactions and drivers of behaviour. Co-design workshops were then used to explore and prototype-test concepts for the final design. With extensive employee engagement and design process expertise, an innovative solution was created that focussed on meeting the functional workspace needs of a diverse group of staff requiring a range of different spaces, incorporating space constraints and equity. This project demonstrated the strength of engaging employees in an expert-led Human-Centred Design process. We believe this is a successful blueprint process for other institutions to embrace when facing similar workspace design challenges. [ABSTRACT FROM AUTHOR]

Objective: To identify techniques commonly used in the management of periradicular disease by general dental practitioners and to ascertain views on continuing professional education in endodontics.Design: Data was collected via a postal questionnaire distributed to 617 general dental practitioners in Scotland (33% of practitioners registered with the Dental Practice Board).Results: 417 (69%) questionnaires were completed and returned. Only 24.9% of respondents used rubber dam routinely. The majority of respondents used hand instruments for preparation with either sodium hypochlorite or local anaesthetic being used most frequently for irrigation. The mean time for treatment of a single rooted tooth was 71 minutes. The demand for continuing education courses was high with 340 and 197 respondents requesting endodontic and rubber dam courses, respectively.Conclusions: Traditional methods for preparing the root canal using hand instruments were favoured by most dentists. The major disincentive to the use of rotary instruments and new techniques for obturating with thermally softened gutta-percha was expense. The importance of rubber dam isolation requires reiteration and more continuing education courses are required to update clinical skills. [ABSTRACT FROM AUTHOR]

Objective: To identify factors influencing the diagnosis and management of periradicular disease by general dental practitioners.Design: The study was conducted in two stages. 1. Analysis of recent returns to the Scottish Dental Practice Board. 2. Data collection via a postal questionnaire distributed to 617 general dental practitioners in Scotland (33% of practitioners registered with the Dental Practice Board).Results: 417 (69%) questionnaires were completed and returned. The majority of respondents undertook root canal treatment and the number of cases treated had increased in the last five years. The vast majority of the respondents (89.3%) were confident in their diagnosis of periradicular disease and 77.1% were confident of their treatment of the disease. A referral system for treatment was used by 31% of respondents of whom the majority used a specialist in a hospital. Over 50% of the respondents undertook surgical root canal treatment. Only 40% of respondents followed up their completed cases for longer than six months. Constraints on the provision of treatment included the time available and the low level of fees.Conclusions: Current arrangements for the treatment of periradicular disease in general dental practice are less than optimal. The fiscal arrangements for the provision of these treatments must be developed to encourage a high standard of treatment to be performed thereby maximising the likelihood of success. In addition, efforts to inform patients of the benefits of the treatment of periradicular disease should be increased. [ABSTRACT FROM AUTHOR]

Background: A family history of prostate cancer (PrCa) is a strong risk factor for the disease, indicating that inherited factors are important in this disease. We previously estimated that about 2% of PrCa cases diagnosed ≤ 55 years harbour a BRCA2 mutation and PrCa among BRCA2 carriers has been shown to be more aggressive, with poorer survival.Methods: To further evaluate the role of BRCA2 in PrCa predisposition, we screened 1864 men with PrCa aged between 36 and 88 years. We analysed the BRCA2 gene using a novel high-throughput multiplex fluorescence heteroduplex detection system developed for the ABI3130xl genetic analyzer.Results: We identified 19 protein-truncating mutations, 3 in-frame deletions and 69 missense variants of uncertain significance (UV) in our sample set. All the carriers of truncating mutations developed PrCa at ≤ 65 years, with a prevalence of BRCA2 mutation of 1.20% for cases in this age group.Conclusion: Based on the estimated frequency of BRCA2 mutations in the United Kingdom we estimate that germline mutations in the BRCA2 gene confer an ∼ 8.6-fold increased risk of PrCa by age 65, corresponding to an absolute risk of ∼ 15% by age 65. These results suggest that routine testing of early onset PrCa cases for germline BRCA2 mutations will further help to refine the prevalence and risk associated with BRCA2 mutations and may be useful for guiding management options. [ABSTRACT FROM AUTHOR]

Robust protocols for microarray gene expression profiling of archival formalin-fixed paraffin-embedded tissue (FFPET) are needed to facilitate research when availability of fresh-frozen tissue is limited. Recent reports attest to the feasibility of this approach, but the clinical value of these data is poorly understood. We employed state-of-the-art RNA extraction and Affymetrix microarray technology to examine 34 archival FFPET primary extremity soft tissue sarcomas. Nineteen arrays met stringent QC criteria and were used to model prognostic signatures for metastatic recurrence. Arrays from two paired frozen and FFPET samples were compared: although FFPET sensitivity was low ( approximately 50%), high specificity (95%) and positive predictive value (92%) suggest that transcript detection is reliable. Good agreement between arrays and real time (RT)-PCR was confirmed, especially for abundant transcripts, and RT-PCR validated the regulation pattern for 19 of 24 candidate genes (overall R(2)=0.4662). RT-PCR and immunohistochemistry on independent cases validated prognostic significance for several genes including RECQL4, FRRS1, CFH and MET - whose combined expression carried greater prognostic value than tumour grade - and cmet and TRKB proteins. These molecules warrant further evaluation in larger series. Reliable clinically relevant data can be obtained from archival FFPET, but protocol amendments are needed to improve the sensitivity and broad application of this approach. [ABSTRACT FROM AUTHOR]

To determine graft-versus-leukemia (GVL) effect after hematopoietic stem cell transplantation (HSCT), we studied the outcome of consecutive children with acute lymphoblastic leukemia (ALL) who received fully matched marrow allografts comparing relapse rate post HSCT between matched sibling donor (MSD) and matched unrelated donor (MUD) recipients. Furthermore, we estimated event-free survival (EFS) on the basis of the occurrence of acute graft-versus-host disease (aGVHD). Between 1998 and 2006 we performed 37 fully MSD and 36 fully MUD HSCTs. All patients received identical conditioning regimens with cyclophosphamide/total body irradiation and dual GVHD prophylaxis with cyclosporine (CSA) and methotrexate (MTX). Three-year cumulative incidence of relapse for the MSD and MUD groups were 55.6±12.3 and 22.0±8.1%, respectively (P=0.03). Three-year EFS according to aGVHD was 32.7±12.2% for no aGVHD, 61.2±10.0% for grade I–II aGVHD and 66.7±11.1% for grade III–IV aGVHD. Three-year EFS and overall survival (OS) were 40.5±11.6, 49.1±9.5% for the MSD group, and 60.5±8.7, 62.3±8.4% for the MUD group. In children with ALL receiving dual GVHD prophylaxis, relapse rate is significantly higher among recipients of MSD compared to MUD transplantation, which may in part be attributed to a better GVL effect with the unrelated graft.Bone Marrow Transplantation (2007) 40, 951–955; doi:10.1038/sj.bmt.1705853; published online 17 September 2007 [ABSTRACT FROM AUTHOR]

To compare the outcome of hematopoietic stem cell transplantation (HSCT) in pediatric acute lymphoblastic leukemia (ALL) conditioned with two different regimens: (1) single dose of VP16 (60 mg/kg over 4 h) and total body irradiation (TBI; 1200 cGy, in six fractions) or (2) Cyclophosphamide 50 mg/kg over 1 h daily for 4 days followed by the same dose of TBI. One hundred and seven children with ALL received fully matched HSCT from 1990 to 2003 in the Hospital for Sick Children, Toronto. All received cyclosporin A and a short course of methotrexate for graft-versus-host disease (GVHD) prophylaxis. The VP16 group, there were 36 matched related donor transplants (MRD) and 26 matched unrelated donor transplants (MUD), and in the cyclophosphamide group there were 23 MRD and 22 MUD transplants. Neutrophil engraftment occurred at a median of 18 and 17 days for the VP16/TBI and the CY/TBI groups, respectively. The 3 year event-free survival and overall survival were 47±7 and 55±7% for those receiving VP16/TBI, and 51±8 and 53±8% for the CY/TBI group. There were no significant differences in the prevalence of acute or chronic GVHD and transplant-related mortality between the two groups. Both VP16/FTBI and CY/FTBI regimen are equally effective regimens.Bone Marrow Transplantation (2006) 38, 739–743. doi:10.1038/sj.bmt.1705515; published online 2 October 2006 [ABSTRACT FROM AUTHOR]

Study Objectives. To compare the disposition of cyclosporine after the administration of two oral formulations to children undergoing hematopoietic stem cell transplantation, and to evaluate the relationship between whole blood cyclosporine concentrations during the dosing interval and the area under the whole blood concentration-time curve. Design. Prospective, descriptive, crossover study. Setting. Hematopoietic stem cell transplantation unit in a tertiary-quaternary university-affiliated pediatric hospital. Patients. Twenty-four pediatric patients aged 0.5-16.9 years undergoing allogeneic hematopoietic stem cell transplantation. Intervention. The modified oral formulation of cyclosporine was given on the first day (divided as two doses), and a single identical dose of the original oral formulation was given on the morning of the second day. Measurements and Main Results. Blood samples were obtained at 0, 0.5, 1.25, 2, 4, 6, 9, and 12 hours after the morning close from the lumen of the central venous catheter not previously used for intravenous cyclosporine administration. Cyclosporine concentration-time data were analyzed by using noncompartmental methods. Mean ± SD maximum concentrations were significantly higher after administration of the modified form than after administration of the original form (594.9 ± 349.7 vs 483.0 ± 363.0 µg/L, p=0.003), as was the area under the concentration-time curve from 0-12 hours (AUC0-12; 3432 ± 1563 vs 3144 ± 1780 µg/L⋅hr, p=0.022). For both formulations, cyclosporine concentrations at 4 hours after administration were most strongly correlated with the AUC0-12. Unlike that of the original formulation, the trough cyclosporine concentration of the modified form had the weakest relationship with AUC (Spearman p coefficient 0.584, p=0.003). Conclusion. Cyclosporine absorption is lower in children undergoing hematopoietic stem cell transplantation than in children receiving solid organ transplants. Dosage adjustment for the modified formulation based on trough concentration may not be appropriate because its relationship with the AUC was weak. The link between pharmacokinetic parameters and clinical outcomes, such as graft-versus-bust disease, must be further studied. [ABSTRACT FROM AUTHOR]

This report describes and critically appraises our experience with busulfan dose adjustment in children undergoing bone marrow transplant between April 1997 and March 1999. All children received an initial busulfan dose of 40 mg/m2 p.o. or by nasogastric tube. Whole blood samples were obtained 1, 1.5 and 6 h later and analyzed for busulfan content by gas chromatography with electron capture detection. The area under the whole blood busulfan concentration vs time curve (auc) and an individualized dose which would achieve an auc of 1300 μm/min were calculated. mean and median busulfan doses were calculated using actual, ideal and effective body weight and stratified according to age. the relationship between the busulfan concentration at hour 6 and auc was determined using linear regression. thirty-nine courses of busulfan were evaluated in 38 patients. a change from the initial busulfan dose was required to achieve the target auc in 34 courses (87%). most children >1 to 5 years old required dose increments while most children >5 years old required dose reductions. Obesity did not significantly affect busulfan dose requirements. Busulfan concentrations at 6 h only weakly predicted the AUC achieved (r2 = 0.496; P = 0.001). Based on these findings, we recommend that the initial busulfan dose be assigned according to patient age and actual body weight. We also recommend that busulfan AUC be calculated for children using a four-sample (1, 1.5, 4 and 6 h) limited sampling technique. Bone Marrow Transplantation (2000) 26, 1143–1147. [ABSTRACT FROM AUTHOR]

Presents a summary on hypertension in relation to children while highlighting the use of calcium antagonist amlodipine for bone marrow transplants in these children. Information on causes of hypertension; Methods used to conduct this assessment; Results from this assessment.

This in vitro study investigated the effect of a resin- reinforced glass ionomer lining material on the coronal leakage of a mixed obligate microbial marker in maxillary molars obturated with lateral condensation of cold gutta-percha and Tubliseal sealer, after 2 years' storage. Forty maxillary first molars were prepared chemome- chanically to a size 30-40 master apical file. The teeth were divided into an experimental group (30 teeth) and control group (10 teeth). In the experimental group, the floor of pulp chamber and the root-canal opening of 15 teeth were covered with Vitrebond as a lining; the remaining 15 teeth received no lining. These teeth were tested for leakage using a microbiological marker consisting of anaerobic streptococci and Fusobacterium nucleatum. The teeth were checked daily for bacterial leakage for 60 days. All positive control teeth leaked within 48 h, while the negative control teeth remained uncontaminated throughout the test period. The teeth restored with Vitrebond liner showed no leakage whilst 60% of the specimens with no Vitrebond liner showed leakage after 60 days. [ABSTRACT FROM AUTHOR]

The effect of five root canal sealers and two root canal dressing materials on the growth of three anaerobic bacteria associated with endodontic infections was determined using the agar diffusion inhibitory test. Samples of the following endodontic sealers (Apexit, Ketac-Endo, Roth Sealer, Sealapex and Tubliseal) and root canal dressing materials (Pulpdent and Root-cal) were incubated for 48 h with the following anaerobic bacteria: Capnocytophaga ochracea, Porphyromonas gingivalis and Peptostreptococcus micros. Statistically significant zones of bacterial growth inhibition for all the bacteria tested were observed in descending order of antimicrobial activity: Roth Sealer, Ketac-Endo, Tubliseal, Apexit and Sealapex. Root-cal and Pulpdent also showed statistically significant antimicrobial activity, but only to Capnocytophaga ochracea, not to the other two bacteria tested, with Pulpdent being the least active. [ABSTRACT FROM AUTHOR]

Adaptation and placement of alpha-phase gutta-percha delivered with a plastic core-carrier, Thermafil, was compared to the lateral condensation of gutta-percha in a specific tooth model. Fifty-one mandibular molar roots with separate canals, patent canal orifices and curvatures greater than 15 degrees were cleaned and shaped with K-files and 2.5% sodium hypochlorite to a size 30 at the apex, and flared with Hedstrom files to create a continuously tapering funnel preparation. Canals were randomly obturated with Sealapex root canal sealer and either alpha-phase gutta-percha on a plastic Thermafil carrier, or standard beta-phase gutta-percha with lateral condensation. Roots were radiographed from the proximal and evaluated by three examiners, based on established criteria for overall material adaptation, apical adaptation, and filling material extrusion. Thermafil provided a statistically significant better overall canal obturation (P<0.001), while, in the apical third, both techniques were not significantly different (P>0.05). When the apical orifice was patent there was a significant propensity for the extrusion of filling materials beyond the apex (P<0.001) with the Thermafil technique. [ABSTRACT FROM AUTHOR]

The short- and long-term apical seal of root canals obturated with softened alpha-phase gutta-percha on plastic core-carriers, Thermafil, was compared to that of laterally condensed, cold gutta-percha. Fifty-one roots from mandibular molars with separate canals, patent canal orifices and curvatures greater than 15 degrees were cleaned and shaped with K-flies and 2.5% sodium hypochlorite to a size 30 at the apex, and flared with Hedstrom files to create a continuously tapering tunnel preparation. Canals were randomly obturated with Sealapex root canal sealer and either alpha-phase gutta-percha on a plastic Thermafil carrier, or standard beta-phase gutta-percha with lateral condensation. Teeth were separated into three groups of 17 each and placed in black India ink for 24 h, 7 days or after 5 months storage in water. The teeth were demineralized, rendered transparent, and apical microleakage determined by the linear measurement of dye penetration. Significant differences in microleakage were noted between the 24 h and 5-month Thermafil groups (P<0.05), 24-h and 7-day lateral condensation groups (P<0.05), and 24-h and 5-month lateral condensation groups (P<0.05). There were no significant differences between the two techniques at each time interval. It was concluded that both techniques demonstrated a significant increase in apical microleakage over a 5-month period. [ABSTRACT FROM AUTHOR]

Focuses on issues related to medicine in Great Britain. Influence of government policies on the practice of medical services; Attributes of estrogens in the causation of endometrial carcinoma; Effects of feeding infants with cows milk as a breast milk supplement.

Background: A rare recurrent missense variant in HOXB13 (rs138213197/G84E) was recently reported to be associated with hereditary prostate cancer. Population-based studies have established that, since the frequency of this singlenucleotide polymorphism (SNP) varies between geographic regions, the associated proportion of prostate cancer (PrCa) risk contribution is also highly variable by country. Patients and methods: This is the largest comprehensive case-control study assessing the prevalence of the HOXB13 G84E variant to date and is the first in the UK population. We genotyped 8652 men diagnosed with PrCa within the UK Genetic Prostate Cancer Study (UKGPCS) and 5252 healthy men from the UK ProtecT study. Results: HOXB13 G84E was identified in 0.5% of the healthy controls and 1.5% of the PrCa cases, and it was associated with a 2.93-fold increased risk of PrCa [95% confidence interval (CI) 1.94-4.59; P = 6.27 x 10-8]. The risk was even higher among men with family history of PrCa [odds ratio (OR) = 4.53, 95% CI 2.86-7.34; P = 3.1 x 10-8] and in young-onset PrCa (diagnosed up to the age of 55 years; OR = 3.11, 95% CI 1.98-5.00; P = 6.1 x 10-7). There was no significant association between Gleason Score, presenting prostate specific antigen, tumour-node-metastasis (TNM) stage or NCCN risk group and carrier status. HOXB13 G84E was not associated with overall or cancer-specific survival. We found that the polygenic PrCa risk score (PR score), calculated using the 71 known single-nucleotide polymorphisms (SNPs) associated with PrCa and the HOXB13 G84E variant act multiplicatively on PrCa risk. Based on the estimated prevalence and risk, this rare variant explains ~1% of the familial risk of PrCa in the UK population. Conclusions: The clinical importance of HOXB13 G84E in PrCa management has not been established. This variant was found to have no effect on prognostic implications but could be used for stratifying screening, by identifying men at high risk. Clinical Trials Numbers: Prostate Testing for Cancer and Treatment (ProtecT): NCT02044172. UK Genetic Prostate Cancer Study: Epidemiology and Molecular Genetics Studies (UKGPCS): NCT01737242. [ABSTRACT FROM AUTHOR]

Comparing effects of inhaled particles across rodent test systems and between rodent test systems and humans is a key obstacle to the interpretation of common toxicological test systems for human risk assessment. These comparisons, correlation with effects and prediction of effects, are best conducted using measures of tissue dose in the respiratory tract. Differences in lung geometry, physiology and the characteristics of ventilation can give rise to differences in the regional deposition of particles in the lung in these species. Differences in regional lung tissue doses cannot currently be measured experimentally. Regional lung tissue dosimetry can however be predicted using models developed for rats, monkeys, and humans. A computational model of particle respiratory tract deposition and clearance was developed for BALB/c and B6C3F1 mice, creating a cross-species suite of available models for particle dosimetry in the lung. Airflow and particle transport equations were solved throughout the respiratory tract of these mice strains to obtain temporal and spatial concentration of inhaled particles from which deposition fractions were determined. Particle inhalability (Inhalable fraction, IF) and upper respiratory tract (URT) deposition were directly related to particle diffusive and inertial properties. Measurements of the retained mass at several post-exposure times following exposure to iron oxide nanoparticles, micro- and nanoscale C60 fullerene, and nanoscale silver particles were used to calibrate and verify model predictions of total lung dose. Interstrain (mice) and interspecies (mouse, rat and human) differences in particle inhalability, fractional deposition and tissue dosimetry are described for ultrafine, fine and coarse particles. [ABSTRACT FROM AUTHOR]