Demonstration of lightweight gamma spectrometry systems in urban environments

Urban areas present highly complex radiation environments; with small scale features resulting from different construction materials, topographic effects and potential anthropogenic inputs from past industrial activity or other sources. Mapping of the radiation fields in urban areas allows a detailed assessment of exposure pathways for the people who live and work there, as well as locating discrete sources of activity that may warrant removal to mitigate dose to the general public. These areas also present access difficulties for radiometric mapping using vehicles or aircraft. A lightweight portable gamma spectrometry system has been used to survey sites in the vicinity of Glasgow to demonstrate the possibilities of radiometric mapping of urban areas, and to investigate the complex radiometric features such areas present. Variations in natural activity due to construction materials have been described, the presence of (137)Cs used to identify relatively undisturbed ground, and a previously unknown NORM feature identified. The effect of topographic enclosure on measurements of activity concentration has been quantified. The portable system is compared with the outputs that might be expected from larger vehicular or airborne systems. For large areas airborne surveys are the most cost effective approach, but provide limited spatial resolution, vehicular surveys can provide sparse exploratory data rapidly or detailed mapping of open areas where off-road access is possible. Backpack systems are ideally suited to detailed surveys of small areas, especially where vehicular access is difficult.

Responsibility without legal authority? Tackling alcohol-related health harms through licensing and planning policy in local government

Background

The power to influence many social determinants of health lies within local government sectors that are outside public health's traditional remit. We analyse the challenges of achieving health gains through local government alcohol control policies, where legal and professional practice frameworks appear to conflict with public health action.

Methods

Current legislation governing local alcohol control in England and Wales is reviewed and analysed for barriers and opportunities to implement effective population-level health interventions. Case studies of local government alcohol control practices are described.

Results

Addressing alcohol-related health harms is constrained by the absence of a specific legal health licensing objective and differences between public health and legal assessments of the relevance of health evidence to a specific place. Local governments can, however, implement health-relevant policies by developing local evidence for alcohol-related health harms; addressing cumulative impact in licensing policy statements and through other non-legislative approaches such as health and non-health sector partnerships. Innovative local initiatives—for example, minimum unit pricing licensing conditions—can serve as test cases for wider national implementation.

Conclusions

By combining the powers available to the many local government sectors involved in alcohol control, alcohol-related health and social harms can be tackled through existing local mechanisms.

Impact of NOTCH1/FBXW7 mutations on outcome in pediatric T-cell acute lymphoblastic leukemia patients treated on the MRC UKALL 2003 trial

Activating mutations in the NOTCH1 pathway are frequent in pediatric T-cell acute lymphoblastic leukemia (T-ALL) but their role in refining risk stratification is unclear. We screened 162 pediatric T-ALL patients treated on the MRC UKALL2003 trial for NOTCH1/FBXW7 gene mutations and related genotype to response to therapy and long-term outcome. Overall, 35% were wild-type (WT) for both genes (NOTCH1(WT)FBXW7(WT)), 38% single NOTCH1 mutant (NOTCH1(Single)FBXW7(WT)), 3% just FBXW7 mutant (NOTCH1(WT)FBXW7(MUT)) and 24% either double NOTCH1 mutant (NOTCH1(Double)FBXW7(WT)) or mutant in both genes (NOTCH1(MUT)FBXW7(MUT)), hereafter called as NOTCH1±FBXW7(Double). There was no difference between groups in early response to therapy, but NOTCH1±FBXW7(Double) patients were more likely to be associated with negative minimal residual disease (MRD) post-induction than NOTCH1(WT)FBXW7(WT) patients (71% versus 40%, P=0.004). Outcome improved according to the number of mutations, overall survival at 5 years 82%, 88% and 100% for NOTCH1(WT)FBXW7(WT), NOTCH1(Single)FBXW7(WT) and NOTCH1±FBXW7(Double) patients, respectively (log-rank P for trend=0.005). Although 14 NOTCH1±FBXW7(Double) patients were classified as high risk (slow response and/or MRD positive), only two had disease progression and all remain alive. Patients with double NOTCH1 and/or FBXW7 mutations have a very good outcome and should not be considered for more intensive therapy in first remission, even if slow early responders or MRD positive after induction therapy.

LETTER TO THE EDITOR : ARE PRESCRIBING INDICATORS ESSENTIALLY REPRESENTING THE FRAIL OLDER POPULATION?

To the Editor: Older populations have multiple comorbidchronic diseases that require multiple treatments, which makethem the larger consumer of medications (1). As a persongrows older the ability to tolerate medications become poor dueto age-related changes in pharmacokinetics andpharmacodynamics. The number of comorbidities increaseswith age that leads to the increase in number of medicationprescribed which is associated with increased risk of adversedrug events (ADEs), impaired mobility, morbidity,hospitalization and death.

Comparing phosphorus indices from twelve southern U.S. states against monitored phosphorus loads from six prior southern studies

Forty-eight states in the United States use phosphorus (P) indices to meet the requirements of their Natural Resources Conservation Service (NRCS) Code 590 Standard, which provides national guidance for nutrient management of agricultural lands. The majority of states developed these indices without consultation or coordination with neighboring states to meet specific local conditions and policy needs. Using water quality and land treatment data from six previously published articles, we compared P loads with P-Index values and ratings using the 12 southern P indices. When total measured P loads were regressed with P-Index rating values, moderate to very strong relationships (0.50 to 0.97) existed for five indices (Arkansas, Florida, Georgia, North Carolina, and South Carolina) and all but one index was directionally correct. Regressions with dissolved P were also moderate to very strong ( of 0.55 to 0.95) for the same five state P indices (Arkansas, Florida, Georgia, North Carolina, and South Carolina); directionality of the Alabama Index was negative. When total measured P loads were transformed to current NRCS 590 Standard ratings (Low [<2.2 kg P ha], Moderate, [2.2-5.5 kg P ha], and High [>5.5 kg P ha]) and these ratings were then compared to the southern-Index ratings, many of the P indices correctly identified Low losses (77%), but most did not correctly identify Moderate or High loss situations (14 and 31%, respectively). This study demonstrates that while many of the P indices were directionally correct relative to the measured water quality data, there is a large variability among southern P indices that may result in different P management strategies being employed under similar conditions.

Methods for robust in vivo strain estimation in the carotid artery

A hierarchical block-matching motion tracking algorithm for strain imaging is presented. Displacements are estimated with improved robustness and precision by utilizing a Bayesian regularization algorithm and an unbiased subsample interpolation technique. A modified least-squares strain estimator is proposed to estimate strain images from a noisy displacement input while addressing the motion discontinuity at the wall-lumen boundary. Methods to track deformation over the cardiac cycle incorporate a dynamic frame skip criterion to process data frames with sufficient deformation to produce high signal-to-noise displacement and strain images. Algorithms to accumulate displacement and/or strain on particles in a region of interest over the cardiac cycle are described. New methods to visualize and characterize the deformation measured with the full 2D strain tensor are presented. Initial results from patients imaged prior to carotid endarterectomy suggest that strain imaging detects conditions that are traditionally considered high risk including soft plaque composition, unstable morphology, abnormal hemodynamics and shear of plaque against tethering tissue can be exacerbated by neoangiogenesis. For example, a maximum absolute principal strain exceeding 0.2 is observed near calcified regions adjacent to turbulent flow, protrusion of the plaque into the arterial lumen and regions of low echogenicity associated with soft plaques. Non-invasive carotid strain imaging is therefore a potentially useful tool for detecting unstable carotid plaque.

Sexual selection and experimental evolution of chemical signals in Drosophila pseudoobscura

Our expectations for the evolution of chemical signals in response to sexual selection are uncertain. How are chemical signals elaborated? Does sexual selection result in complexity of the composition or in altered quantities of expression? We addressed this in Drosophila pseudoobscura by examining male and female cuticular hydrocarbons (CHs) after 82 generations of elevated (E) sexual selection or relaxed sexual selection through monogamy (M). The CH profile consisted of 18 different components. We extracted three eigenvectors using principal component analysis that explained 72% of the variation. principal component (PC)1 described the amount of CHs produced, PC2 the trade-off between short- and long-chain CHs and PC3 the trade-off between apparently arbitrary CHs. In both sexes, the amount of CHs produced was greater in flies from the E treatment. PC3 was also higher, indicating that sexual selection also influenced the evolution of CH composition. The sexes differed in all three PCs, indicating substantial sexual dimorphism in this species, although the magnitude of this dimorphism was not increased as a result of our experimental evolution. Collectively, our work provides direct evidence that sexual selection plays an important role in the evolution of CHs in D. pseudoobscura and that both increased quantity and overall composition are targeted.

Treatment and outcome of Wilms' tumour patients: an analysis of all cases registered in the UKW3 trial

BACKGROUND

The randomised findings of the UKW3 trial were that preoperative chemotherapy was associated with a more advantageous stage distribution and reduction in therapy burden versus immediate nephrectomy without compromising outcome in localised Wilms' tumour (WT). We analysed outcome in all WT registered in UKW3.

PATIENTS AND METHODS

Seven hundred and eighteen WT cases (7% anaplastic) were registered in UKW3. We assigned a treatment stage and conducted survival analysis.

RESULTS

Five-year event-free survival (EFS) and overall survival (OS) were 77.2% [95% confidence interval (CI) 73.9-80.2] and 87.5% (95% CI 84.8-89.7) after median follow-up of 9.5 years and 10.0 years, respectively. Five-year OS in localised non-anaplastic cases was 92.9% (95% CI 90.2-94.9). Anaplasia was associated with adverse outcome compared with non-anaplastic cases: 5-year EFS of 42.0% (95% CI 28.3-55.1) versus 79.8% (95% CI 76.5-82.7) and 5-year OS of 60% (95% CI 45.1-72.0) versus 89.6% (95% CI 87.0-91.7), respectively. Outcomes were similar for non-anaplastic stage I or II but significantly poorer in stage III cases than stage I. Five-year OS after relapse was 54.1% (95% CI 44.5-62.8). Forty-seven percent of non-anaplastic WT received anthracycline; 27% were treated with radiotherapy first line.

CONCLUSION

These outcomes provide a baseline for future comparisons of WT treatment approach, burden and patient outcome.

Sex-specific genotype-by-environment interactions for cuticular hydrocarbon expression in decorated crickets, Gryllodes sigillatus: implications for the evolution of signal reliability

Phenotypic traits that convey information about individual identity or quality are important in animal social interactions, and the degree to which such traits are influenced by environmental variation can have profound effects on the reliability of these cues. Using inbred genetic lines of the decorated cricket, Gryllodes sigillatus, we manipulated diet quality to test how the cuticular hydrocarbon (CHC) profiles of males and females respond across two different nutritional rearing environments. There were significant differences between lines in the CHC profiles of females, but the effect of diet was not quite statistically significant. There was no significant genotype-by-environment interaction (GEI), suggesting that environmental effects on phenotypic variation in female CHCs are independent of genotype. There was, however, a significant effect of GEI for males, with changes in both signal quantity and content, suggesting that environmental effects on phenotypic expression of male CHCs are dependent on genotype. The differential response of male and female CHC expression to variation in the nutritional environment suggests that these chemical cues may be under sex-specific selection for signal reliability. Female CHCs show the characteristics of reliable cues of identity: high genetic variability, low condition dependence and a high degree of genetic determination. This supports earlier work showing that female CHCs are used in self-recognition to identify previous mates and facilitate polyandry. In contrast, male CHCs show the characteristics of reliable cues of quality: condition dependence and a relatively higher degree of environmental determination. This suggests that male CHCs are likely to function as cues of underlying quality during mate choice and/or male dominance interactions.

High prevalence of drug resistance amongst HIV-exposed and -infected children in a tuberculosis prevention trial

An emergence of drug-resistant tuberculosis (DR-TB) in settings affected by human immunodeficiency virus (HIV) and tuberculosis (TB) has been observed. We investigated the prevalence of DR-TB in P1041, a multicentered, randomised, double-blind trial which compared the administration of isoniazid (INH) to placebo, in HIV-exposed, non-infected and -infected African infants in the absence of any documented TB exposure. The prevalence of multidrug-resistant TB (MDR-TB) was 22.2% (95%CI 8.5-45.8) and INH monoresistance 5.6% (95%CI 0.1-27.6) among culture-confirmed cases, with all MDR-TB occurring in a single site. There was no association between INH treatment or placebo group, or between HIV infection status, and DR-TB prevalence. There was a high prevalence of DR-TB among HIV-exposed and -infected children. Surveillance of DR-TB among children in high-burden TB-HIV settings should be routine.

Term myometrium is characterized by increased activating epigenetic modifications at the progesterone receptor-A promoter

Term human myometrial expression of progesterone receptor (PR)-A is increased relative to PR-B, and as PR-A is a repressor of progesterone action mediated through PR-B, this increase may mediate the withdrawal of progesterone action and precipitate the onset of labour. PR-A and PR-B expression is regulated by two separate promoters of the PR gene. We hypothesized that epigenetic histone modifications at the two promoters contribute to the labour-associated regulation of PR-A and PR-B expression in term myometrium. PR total, PR-B and PR-A mRNA levels were determined using quantitative real-time PCR, and chromatin immunoprecipitation was used to determine the levels of activating and repressive histone modifications at the PR-A and PR-B promoters in human myometrial samples not in labour (n = 4) and in labour (n = 4). Chromatin extracts were immunoprecipitated with antibodies against activating (histone H3 and H4 acetylation and histone H3 lysine 4 trimethylation), and repressive (histone H3 lysine 9 trimethylation, histone H3 lysine 27 trimethylation and asymmetrical histone H3 arginine 2 dimethylation) histone modifications. PR-A mRNA levels increased during labour, while PR-B mRNA levels remained constant resulting in an increase of PR-A/PR-B mRNA ratio, as expected. Regardless of labour status, significantly higher levels of the activating histone modifications were found at the PR-A promoter compared with the PR-B promoter (P <0.001). H3K4me3 increased significantly at both promoters with labour onset (P =0.001). Low levels of the repressive histone modifications were also present at both promoters, with no labour-associated changes observed. Our data indicate that the PR-A promoter is epigenetically marked for activation in term myometrium more extensively than the PR-B promoter, and that labour is associated with an increase in H3K4me3 activating modification, consistent with the previously described increase in PR protein at this time.