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Water quality standards of raw water resources are getting more stringent in Taiwan. This is due to the higher number of potential contaminants released to the water bodies leading to the potential risks to the human health. Raw water resources, including one river and three reservoirs representative of the major raw water resources in northern and central Taiwan, at four locations were selected to measure turbidity, electrical conductivity (EC), oxidation and reduction potential (ORP), pH, alkalinity, total organic compounds (TOC), zeta potential, particle size, Al, Fe and heavy metal contents. Natural organic matter (NOM) was also examined using high-performance size-exclusion chromatography to distinguish the different molecular weight distribution of organic compounds, such as humic acids, that might affect the subsequent raw water treatment. TOC is highly related to NOM, biochemical oxygen demand (BOD5) and chemical oxygen demand, and the influent standard is 4 mg/L in Taiwan. EC, ORP, pH, alkalinity, TOC and zeta potential had values of 231.68-350.60 µS/cm, 210.5-271.55 mV, 8.17-8.58, 65.65-86.25 mg/L, 1.54-2.73 mg/L and -16.58 to -22.60 mV, respectively. However, average turbidity (128.24 NTU) and average particle size at the Daiji River (5,067.56 nm) were higher than those at the Shimen, Yongheshan and Liyutan Reservoirs (2.20-6.39 NTU and 1,105.12-1,627.26 nm, respectively). These measured data and metal contents (the latest three years' data, at least two seasons including summer and autumn) met the regulatory standards in Taiwan. Water quality index (WQI) containing dissolved oxygen solubility, faecal coliforms, pH, BOD5, nitrates, total phosphates, temperature deviation, turbidity and total solids indicated good conditions for three reservoirs and medium condition for Daiji River. NOM, which might produce potential disinfectant by-products, had similar patterns and contained humic acids and low molecular weight acids (LMWs), with the intensity order of Yongheshan Reservoir > Shimen Reservoir > Liyutan Reservoir > Daiji River. The Carlson trophic state index and field-emission scanning electron microscope plot of filtered solid of raw water showed the potential risk of algae to drinking water safety. [ABSTRACT FROM AUTHOR]

Abstract Chronic antibody-mediated rejection is the most common cause of late graft loss in renal transplant recipients. Visfatin is a pre-B cell colony-enhancing factor secreted by activated lymphocytes. We hypothesize that visfatin may play a role in the augmentation of B cell colonies and facilitate antibody-mediated rejection. Renal transplant recipients were randomly selected for the study. Fasting blood samples were obtained for the assay of visfatin. The participants were prospectively followed up for 3 years. A total of 146 patients were recruited for the study and were divided into 3 groups according to tertile of serum visfatin level. At the end of follow-up, 6 patients had graft loss, including 1 graft loss in tertile 1, 3 in tertile 2, and 2 in tertile 3 (P =.60). Fourteen patients experienced at least 1 episode of acute rejection, while 21 patients were diagnosed as having chronic rejection. The distribution of acute rejection was 10.2% in tertile 1, 10.2% in tertile 2, and 8.3% in tertile 3 (P =.94); chronic rejection occurred in 10.2%, 16.3%, and 16.7%, respectively (P =.59). We conclude that serum visfatin level was not correlated with either graft failure or patient mortality in a 3-year observation period. Highlights • Serum visfatin level is not correlated with either graft function or patient survival in renal transplant recipients. [ABSTRACT FROM AUTHOR]

To investigate the feasibility of using deep learning (DL) to differentiate normal from abnormal (or scarred) kidneys using technetium-99m dimercaptosuccinic acid (99mTc-DMSA) single-photon-emission computed tomography (SPECT) in paediatric patients. Three hundred and one 99mTc-DMSA renal SPECT examinations were reviewed retrospectively. The 301 patients were split randomly into 261, 20, and 20 for training, validation, and testing data, respectively. The DL model was trained using three-dimensional (3D) SPECT images, two-dimensional (2D) maximum intensity projections (MIPs), and 2.5-dimensional (2.5D) MIPs (i.e., transverse, sagittal, and coronal views). Each DL model was trained to determine renal SPECT images into either normal or abnormal. Consensus reading results by two nuclear medicine physicians served as the reference standard. The DL model trained by 2.5D MIPs outperformed that trained by either 3D SPECT images or 2D MIPs. The accuracy, sensitivity, and specificity of the 2.5D model for the differentiation between normal and abnormal kidneys were 92.5%, 90% and 95%, respectively. The experimental results suggest that DL has the potential to differentiate normal from abnormal kidneys in children using 99mTc-DMSA SPECT imaging. [ABSTRACT FROM AUTHOR]

Abstract: The present study adopted commercial chemical process simulator, Pro/II® V8.1.1, to analyse the system performance of Integrated Gasification Combined-Cycle (IGCC) with CO2 capture. There are four major blocks in a reference IGCC plant, i.e. air separation unit (ASU), gasification island, gas clean-up unit, and combined-cycle power block. Additional water gas shift reaction and CO2 absorption processes are integrated into the gas clean-up system for CO2 capture. The feedstock is Kaltim Prima Coal (KPC) from Indonesia, which is generally used in Taiwan, to evaluate the data with actual situation in Taiwan. The results show that the efficiency of IGCC is around 42.22% (HHV). When 90% CO2 capture is employed in the IGCC, the efficiency is decreased to around 36.74% (HHV). It means that the energy penalty of 90% CO2 capture is about 5.48 percentage points. Furthermore, data of 50% CO2 capture is evaluated to reach the CO2 emission condition close to that of Natural Gas Combined-Cycle (NGCC). [Copyright &y& Elsevier]

Objective The objective of this study was to evaluate the prognosis of kidney transplant recipients with pretransplantation malignancy and the incidence of recurrent malignancy in kidney transplant recipients using claims data from Taiwan's universal health insurance program. Method A total of 4350 transplant recipients were retrospectively analyzed. The rates of pretransplantation or recurrent malignancy, which was defined by their inclusion in the catastrophic illness patient registry using the International Classification of Diseases, 9th Revision, were evaluated. Cox proportional hazard regression and Kaplan-Meier curves were used for the analyses. Results In total, there were 4350 kidney transplant recipients, 52.1% of patients were male, the mean age at transplantation was 45.8 years old, and the percentages of diabetes mellitus, hypertension, hepatitis B viral infection, and hepatitis C viral infection were 14%, 63.2%, 4.2%, and 2.4%, respectively. There were 95 patients (2.2%) with pretransplantation malignancy. The top 3 pretransplantation malignancies, in decreasing order, were urinary tract, kidney, and breast cancers. After kidney transplantation, 10 recipients had recurrent cancer. The overall cancer recurrence rate was 10.5%. These 10 cancers included urothelial carcinoma (n = 5), renal cell carcinoma (n = 3), breast cancer (n = 1), and thyroid cancer (n = 1). Eleven recipients had a secondary cancer. Patients without pretransplantation and post-transplantation malignancy had the best survival. Patients with pretransplantation malignancy had a greater occurrence of cancers and increased mortality regardless of whether or not they had recurrence of cancer. Conclusion Our results suggest the higher risk of cancer, recurrent or secondary, and mortality after kidney transplantation. Adequate waiting time before transplantation and preventive strategies are strongly suggested in kidney transplant recipients with cancer history. [ABSTRACT FROM AUTHOR]

BACKGROUND: Early detection of esophageal cancer in patients with head and neck cancers may alter treatment planning and improve survival. However, standard endoscopic screening is not feasible for some patients with tumor-related airway compromise or postirradiation trismus. OBJECTIVE: To evaluate a novel, sequential approach by integrating ultrathin endoscopy with narrow-band imaging and Lugol chromoendoscopy. DESIGN: Cross-sectional study. SETTING: Single center in Taiwan. PATIENTS: Forty-four consecutive patients with transoral difficulty screened for synchronous or metachronous esophageal cancer. MAIN OUTCOME MEASUREMENTS: Sensitivity, specificity, and accuracy in the detection of mucosal high-grade neoplasia or invasive cancer. RESULTS: Fifty-four endoscopic interpretations were obtained, and 11 mucosal high-grade neoplasia and 7 invasive cancers were confirmed by histology. The mean examination time was 19.4 minutes (range 7.9-35.2 minutes), and all patients tolerated the procedure well. Sensitivity, specificity, and accuracy (with 95% CI) were 55.6% (95% CI, 33.5%-75.6%), 97.2% (95% CI, 85.8%-99.3%), and 83.3% (95% CI, 71.2%-90.9%), respectively, for standard endoscopy; 88.9% (95% CI, 66.9%-96.6%), 97.2% (95% CI, 85.8%-99.3%), and 94.4% (95% CI, 84.9%-97.9%), respectively, with the adjunct of narrow-band imaging; and 88.9% (95% CI, 66.9%-96.6%), 72.2% (95% CI, 55.9%-84.1%), and 77.8% (95% CI, 64.9%-86.8%), respectively, with the adjunct of Lugol chromoendoscopy. When we integrated all interpretations on the basis of the sequential approach, the estimated probability of false-negative findings was 1.2% (95% CI, 0.1%-4.6%). LIMITATIONS: Inherent shortcomings of ultrathin endoscopy, such as its resolution, light source, and lack of magnification. CONCLUSIONS: The use of ultrathin endoscopy in a sequential approach for multimodal detection is feasible in patients with transoral difficulty and substantially increases the detection rate of synchronous or metachronous neoplasms. [ABSTRACT FROM AUTHOR]

BACKGROUND: We performed a prospective analysis to determine the prevalence of nosocomial infection and associated risk factors in our neonatal intensive care unit (NICU). METHODS: Data were collected prospectively on underlying diagnoses, therapeutic interventions/treatments, infections, and outcomes at 9 am every day from November 2004 through October 2005. Prevalence of nosocomial infection and infection site definitions were according to the National Nosocomial Infections Surveillance system of the Centers for Disease Control and Prevention. RESULTS: Among 528 infants enrolled, 60 (11.4%) had 97 nosocomial infections. The survival rate was 92%. The prevalence of nosocomial infections was 17.5%: bloodstream infection, 4.7%, clinical sepsis, 6.3%, pneumonia, 5.1%, urinary tract infections (UTIs), 0.7%, surgical site infection, 0.7%. Intervention-associated infection rate: central intravascular catheter-associated bloodstream infection, 13.7%, TPN-associated bloodstream infection, 15.8%, ventilator-associated pneumonia, 18.6%, surgical site infection 13.7%, urinary catheter-associated UTI, 17.3%. Cut-off values of onset of central intravascular catheter-associated bloodstream infection and ventilator-associated pneumonia were 6 days and 10 days after intervention, respectively. Patients with a birth weight <1000 g (relative risk, 11.8, 95% confidence interval, 7.66-18.18; P < .001) were at the greatest risk for nosocomial infection. CONCLUSIONS: This study revealed the high prevalence of nosocomial infections in NICU patients, and the urgent need for a national surveillance and more effective prevention interventions. [ABSTRACT FROM AUTHOR]

BACKGROUND: Although the wireless Bravo pH system is effective, some patients experience retrosternal sensations possibly caused by esophageal sensitivity that may complicate clinical application. METHODS: Ambulatory pH of 40 consecutive patients with GERD who had erosive esophagitis or nonerosive reflux disease, were monitored for 2 days with the Bravo system. Results were stratified and compared on the basis of self-awareness of the intraesophageal capsule. RESULTS: Pathologic acid reflux was diagnosed in 20 patients and normal reflux was diagnosed in 20 patients. Seventeen patients (42.5%) reported retrosternal discomfort, and 12 of them (70.6%) had normal reflux. Patients with retrosternal discomfort were less likely to have moderate endoscopic esophagitis, i.e., Los Angeles classification grades B, C, and D endoscopic esophagitis (p = 0.006), and were less likely to have significantly elevated esophageal acid exposure (p = 0.0036) than those who did not perceive the discomfort. Reported discomfort was not associated with age, gender, or the presence of endoscopic esophagitis. CONCLUSIONS: The negative correlation between Bravo-capsule-induced retrosternal discomfort and esophageal-acid exposure indicates modified mechanical afferent nerve function after long-term acid stimulation. Capsule-induced retrosternal discomfort in the presence of normal acid exposure suggests functional heartburn. [ABSTRACT FROM AUTHOR]

Dysregulation of interleukin-6 has been reported to be associated with various types of tumors, and interleukin-6 plays an important part in regulating apoptosis in many types of cells. Previously, Mcl-1 was shown to be significantly increased in interleukin-6-overexpressed basal cell carcinoma cells and conferred on them anti-apoptotic activity. The aim of this study was to investigate which signaling pathway is involved in the anti-apoptotic effect of interleukin-6 on basal cell carcinoma cells. Here we show that the addition of recombinant 100 ng per ml interleukin-6 to basal cell carcinoma cells induced a 2.3-fold increase in the level of Mcl-1 protein in basal cell carcinoma cells. Transfection with dominant-negative STAT3 (STAT3F) into inter-leukin-6-treated basal cell carcinoma cells caused a decrease of phosphotyrosyl STAT3 but did not alter Mcl-1 protein levels; however, AG490, a Janus tyrosine kinase inhibitor, was capable of inhibiting the interleukin-6-induced elevation of Mcl-1 protein. Next, interleukin-6 stimulation elicited extracellular signal-regulated kinase activation in basal cell carcinoma cells, and the mitogen-activated protein kinase inhibitor, PD98059, could affect this response without affecting the interleukin-6-medi-ated Mcl-1 upregulation. Use of the two phosphotidyl inositol 3-kinase inhibitors, LY294002 and wortmannin, to check whether this pathway is involved in Mcl-1 upregulation by interleukin-6, we found that the phosphotidyl inositol 3-kinase inhibitors completely attenuated the interleukin-6-induced Mcl-1 upregulation. Furthermore, in the interleukin-6-overexpressing basal cell carcinoma cell clone, dominant-negative Akt also significantly reduced the increased level of Mcl-1. Interestingly, Janus tyrosine kinase inhibitor, AG490, treatment strongly blocked the phosphotidyl inositol 3-kinase pathway activation, as evidenced by the decrease in phospho-Akt level. Blockage of phosphotidyl inositol 3-kinase/Akt pathway abolished... [ABSTRACT FROM AUTHOR]

Objective: Our purpose was to test the feasibility of adenovirus-mediated gene therapy of ovarian cancer.Study Design: Ovarian cancer cell lines were exposed to an adenovirus vector expressing a reporter gene (lacZ) and to the same vector bearing the herpes simplex virus thymidine kinase gene (Ad.RSVtk) followed by ganciclovir. lacZ expression and growth inhibition were quantitated. Immunodeficient mice were injected intraperitoneally and subcutaneously with human ovarian cancer cells and treated with Ad.RSVtk and ganciclovir. Statistical analyses included one-way analysis of variance and t tests.Results: Staining for lacZ demonstrated viral transduction in vitro. After exposure to Ad.RSVtk all cell lines showed significant (p < 0.0001, analysis of variance) cytotoxicity to ganciclovir. Human ovarian tumor cells established subcutaneously or intraperitoneally in immunodeficient mice responded to therapy with Ad.RSVtk followed by ganciclovir. Treated mice had a 10- to 20-fold lower subcutaneous tumor burden than did control mice. Additionally, no intraperitoneal tumors were observed in treated mice.Conclusions: Ovarian cancer cells are readily transduced with recombinant adenovirus and become sensitive to ganciclovir after transduction with Ad.RSVtk. These data support the development of this method for human clinical trials. [ABSTRACT FROM AUTHOR]

Abstract: Mutations of codons 185 and 323, especially the W185X mutation, of the PVRL1 gene among non-syndromic cleft lip and/or palate (CL/P) patients and normal controls in Taiwan were studied in order to determine whether there are mutations that play a part in the formation of non-syndromic CL/P. A total of 76 patients were enrolled; 66 sporadic non-syndromic CL/P patients and 10 normal controls. The mutation survey for codons 185 and 323 was conducted using a polymerase chain reaction and DNA sequencing. Neither mutations of codons 185 and 323 were noted for any of the 76 patients (152 alleles), nor were found any other mutations in either exon 3 or 5 of the PVRL1 gene. These results suggest that mutations of the PVRL1 gene at codons 185 and 323, especially the W185X mutation, do not participate in the formation of CL/P within the Taiwanese population examined. [Copyright &y& Elsevier]

Supply chain disruptions have limited the availability of centering baskets for high dose rate endobronchial brachytherapy (HDREB). This study investigated the feasibility of using fluoroscopic intraluminal HDREB with a robotic bronchoscope. The bronchoscope functioned as a spacer housing a plastic catheter. We commissioned it for clinical use and compared its dosimetry to a standard centering basket applicator and plastic catheter. The applicator system, including the robotic bronchoscope, was commissioned for clinical deployment. Well chamber readings were taken with the Ir-192 HDR source inside the plastic catheter, both with and without the bronchoscope, using a custom 3D printed well chamber insert. In preparation for clinical use, standard treatment plans were created in a brachytherapy treatment planning system (TPS) using a water phantom and prescribed to a depth of 5mm or 10mm from the bronchoscope wall. An additional 1 cm distal/proximal margin was added to the tumor length (2-8cm) for treatment length. The dose at the prescription line and endobronchial luminal epithelium surface dose line (at applicator wall including ± 1 cm of the tumor length) from the bronchoscope (3.8mm diameter) was compared to a centering basket applicator (6mm diameter) and standard plastic catheter (1.6mm diameter). Attenuation measurements from the bronchoscope were <1% over a length of 1 to 8 cm, indicating no need to scale treatment delivery time. The bronchoscope, with a catheter, maintained target dose to the prescription line for both 5mm and 10mm prescription depths from the patient surface to within 5%. The surface dose is approximately 35% higher when using the bronchoscope housing a catheter compared to the centering basket applicator, but around 50% less than utilizing only a plastic catheter. A robotic bronchoscope's channel housing a catheter is feasible as an alternative to the centering basket applicator for endobronchial clinical treatment in the operating room. [ABSTRACT FROM AUTHOR]

Aim: To investigate the feasibility of reducing the scan time of paediatric technetium 99m (99mTc) dimercaptosuccinic acid (DMSA) single-photon-emission computed tomographic (SPECT) using a deep learning (DL) method.Material and Methods: A total of 112 paediatric 99mTc-DMSA renal SPECT scans were analysed retrospectively. Of the 112 examinations, 88 (84 for training and four for validation) were used to train a DL-based model that could generate full-acquisition-time reconstructed SPECT images from half-time acquisition. The remaining 24 examinations were used to evaluate the performance of the trained model.Results: DL-based SPECT images obtained from half-time acquisition have image quality similar to the standard clinical SPECT images obtained from full-acquisition-time acquisition. Moreover, the accuracy, sensitivity and specificity of the DL-based SPECT images for detection of affected kidneys were 91.7%, 83.3%, and 100%, respectively.Conclusion: These preliminary results suggest that DL has the potential to reduce the scan time of paediatric 99mTc-DMSA SPECT imaging while maintaining diagnostic accuracy. [ABSTRACT FROM AUTHOR]

The effect of co-administration of interferon (IFN)-γ in pigs undergoing vaccination with an attenuated strain (LPC) of classical swine fever virus (CSFV) was investigated. Unvaccinated pigs demonstrated pyrexia and died 7–9 days after challenge with virulent CSFV. Pigs receiving the attenuated vaccine remained healthy after virus challenge, except for mild, transient pyrexia, whereas pigs receiving IFN-γ simultaneously with the vaccine demonstrated normal body temperatures after virus challenge. Examination by nested RT-PCR revealed greater viral load in the spleens of the pigs vaccinated with the attenuated CSFV, compared with those that had additionally received IFN-γ. Expression of major histocompatibility complex (MHC) class I and MHC class II molecules was upregulated in the spleens of the IFN-γ treated vaccinated pigs, demonstrated by immunohistochemistry. Based on Western blot analysis, anti-CSFV IgG2 antibodies were elevated in vaccinated pigs by co-administration of IFN-γ (IFN-γ Hi : P  < 0.01; IFN-γ Lo : P  <   0.05). By employing the suppression subtractive hybridization technique, RT-PCR, in situ hybridization, and immunohistochemistry, T-cell factor-4 (Tcf-4) mRNA and protein expression were found to be upregulated in the spleens of vaccinated pigs that had received IFN-γ. This study suggests involvement of Tcf-4 in IFN-γ-mediated immune regulation following CSFV vaccination. [ABSTRACT FROM AUTHOR]

Cold-water corals (CWCs) are important ecosystem engineers in the deep sea that provide habitat for numerous species and can form large coral mounds. These mounds influence surrounding currents and induce distinct hydrodynamic features, such as internal waves and episodic downwelling events that accelerate transport of organic matter towards the mounds, supplying the corals with food. To date, research on organic matter distribution at coral mounds has focussed either on seasonal timescales or has provided single point snapshots. Data on food distribution at the timescale of a diurnal tidal cycle is currently limited. Here, we integrate physical, biogeochemical, and biological data throughout the water column and along a transect on the south-eastern slope of Rockall Bank, Northeast Atlantic Ocean. This transect consisted of 24-h sampling stations at four locations: Bank, Upper slope, Lower slope, and the Oreo coral mound. We investigated how the organic matter distribution in the water column along the transect is affected by tidal activity. Repeated CTD casts indicated that the water column above Oreo mound was more dynamic than above other stations in multiple ways. First, the bottom water showed high variability in physical parameters and nutrient concentrations, possibly due to the interaction of the tide with the mound topography. Second, in the surface water a diurnal tidal wave replenished nutrients in the photic zone, supporting new primary production. Third, above the coral mound an internal wave (200 m amplitude) was recorded at 400 m depth after the turning of the barotropic tide. After this wave passed, high quality organic matter was recorded in bottom waters on the mound coinciding with shallow water physical characteristics such as high oxygen concentration and high temperature. Trophic markers in the benthic community suggest feeding on a variety of food sources, including phytodetritus and zooplankton. We suggest that there are three transport mechanisms that supply food to the CWC ecosystem. First, small phytodetritus particles are transported downwards to the seafloor by advection from internal waves, supplying high quality organic matter to the CWC reef community. Second, the shoaling of deeper nutrient-rich water into the surface water layer above the coral mound could stimulate diatom growth, which form fast-sinking aggregates. Third, evidence from lipid analysis indicates that zooplankton faecal pellets also enhance supply of organic matter to the reef communities. This study is the first to report organic matter quality and composition over a tidal cycle at a coral mound and provides evidence that fresh high-quality organic matter is transported towards a coral reef during a tidal cycle. [Display omitted] • We measured physical conditions and food supply at a cold-water coral reef over 24h. • Large variability in environmental conditions and food supply over the tidal cycle. • Internal waves transport fresh organic matter to the cold-water coral reef. • Organic matter delivered to the cold-water coral reef is of high quality. • The reef community feeds on variety of sources, but depends on surface production. [ABSTRACT FROM AUTHOR]

Background: The distinctive epidemiologic profile of suicide in China, with notably high rates among rural young adult females, invites examination of possible underlying risk factors. Although there are accumulating data regarding the epidemiology of suicide among youth and young adults in China, there are meager data on suicidal ideation and attempts despite its importance.Methods: Our study in 2005-06 sought to identify all potentially suitable rural participants, aged 16-34 years, from 10 representative villages in rural Sichuan Province. We conducted structured interviews regarding a range of socio-demographic characteristics and suicidal morbidity.Results: 1654 of a potential 3008 participants participated; lifetime and one-year prevalence were: suicidal ideation (18.8% and 5.2%), serious ideation (8.6% and 2.3%), planning (5.8% and 1.5%), and attempt (2.7% and 0.5%). Comparisons among strata of socio-demographic characteristics showed more prevalent suicidal ideation associated with: female gender, lower education, poorer financial perception, greater rurality of residence, and marital status of "never married" or "others". Suicidal attempt was associated with: female gender and a marital status of "others".Limitations: The study was carried out in one province and caution is required when considering other rural regions of China. There were a substantial number of unapproachable subjects because of their migrant work at distant sites.Conclusions: Our results revealed an apparently higher prevalence for suicide ideation and planning compared with residents of other countries, but a lower prevalence for attempts. These data suggests that the relatively high rate of suicide in rural China reflects an elevated case fatality ratio due to chosen methods. The results also revealed unique patterns for correlates with the occurrence of ideation and attempts. [ABSTRACT FROM AUTHOR]

Abstract: Aims: Since 1999, randomised clinical trials and meta-analyses have reported equal efficacy of pain relief from single- and multiple-fraction radiotherapy for bone metastases. A number of factors, including limited radiotherapy resources, waiting times, and patient convenience, suggest single fraction to be the treatment of choice for patients. However, international patterns of practice indicate that multiple fractions are still commonly used. This study examined whether dose-fractionation schemes used for the treatment of bone metastases at the Rapid Response Radiotherapy Program (RRRP) at the Odette Cancer Centre have changed since 1999. Materials and methods: A retrospective review of the prospective RRRP database and hospital records were conducted for all patients treated with palliative radiotherapy for uncomplicated bone metastases at the RRRP in 1999 (or baseline), 2001, 2004 and from 1 January to 31 July 2005. Data were collected on patient demographics and clinical characteristics. Results: Of the 693 patients, 65 and 35% were prescribed single fraction (predominantly single 8Gy) and multiple fractions (predominantly 20Gy/five fractions), respectively. The administration of single treatments generally increased over time, from 51% in 1999 to 66% in 2005 (P =0.0001). On the basis of multiple logistic regression analyses, patients were more likely to be prescribed single-fraction radiotherapy if they had prostate cancer, had a poorer performance status, were treated to the limbs, hips, shoulders, pelvis, ribs, scapula, sternum, or clavicle (compared with the spine), were treated by a radiation oncologist who had been trained in earlier years, and who were treated after 1999. Conclusions: Between 1999 and 2005, the use of single-fraction radiotherapy increased, corresponding to publications showing equal efficacy of pain relief between single and multiple fractions in the management of uncomplicated bone metastases. However, about a third of patients still received multiple fractions. [Copyright &y& Elsevier]