A Genomic Biomarker for Breast Cancer Development in High-Risk Women

BackgroundFamily history is an important factor contributing to a woman's risk of breast cancer development. This increased risk reflects the participation of inherited genetic components such as breast cancer susceptibility genes. However, many of the genetic components contributing to breast cancer remain unknown, and a number of women with a family history of breast cancer never develop breast cancer despite their high-risk status, while other high-risk woman go on to develop breast cancer. Thus, it is clear that we lack crucial pieces of information to help define a person's true risk of developing breast cancer.Methods and FindingsWe hypothesize that there are many undiscovered germline variations in genes that lead to altered gene expression patterns predictive of breast cancer development in high-risk women. We have developed a genomic model capable of predicting which high-risk women, both BRCA1/2 mutation carriers and BRCAX women, will actually develop breast cancer. Specifically, we use exon-level genome-wide expression profiling of peripheral blood mononuclear cells (PBMCs) to develop a model of disease risk (n=118 samples of either control or high-risk women). From this data, we generate a biomarker consisting of genes that most correlate to cancer development in women with strong family histories of breast cancer. Using an internal independent dataset, our biomarker can predict the high-risk women who will or will not develop cancer with over 85% accuracy. Further, we have validated this model on an independent external cohort (n=36) which was obtained and processed at sites unique to our training dataset. Our genomic biomarker can accurately predict breast cancer development in high-risk women with over 78% accuracy using this external dataset. Therefore, from our analyses, we can calculate with high accuracy an individual woman's true risk of developing breast cancer. This method provides a personalized approach to hereditary breast cancer risk assessment that is not currently available. This personalized risk assessment will aide clinicians in counseling their patients regarding specific management options based on a patient's individual risk of breast cancer. Lastly, these studies have also identified novel genes associated with breast cancer risk, which may provide a basis for targeted therapies that may help modify the risk of breast cancer development in high risk patients.ConclusionsTogether, these studies deliver both a non-invasive biomarker for hereditary breast cancer risk and a characterization of genes that contribute to breast cancer development. Overall, we expect these experiments to identify the genetic changes that underlie breast cancer predisposition, and assist clinicians and patients in determining the appropriate preventative measures based on their personal risk of developing breast cancer.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4059.

Measurement of D{0}-D[-over]{0} mixing from a time-dependent amplitude analysis of D{0}-->K+pi{-}pi{0} decays

We present evidence of D{0}-D[-over ]{0} mixing using a time-dependent amplitude analysis of the decay D{0}-->K+pi{-}pi;{0} in a data sample of 384 fb{-1} collected with the BABAR detector at the PEP-II e+e{-} collider at the Stanford Linear Accelerator Center. Assuming CP conservation, we measure the mixing parameters x{Kpipi{0}}{'}=[2.61{-0.68}{+0.57}(stat)+/-0.39(syst)]%, y{Kpipi;{0}}{'}=[-0.06{-0.64}{+0.55}(stat)+/-0.34(syst)]%. This result is inconsistent with the no-mixing hypothesis with a significance of 3.2 standard deviations. We find no evidence of CP violation in mixing.

Measurement of bottom versus charm as a function of transverse momentum with electron-hadron correlations in p + p collisions at square root of s = 200 GeV

The momentum distribution of electrons from semileptonic decays of charm and bottom quarks for midrapidity |y|<0.35 in p+p collisions at square root of s=200 GeV is measured by the PHENIX experiment at the Relativistic Heavy Ion Collider over the transverse momentum range 2<pT<7 GeV/c. The ratio of the yield of electrons from bottom to that from charm is presented. The ratio is determined using partial D/D-->e(+/-)K(-/+)X (K unidentified) reconstruction. It is found that the yield of electrons from bottom becomes significant above 4 GeV/c in pT. A fixed-order-plus-next-to-leading-log perturbative quantum chromodynamics calculation agrees with the data within the theoretical and experimental uncertainties. The extracted total bottom production cross section at this energy is sigma(bb)=3.2(-1.1)(+1.2)(stat)(-1.3)(+1.4)(syst)mub.

Efficacy of silver diamine fluoride for Arresting Caries Treatment

Arresting Caries Treatment (ACT) has been proposed to manage untreated dental caries in children. This prospective randomized clinical trial investigated the caries-arresting effectiveness of a single spot application of: (1) 38% silver diamine fluoride (SDF) with tannic acid as a reducing agent; (2) 38% SDF alone; (3) 12% SDF alone; and (4) no SDF application in primary teeth of 976 Nepalese schoolchildren. The a priori null hypothesis was that the different treatments have no effect in arresting active cavitated caries. Only the single application of 38% SDF with or without tannic acid was effective in arresting caries after 6 months (4.5 and 4.2 mean number of arrested surfaces; p < 0.001), after 1 year (4.1 and 3.4; p < 0.001), and after 2 years (2.2 and 2.1; p < 0.01). Tannic acid conferred no additional benefit. ACT with 38% SDF provides an alternative when restorative treatment for primary teeth is not an option.

Measurement of semileptonic B decays into orbitally excited charmed mesons

We present a study of B decays into semileptonic final states containing charged and neutral D1(2420) and D_{2};{*}(2460). The analysis is based on a data sample of 208 fb;{-1} collected at the Upsilon(4S) resonance with the BABAR detector at the PEP-II asymmetric-energy B factory at SLAC. With a simultaneous fit to four different decay chains, the semileptonic branching fractions are extracted from measurements of the mass difference Deltam=m(D;{**})-m(D) distributions. Product branching fractions are determined to be B(B;{+}-->D_{1};{0}l;{+}nu_{l})xB(D_{1};{0}-->D;{*+}pi;{-})=(2.97+/-0.17+/-0.17)x10;{-3}, B(B;{+}-->D_{2};{*0}l;{+}nu_{l})xB(D_{2};{*0}-->D;{(*)+}pi;{-})=(2.29+/-0.23+/-0.21)x10;{-3}, B(B;{0}-->D_{1};{-}l;{+}nu_{l})xB(D_{1};{-}-->D;{*0}pi;{-})=(2.78+/-0.24+/-0.25)x10;{-3} and B(B;{0}-->D_{2};{*-}l;{+}nu_{l})xB(D_{2};{*-}-->D;{(*)0}pi;{-})=(1.77+/-0.26+/-0.11)x10;{-3}. In addition we measure the branching ratio Gamma(D_{2};{*}-->Dpi;{-})/Gamma(D_{2};{*}-->D;{(*)}pi;{-})=0.62+/-0.03+/-0.02.

Gluon-spin contribution to the proton spin from the double-helicity asymmetry in inclusive pi0 production in polarized p+p collisions at [sqrt]s=200 GeV

The double helicity asymmetry in neutral pion production for pT=1 to 12 GeV/c was measured with the PHENIX experiment to access the gluon-spin contribution, DeltaG, to the proton spin. Measured asymmetries are consistent with zero, and at a theory scale of micro2=4 GeV2 a next to leading order QCD analysis gives DeltaG[0.02,0.3]=0.2, with a constraint of -0.7<DeltaG[0.02,0.3]<0.5 at Deltachi2=9 (approximately 3sigma) for the sampled gluon momentum fraction (x) range, 0.02 to 0.3. The results are obtained using predictions for the measured asymmetries generated from four representative fits to polarized deep inelastic scattering data. We also consider the dependence of the DeltaG constraint on the choice of the theoretical scale, a dominant uncertainty in these predictions.

Differential effects of the CRF-R1 antagonist GSK876008 on fear-potentiated, light- and CRF-enhanced startle suggest preferential involvement in sustained vs phasic threat responses

The amplitude of the acoustic startle response is increased when elicited in the presence of brief cues that predict shock (fear-potentiated startle) and also when elicited during sustained exposure to bright light (light-enhanced startle). Although both effects are thought to reflect fear or anxiety, their neuroanatomical substrates differ. Although fear-potentiated startle is disrupted by reversible inactivation of the central nucleus of the amygdala (CeA) but not the closely related bed nucleus of the stria terminalis (BNST), light-enhanced startle is disrupted by BNST inactivation but not by CeA inactivation. Intraventricular infusions of corticotropin-releasing factor (CRF) also increase startle (CRF-enhanced startle) and this effect is mediated by CRF receptors within the BNST, with no involvement of the CeA. Together, these observations suggest that CeA- and BNST-dependent fear and anxiety may be differentially sensitive to CRF receptor blockade. We tested this by orally administering the novel, potent, and selective CRF-R1 antagonist GSK876008 to rats before CRF-enhanced, light-enhanced, or fear-potentiated startle testing. GSK876008 disrupted CRF-enhanced startle with a linear dose-response curve, and light-enhanced startle with a U-shaped dose-response curve, but did not disrupt fear-potentiated startle to a visual stimulus at any dose tested, and even augmented the response in some animals. GSK876008 also disrupted shock-related 'baseline' startle increases, which may have reflected context conditioning (shown elsewhere to also be BNST-dependent). Overall, these results suggest that short-duration CeA-dependent threat responses can be pharmacologically dissociated from longer duration BNST-dependent responses in terms of their sensitivity to CRF1 receptor antagonists.

Measurement of B-->Xgamma decays and determination of |Vtd/Vts|

Using a sample of 383 x 10;{6} BB[over ] events collected by the BABAR experiment, we measure sums of seven exclusive final states B-->X_{d(s)}gamma, where X_{d}(X_{s}) is a nonstrange (strange) charmless hadronic system in the mass range 0.6-1.8 GeV/c;{2}. After correcting for unmeasured decay modes in this mass range, we obtain a branching fraction for b-->dgamma of (7.2+/-2.7(stat)+/-2.3(syst))x10;{-6}. Taking the ratio of X_{d} to X_{s} we find Gamma(b-->dgamma)/Gamma(b-->sgamma)=0.033+/-0.013(stat)+/-0.009(syst), from which we determine |V_{td}/V_{ts}|=0.177+/-0.043.

Evidence for X(3872)-->psi(2S)gamma in B(+/-)-->X(3872)K(+/-) decays and a study of B-->cc[over ]gammaK

In a search for B-->cc[over ]gammaK decays with the BABAR detector, where cc[over ] includes J/psi and psi(2S), and K includes K(+/-), K(S)(0), and K(*)(892), we find evidence for X(3872)-->J/psigamma and X(3872)-->psi(2S)gamma with 3.6sigma and 3.5sigma significance, respectively. We measure the product of branching fractions B(B(+/-)-->X(3872)K(+/-))xB(X(3872)-->J/psigamma)=[2.8+/-0.8(stat)+/-0.1(syst)]x10(-6) and B(B(+/-)-->X(3872)K(+/-))xB(X(3872)-->psi(2S)gamma)=[9.5+/-2.7(stat)+/-0.6(syst)]x10(-6).

Direct CP, lepton flavor, and isospin asymmetries in the decays B-->K(*)l+l-

We measure branching fractions and integrated rate asymmetries for the rare decays B-->K(*)l+l-, where l+l- is either e+e- or micro+micro-, using a sample of 384x10(6) BB events collected with the BABAR detector at the PEP-II e+e- collider. We find no evidence for direct CP or lepton-flavor asymmetries. However, for dilepton masses below the J/psi resonance, we find evidence for unexpectedly large isospin asymmetries in both B-->Kl+l- and B-->K*l+l- which differ, respectively, by 3.2sigma and 2.7sigma, including systematic uncertainties, from the standard model expectations.

Progenitor cells for the prostate epithelium: roles in development, regeneration, and cancer

The identification of stem cell/progenitor populations represents a critical step for deducing the putative cell type(s) of origin for epithelial cancers and may provide important therapeutic insights. In the case of the prostate gland, recent studies have made significant progress in the identification of candidate stem cell populations, but they have left unresolved key questions about their tissue localization and functional properties. In our work, we have used genetic lineage marking in vivo to demonstrate that a rare epithelial cell population marked by expression of the Nkx3.1 homeobox gene in the androgen-deprived prostate contains bipotential progenitor cells that are capable of self-renewal. Inducible targeting of the Pten tumor suppressor in these castrate-resistant Nkx3.1-expressing cells demonstrates that this stem/progenitor population is also a potent cell of origin for prostate cancer in mouse models. These findings may help to explain several intriguing features of prostate cancer and its phenotypic progression.

Measurement of the e;{+}e;{-}-->bb[over ] Cross Section between sqrt[s]=10.54 and 11.20 GeV

We report e;{+}e;{-}-->bb[over ] cross section measurements by the BABAR experiment performed during an energy scan in the range of 10.54 to 11.20 GeV at the SLAC PEP-II e;{+}e;{-} collider. A total relative error of about 5% is reached in more than 300 center-of-mass energy steps, separated by about 5 MeV. These measurements can be used to derive precise information on the parameters of the Upsilon(10860) and Upsilon(11020) resonances. In particular we show that their widths may be smaller than previously measured.

Measurement of the branching fractions of B-->D**(l) nu(l) decays in events tagged by a fully reconstructed B meson

We report a measurement of the branching fractions of B-->D**(l) nu(l), decays based on 417 fb(-1) of data collected at the Y(4S) resonance with the BABAR detector at the PEP-II e+e- storage rings. Events are selected by full reconstructing one of the B mesons in a hadronic decay mode. A fit to the invariant mass differences m(D(*) pi)- m(D(*)) is performed to extract the signal yields of the different D** states. We observe the B-->D**l(-1)nu(l) decay modes corresponding to the four D states predicted by heavy quark symmetry with a significance greater than 5 standard deviations including systematic uncertainties.

Suppression pattern of neutral pions at high transverse momentum in Au + Au collisions at sqrt[sNN]=200 GeV and constraints on medium transport coefficients

For Au + Au collisions at 200 GeV, we measure neutral pion production with good statistics for transverse momentum, pT, up to 20 GeV/c. A fivefold suppression is found, which is essentially constant for 5 < pT < 20 GeV/c. Experimental uncertainties are small enough to constrain any model-dependent parametrization for the transport coefficient of the medium, e.g., q in the parton quenching model. The spectral shape is similar for all collision classes, and the suppression does not saturate in Au + Au collisions.

Searches for B meson decays to phiphi, phirho, phif_{0}(980), and f_{0}(980)f_{0}(980) final states

We present the results of searches for B decays to charmless final states involving varphi, f_{0}(980), and charged or neutral rho mesons. The data sample corresponds to 384x10;{6} BB[over ] pairs collected with the BABAR detector operating at the PEP-II asymmetric-energy e;{+}e;{-} collider at SLAC. We find no significant signals and determine the following 90% confidence level upper limits on the branching fractions, including systematic uncertainties: B(B;{0}-->varphivarphi)<2.0x10;{-7}, B(B;{+}-->varphirho;{+})<30x10;{-7}, B(B;{0}-->varphirho;{0})<3.3x10;{-7}, B[B;{0}-->varphif_{0}(980)]xB[f_{0}(980)-->pi;{+}pi;{-}]<3.8x10;{-7}, and B[B;{0}-->f_{0}(980)f_{0}(980)]xB[f_{0}(980)-->pi;{+}pi;{-}]xB[f_{0}(980)-->K;{+}K;{-}]<2.3x10;{-7}.

Measurement of the CP asymmetry in b-->sgamma using a sum of exclusive final states

We perform a measurement of the CP asymmetry in b-->sgamma decays using a sample of 383 x 10(6) B[over] B events collected by the BABAR detector at the SLAC PEP-II asymmetric B factory. We reconstruct 16 flavor-specific B decay modes containing a high-energy photon and a hadronic system X_(s) containing an s quark. We measure the CP asymmetry to be -0.011+/-0.030(stat)+/-0.014(syst) for a hadronic system mass between 0.6 and 2.8 GeV/c(2).

Radiological classification of optic pathway gliomas: experience of a modified functional classification system

Optic pathway gliomas (OPGs) in childhood are associated with neurofibromatosis type 1 (NF1) and since 1958 have been classified anatomically using the Dodge classification (DC). MR scanning permits a more detailed anatomical description than can be classified by this historical system. A modified Dodge classification (MDC) has been applied to MRI scans from a cohort of 72 patients (36.1% NF1-positive) from 4 centres participating in an international clinical trial. The MDC was feasible, applicable and more detailed than the original DC. NF1-positive cases more commonly involved both optic nerves (p = 0.021) and other multiple locations (p = 0.001). NF1-negative tumours more commonly involved the central chiasm (p = 0.005) and hypothalamus (p = 0.003). Fewer hypothalamus-positive tumours were associated with optic nerve involvement (p = 0.009), whereas more were associated with central chiasm involvement (p<0.001). From diagnosis to follow-up, there was concordance between DC and MDC in 51/72 cases (70.8%). The MDC is therefore proposed for use in clinical trials of new treatments for OPGs.

Observation and polarization measurements of B+/- -->phiK1 +/- and B +/- -->phiK2 *+/-

With the full BABAR data sample of 465 x 10(6) B(over)B pairs, we observe the decays B+/- -->phiK_(1)(1270) +/- and B +/- -->phiK*_(2)(1430)+/-. We measure the branching fractions (6.1+/-1.6+/-1.1) x 10(-6) and (8.4+/-1.8+/-1.0) x 10(-6) and the fractions of longitudinal polarization 0.46 (+0.12+0.06) _(-0.13-0.07) and 0.80(+0.09)_(-0.10)+/-0.03, respectively. We also report on the B+/- -->phiK*_(0)(1430)+/- decay branching fraction of (7.0+/-1.3+/-0.9) x 10(-6) and several parameters sensitive to CP violation and interference in the above three decays. Upper limits are placed on the B+/- decay rates to final states with phi and K_1(1400)+/-, K*(1410)+/-, K2(1770)+/-, or K_2(1820)+/-. Understanding the observed polarization pattern requires amplitude contributions from an uncertain source.

Onset of pi(0) suppression studied in Cu+Cu collisions at sqrt S NN=22.4, 62.4, and 200 GeV

Neutral pion transverse momentum (p(T)) spectra at midrapidity (|y| less than or approximately 0.35) were measured in Cu+Cu collisions at sqrt[s(NN)]=22.4, 62.4, and 200 GeV. Relative to pi_(0) yields in p+p collisions scaled by the number of inelastic nucleon-nucleon collisions (N(coll) the pi_(0) yields for p(T) more than or approximately 2 GeV/c in central Cu+Cu collisions are suppressed at 62.4 and 200 GeV whereas an enhancement is observed at 22.4 GeV. A comparison with a jet-quenching model suggests that final state parton energy loss dominates in central Cu+Cu collisions at 62.4 and 200 GeV, while the enhancement at 22.4 GeV is consistent with nuclear modifications in the initial state alone.

The genome of the simian and human malaria parasite Plasmodium knowlesi

Plasmodium knowlesi is an intracellular malaria parasite whose natural vertebrate host is Macaca fascicularis (the 'kra' monkey); however, it is now increasingly recognized as a significant cause of human malaria, particularly in southeast Asia. Plasmodium knowlesi was the first malaria parasite species in which antigenic variation was demonstrated, and it has a close phylogenetic relationship to Plasmodium vivax, the second most important species of human malaria parasite (reviewed in ref. 4). Despite their relatedness, there are important phenotypic differences between them, such as host blood cell preference, absence of a dormant liver stage or 'hypnozoite' in P. knowlesi, and length of the asexual cycle (reviewed in ref. 4). Here we present an analysis of the P. knowlesi (H strain, Pk1(A+) clone) nuclear genome sequence. This is the first monkey malaria parasite genome to be described, and it provides an opportunity for comparison with the recently completed P. vivax genome and other sequenced Plasmodium genomes. In contrast to other Plasmodium genomes, putative variant antigen families are dispersed throughout the genome and are associated with intrachromosomal telomere repeats. One of these families, the KIRs, contains sequences that collectively match over one-half of the host CD99 extracellular domain, which may represent an unusual form of molecular mimicry.

The application of multiscale modelling to the process of development and prevention of stenosis in a stented coronary artery

The inherent complexity of biomedical systems is well recognized; they are multiscale, multiscience systems, bridging a wide range of temporal and spatial scales. While the importance of multiscale modelling in this context is increasingly recognized, there is little underpinning literature on the methodology and generic description of the process. The COAST (complex autonoma simulation technique) project aims to address this by developing a multiscale, multiscience framework, coined complex autonoma (CxA), based on a hierarchical aggregation of coupled cellular automata (CA) and agent-based models (ABMs). The key tenet of COAST is that a multiscale system can be decomposed into N single-scale CA or ABMs that mutually interact across the scales. Decomposition is facilitated by building a scale separation map on which each single-scale system is represented according to its spatial and temporal characteristics. Processes having well-separated scales are thus easily identified as the components of the multiscale model. This paper focuses on methodology, introduces the concept of the CxA and demonstrates its use in the generation of a multiscale model of the physical and biological processes implicated in a challenging and clinically relevant problem, namely coronary artery in-stent restenosis.

Evaluation of the role of the asialoglycoprotein receptor in the clearance of UK-279,276 (recombinant neutrophil inhibitory factor)

1. UK-279,276 or recombinant neutrophil inhibitory factor (rNIF) is a glycoprotein that has been investigated as an intravenous treatment for stroke. Previous data indicate that the asialoglycoprotein receptor (ASGPR) in the liver might have a role in the uptake and clearance of UK-279,276 from plasma in rats and dogs. 2. Biliary elimination of sialo UK-279,276 can be inhibited by the co-administration of asialo fetuin, a known substrate for ASGPR. These data are in keeping with sialo UK-279,276 being cleared by ASGPR. 3. In vitro experiments have demonstrated that asialo UK-279,276 (Sialo UK-279,276 treated to remove the sialic acid residues present on the glycans) shows a significantly greater uptake in rat, dog and human precision-cut liver slices than the sialylated protein. The addition of asialo fetuin to precision-cut liver slice incubations (rat, dog and man) containing asialo UK-279,276 reduced the uptake to levels similar to those seen for the sialylated protein. These data support the potential role of the ASGPR in the clearance of UK-279,276 in rat, dog and man.

J/psi production in sqrt s_NN=200 GeV Cu+Cu collisions

Yields for J/psi production in Cu+Cu collisions at sqrt s_NN=200 GeV have been measured over the rapidity range |y|<2.2 and compared with results in p+p and Au+Au collisions at the same energy. The Cu+Cu data offer greatly improved precision over existing Au+Au data for J/psi production in collisions with small to intermediate numbers of participants, in the range where the quark-gluon plasma transition threshold is predicted to lie. Cold nuclear matter estimates based on ad hoc fits to d+Au data describe the Cu+Cu data up to N_part approximately 50, corresponding to a Bjorken energy density of at least 1.5 GeV/fm(3).

Study of B meson decays with excited eta and eta' mesons

Using 383 x 10(6) BBover pairs from the BABAR data sample, we report results for branching fractions of six charged B-meson decay modes, where a charged kaon recoils against a charmless resonance decaying to KKover* or etapipi final states with mass in the range (1.2-1.8) GeV/c2. We observe a significant enhancement at the low KKover* invariant mass which is interpreted as B+-->eta(1475)K+, find evidence for the decay B+-->eta(1295)K+, and place upper limits on the decays B+-->eta(1405)K+, B+-->f1(1285)K+, B+-->f1(1420)K+, and B+-->phi(1680)K+.

Observation of Y(3940) --> J/psiomega in B --> J/psiomegaK at BABAR

We present a study of the decays B;{0,+}-->J/psiomegaK;{0,+} using 383x10;{6} BB[over ] events obtained with the BABAR detector at PEP-II. We observe Y(3940)-->J/psiomega, with mass 3914.6_{-3.4};{+3.8}(stat)+/-2.0(syst) MeV/c;{2}, and width 34_{-8};{+12}(stat)+/-5(syst) MeV. The ratio of B0 and B+ decay to YK is 0.27_{-0.23};{+0.28}(stat)-0.01+0.04(syst), and the relevant B0 and B+ branching fractions are reported.

Measurements of B --> {pi,eta,eta;{'}}lnu_{l} branching fractions and determination of |V_{ub}| with semileptonically tagged B mesons

We report measurements of branching fractions for the decays B-->Plnu_{l}, where P are the pseudoscalar charmless mesons pi;{-}, pi;{0}, eta and eta;{'}, based on 348 fb;{-1} of data collected with the BABAR detector, using B0 and B+ mesons found in the recoil of a second B meson decaying as B-->D;{(*)}lnu_{l}. Assuming isospin symmetry, we combine pionic branching fractions to obtain B(B;{0}-->pi;{-}l;{+}nu_{l})=(1.54+/-0.17_{(stat)}+/-0.09_{(syst)})x10;{-4}; we find 3.2sigma evidence of the decay B;{+}-->etal;{+}nu_{l} and measure its branching fraction to be (0.64+/-0.20_{(stat)}+/-0.03_{(syst)})x10;{-4}, and determine B(B;{+}-->eta;{'}l;{+}nu_{l})<0.47x10;{-4} to 90% confidence level. Using partial branching fractions for the pionic decays in ranges of the momentum transfer and a variety of form factor calculation, we obtain values of the magnitude of the Cabibbo-Kobayashi-Maskawa matrix element |V_{ub}| in ranging from 3.6x10;{-3} to 4.1x10;{-3}.

Observation of the bottomonium ground state in the decay Upsilon(3S)-->gammaetab

We report the results of a search for the bottomonium ground state etab(1S) in the photon energy spectrum with a sample of (109+/-1) million of Upsilon(3S) recorded at the Upsilon(3S) energy with the BABAR detector at the PEP-II B factory at SLAC. We observe a peak in the photon energy spectrum at Egamma=921.2(-2.8)+2.1(stat)+/-2.4(syst) MeV with a significance of 10 standard deviations. We interpret the observed peak as being due to monochromatic photons from the radiative transition Upsilon(3S)-->gammaetab(1S). This photon energy corresponds to an etab(1S) mass of 9388.9(-2.3)+3.1(stat)+/-2.7(syst) MeV/c2. The hyperfine Upsilon(1S)-etab(1S) mass splitting is 71.4(-3.1)+2.3(stat)+/-2.7(syst) MeV/c2. The branching fraction for this radiative Upsilon(3S) decay is estimated to be [4.8+/-0.5(stat)+/-1.2(syst)]x10(-4).

Evidence for CP violation in B0-->J/psipi0 decays

We present measurements of the branching fraction and time-dependent CP asymmetries in B0-->J/psipi0 decays based on 466 x 10(6) Upsilon(4S)-->BB over events collected with the BABAR detector at the SLAC PEP-II asymmetric-energy B factory. We measure the CP asymmetry parameters S= -1.23+/-0.21(stat)+/-0.04(syst) and C= -0.20+/-0.19(stat)+/-0.03(syst), where the measured value of (S, C) is 4.0 standard deviations from (0, 0) including systematic uncertainties. The branching fraction is determined to be B(B0-->J/psipi0)=[1.69+/-0.14(stat)+/-0.07(syst)]x10(-5).

The Teen Marijuana Check-Up: An In-School Protocol for Eliciting Voluntary Self-Assessment of Marijuana Use

Given the prevalence of regular marijuana use among adolescents and associated risks for adverse consequences to functioning, effective interventions are needed that are tailored for this population. To date, most such counseling approaches have relied on non-voluntary participation by adolescent marijuana smokers and the outcomes have been only modestly successful. The Teen Marijuana Check-Up is a brief motivational enhancement intervention publicized as a non-pressured and confidential opportunity for the teen marijuana smoker to "take stock" of his/her use. The intervention is designed for in-school implementation and intended to elicit the teen's voluntary participation. This paper highlights the manner in which adolescents are recruited, key intervention elements, the nature of the counseling style utilized, and clinical challenges. The outcomes of two trials with this intervention are briefly discussed.

Intrathecal chemotherapy delivered by a lumbar-thecal catheter in metastatic medulloblastoma: a case illustration

BACKGROUND

Medulloblastoma is the most common malignant brain tumour in children. Despite recent advances, the prognosis in high risk patients remains poor. Further improvement in survival is dependent upon the development of strategies to attack the tumour more effectively, but with less toxicity. Intrathecal chemotherapy, is an ideal but currently underused method of directly targeting residual tumour within the area of resection and the leptomeningeal disease commonly associated with this tumour.

METHOD

We describe the case of a 12 yr old child with metastatic medulloblastoma, who received intrathecal topotecan via a spinal catheter.

CONCLUSION

This method represents a simple, safe and effective method of delivering an even and widespread distribution of drug within the cerebrospinal fluid (CSF) of the neuroaxis. With new agents being identified and others in the early stages of development, intrathecal chemotherapy may emerge as an important therapeutic option to consider when faced with such challenging cases.

Development of a Marketing Campaign to Recruit Non-adjudicated and Untreated Abusive Men for a Brief Telephone Intervention

Although voluntary enrollment by abusive men in domestic violence perpetrator treatment programs occurs, most men enter treatment only after they have injured a partner or family member and have been arrested, convicted and sentenced. This leaves a serious gap for those who engage in abusive behavior but who have not been served by the legal or social service systems. To address this gap, the researchers applied social marketing principles to recruit abusive men to a telephone-delivered pre-treatment intervention (the Men's Domestic Abuse Check-Up-MDACU), designed to motivate non-adjudicated and untreated abusive men who are concurrently using alcohol and drugs to enter treatment voluntarily. This article discusses recruitment efforts in reaching perpetrators of intimate partner violence, an underserved population. Informed by McGuire's communication and persuasion matrix, the researchers describe three phases of the MDACU's marketing campaign: (1) planning, (2) early implementation, and (3) revision of marketing strategies based on initial results. The researchers' "lessons learned" conclude the paper.

Measurement of the decay B(-) ---> D(*0)e(-)nu[overline](e)

Using 226 x 10(6) BB[overline] events recorded on the Upsilon(4S) resonance with the BABAR detector at the SLAC e(+)e(-) PEP-II storage rings, we reconstruct B(-) ---> D(*0)e(-)nu[overline](e) decays using the decay chain D(*0) --> D(0)pi(0) and D(0)-->K(-)pi(+). From the dependence of their differential rate on w, the dot product of the four velocities of B(-) and D(*0), and using the form factor description by Caprini et al. with the parameters F(1) and rhoA(1)(2), we obtain the results rhoA(1)(2) = 1.16+/-0.06+/-0.08, F(1)|V(cb)|=(35.9+/-0.6+/-1.4) x 10(-3), and B(B(-) --> D(*0)e(-)nu[overline](e))=(5.56+/-0.08+/-0.41)%.

Safety of GH replacement in hypopituitary patients with nonirradiated pituitary and peripituitary tumours

BACKGROUND

Published data suggest that growth hormone replacement (GHR) may be given safely to patients with hypopituitarism consequent upon a pituitary/peripituitary tumour. However, a preponderance of patients treated with external pituitary irradiation were included.

OBJECTIVE

To assess the safety of GHR in nonirradiated pituitary/peripituitary tumour.

DESIGN

Prospective audit.

SETTING

Tertiary university referral centre.

PATIENTS

We imaged prospectively the pituitary glands of 48 patients (18 males; mean age 51.6 years range 21-77) who had adult onset growth hormone deficiency (AO-GHD) after appropriate treatment for a pituitary/peripituitary tumour but who did not receive external pituitary irradiation.

INTERVENTION

All patients were treated with a dose titration regimen of GH to maintain serum IGF-1 between the median and upper end of the age-related reference range. Pituitary surveillance imaging was performed prior to the commencement of GHR, at 6-12 months and then yearly. For patients with secretory tumours, biochemical markers (cortisol and prolactin) were used as evidence of tumour recurrence.

RESULTS

48 patients with median follow up since commencement of GHR was 38 months (range 9-104). Three patients were judged to have an apparent increase in tumour volume and/or marker, although only one was thought to be possibly GH related--a patient with a cystic chromophobe adenoma who demonstrated a marginal increase in residual tumour volume 4 years after commencement of GHR.

CONCLUSION

These data add to the growing body of evidence for the safety of GHR in hypopituitary patients consequent upon pituitary/peripituitary mass lesions and represents the first reported series in a heterogeneous group of nonirradiated patients.

A non-inferiority comparison of duloxetine and venlafaxine in the treatment of adult patients with generalized anxiety disorder

The present study is a non-inferiority comparison of duloxetine 60-120 mg/day and venlafaxine extended-release (XR) 75-225 mg/day for the treatment of adults with generalized anxiety disorder (GAD). The non-inferiority test was a prespecified plan to pool data from two nearly identical 10-week, multicentre, randomized, placebo-controlled, double-blind studies of duloxetine 60-120 mg/day and venlafaxine 75-225 mg/ day for the treatment of GAD. An independent expert consensus panel provided six statistical and clinical criteria for determining non-inferiority between treatments. Response was defined as > or =50% reduction in Hamilton Anxiety Rating Scale (HAMA) total score. In the pooled sample, patients were randomly assigned to duloxetine (n = 320), venlafaxine XR (n = 333) or placebo (n = 331). For the non-inferiority analysis, the per-protocol patients who were treated with duloxetine (n = 239) or venlafaxine XR (n = 262) improved significantly more (mean HAMA reductions were -15.4 and -15.2, respectively) than placebo-treated patients (n = 267; -11.6, P < or = 0.001, both comparisons). Response rates were 56%, 58% and 40%, respectively. Discontinuation rate because of AEs was significantly higher for duloxetine (13.4%, P < or = 0.001) and venlafaxine XR (11.4%, P < or = 0.01) groups compared with placebo (5.4%). Duloxetine 60-120 mg/day met all statistical and clinical criteria for non-inferiority and exhibited a similar tolerability profile compared with venlafaxine XR 75-225 mg/day for the treatment of adults with GAD.