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Eiliv Lund,1,2 Aurelie Nakamura,3,4 Igor Snapkov,1 Jean-Christophe Thalabard,5 Karina Standahl Olsen,1 Lars Holden,6 Marit Holden6 1Department of Community Medicine, UiT The Arctic University of Norway, Tromso, Norway; 2The Cancer Registry of Norway, Oslo, Norway; 3Department of Social Epidemiology, Pierre Louis Institute of Epidemiology and Public Health, Sorbonne University, INSERM, Paris, France; 4French School of Public Health (EHESP), Doctoral Network, Rennes, France; 5MAP5, UMR CNRS 8145, Université Paris Descartes, Sorbonne Paris Cite, Paris, France; 6Norwegian Computing Center, Oslo, Norway Background: There is a large body of evidence demonstrating long-lasting protective effect of each full-term pregnancy (FTP) on the development of breast cancer (BC) later in life, a phenomenon that could be related to both hormonal and immunological changes during pregnancies. In this work, we studied the pregnancy-associated differences in peripheral blood gene expression profiles between healthy women and women diagnosed with BC in a prospective design. Methods: Using an integrated system epidemiology approach, we modeled BC incidence as a function of parity in the Norwegian Women and Cancer (NOWAC) cohort (165,000 women) and then tested the resulting mathematical model using gene expression profiles in blood in a nested case–control study (460 invasive case–control pairs) of women from the NOWAC postgenome cohort. Lastly, we undertook a gene set enrichment analysis for immunological gene sets. Results: A linear trend fitted the dataset precisely showing an 8% decrease in risk of BC for each FTP, independent of stratification on other risk factors and lasting for decades after a woman’s last FTP. Women with six children demonstrated 48% reduction in the incidence of BC compared to nulliparous. When we looked at gene expression, we found that 756 genes showed linear trends in cancer-free controls (false discovery rate [FDR] 5%), but this was not the case for any of the genes in BC cases. Gene set enrichment analysis of immunologic gene sets (C7 collection in Molecular Signatures Database) revealed 215 significantly enriched human gene sets (FDR 5%). Conclusion: We found marked differences in gene expression and enrichment profiles of immunologic gene sets between BC cases and healthy controls, suggesting an important protective effect of the immune system on BC risk. Keywords: breast cancer, Norwegian Women and Cancer Study, gene expression, parity, semi-allograft, hormones, pregnancy

Susan Pager1, Libby Holden2, Xanthe Golenko21Queensland Health Metro South, 2School of Medicine, Griffith University, Brisbane, Queensland, AustraliaPurpose: A sound, scientific base of high quality research is needed to inform service planning and decision making and enable improved policy and practice. However, some areas of health practice, particularly many of the allied health areas, are generally considered to have a low evidence base. In order to successfully build research capacity in allied health, a clearer understanding is required of what assists and encourages research as well as the barriers and challenges.Participants and methods: This study used written surveys to collect data relating to motivators, enablers, and barriers to research capacity building. Respondents were asked to answer questions relating to them as individuals and other questions relating to their team. Allied health professionals were recruited from multidisciplinary primary health care teams in Queensland Health. Eighty-five participants from ten healthcare teams completed a written version of the research capacity and culture survey.Results: The results of this study indicate that individual allied health professionals are more likely to report being motivated to do research by intrinsic factors such as a strong interest in research. Barriers they identified to research are more likely to be extrinsic factors such as workload and lack of time. Allied health professionals identified some additional factors that impact on their research capacity than those reported in the literature, such as a desire to keep at the “cutting edge” and a lack of exposure to research. Some of the factors influencing individuals to do research were different to those influencing teams. These results are discussed with reference to organizational behavior and theories of motivation.Conclusion: Supporting already motivated allied health professional individuals and teams to conduct research by increased skills training, infrastructure, and quarantined time is likely to produce better outcomes for research capacity building investment.Keywords: research capacity building, allied health professionals, motivation theory

The Canadian Association of Medical Radiation Technologists (CAMRT), the certifying organization for Advanced Practice Registered Technologist (Radiation Therapy) ("APRT(T)") in Canada, utilizes a Competency-Based Oral Exam (CBOE) as the final step for certification. To date, eight candidates have attempted the CBOE with only one candidate passing on first attempt. Review of stakeholder feedback and CBOE statistics suggested a lack of candidate preparedness, but not necessarily for their command of the advanced subject matter in clinical, technical or professional practice domains. The challenge was observed in the exam's real-time demand to justify clinical reasoning and engage in professional critical thinking and discussion, as arbitrated by an interprofessional panel of colleagues. This was seen to emulate the expectation of advanced practice and was thus a critical but underappreciated aspect of competence. This elusive skill was termed by the APRT Certification Committee as representing "examsmanship" and is defined as the skill of taking examinations (Wiktionary). It became evident early in the evolution of the CBOE, that radiation therapy professionals were not well versed in the rigour required for acceptable oral examination performance. Upon embarking on the APRT(T) initiative, CAMRT deliberately set its role as one of a certifying body, not one of educator or trainer. As such, applicants are responsible for seeking and accessing all necessary education and preparatory materials to meet established standards independently. Upon analysis, it became evident that exam candidates were not prepared for the CBOE format and struggled to be able to formulate and defend clinical judgment and decisions in a systematic way. It was hypothesized that this kind of training was not naturally inherently incorporated in the radiation therapists training or practice and required explicit support. While not originally planned or intended, it became clear that the CAMRT's investment in equipping candidates in basic examsmanship principles might minimize first exam failures and both optimize use of CAMRT resources and reduce candidate anxiety and time to certification. Utilizing evidence from medical education literature, data from the APRT(T) pilot phase, and learnings from subsequent oral examinations, candidate 'CBOE preparedness' was identified as a priority for the CAMRT. Immediate work focused on revising information on the website to more clearly describe the CBOE format and process and on instituting a model of support for candidates by matching them with a member of the Steering Committee and with a APRT(T) mentor. All elements of the existing and planning program will be described and rationalized. The novel nature of the CBOE format required unique attention to ensure candidates were equipped to demonstrate their competence in this high stakes evaluation. Further plans include a preparation 'program' that will include reference materials as well as video clips of prior examinations to permit familiarization with the format and examples of good examsmanship. [ABSTRACT FROM AUTHOR]

The Canadian Association of Medical Radiation Technologists (CAMRT) is the certifying organization for Advanced Practice Registered Technologist (Radiation Therapy) ("APRT(T)") in Canada. The certification process provides a three-phase standardized mechanism to certify practitioners in this emerging role. Following the successful completion of the first two stages – prior learning assessment portfolio and case log – the candidate is eligible to challenge a competency-based oral examination (CBOE). The objective of the CBOE is to evaluate the candidate's competence in solving clinically relevant problems requiring decision-making in their area of specialization in a live, virtual examination. The exam panel is comprised of 4 trained expert examiners (2 radiation oncologists, 1 medical physicist, 1 APRT(T)/expert therapist) and 1 exam moderator. Competence is assessed at a level defined by the standards outlined in the CAMRT APRT(T) Competency Profile. The CAMRT conducts rigorous evaluation to ensure that the CBOE is justifiable and defensible. Since 2017 the CBOE has been administered 15 times with each iteration being evaluated using 1) examination statistics (candidate performance, time spent and examiner scoring concordance, etc) and 2) qualitative methods (examiner and candidate interview post CBOE). Data was collected in an iterative process to inform ongoing exam and process refinement to ensure the reliability and validity of the exam against sound assessment principles and the standards set for APRT(T) practice in Canada. Results are reviewed by the Exam Preparation Committee and recommendations made to address any issues or deficiencies identified. The following modifications have been recommended and implemented: 1) Professional Practice content - Shorten the number of questions, divide the questions delivering half at the start of the exam and half at the end 2) Exam materials - Provide hard copy versions of supporting documentation (patient history, diagnostic imaging and reports, treatment plans) to give candidates the option of reviewing images, data, etc. on monitor or on hard copy; also provides back up in the event of a technological problem 3) 'Acceptable' probes - for each question, specific statements or questions have been added that can be used by examiners to guide the candidate down a certain line of thinking that might not have been explored in their primary answer, without overt prompting 4) Score review - Schedule immediately following an exam instead of after the scores have been submitted to the central office. This provides an opportunity to review and resolve large item inter-rater variability while the experience is fresh in the examiners mind. 5) Process for second attempt – Candidates who did not pass on their first try are now only required to complete the portion of the exam where they were unsuccessful, not sit the entire exam again The CBOE model is an established mechanism for assessment, and provides a meaningful capstone to the Canadian APRT(T) certification process. Approached with rigour, it is nonetheless new territory for the CAMRT and many of its stakeholders, and ongoing efforts will be made to balance the need for consistent, valid, and reliable processes with opportunities for refinement. [ABSTRACT FROM AUTHOR]

Considerable uncertainties remain about the nature of warm, AGN-driven outflows and their impact on the evolution of galaxies. This is because the outflows are often unresolved in ground-based observations. As part of a project to study the AGN outflows in some of the most rapidly evolving galaxies in the local Universe, here we present Hubble Space Telescope (HST)/ Space Telescope Imaging Spectrograph (STIS) observations of F14394+5332E that resolve the sub-kpc warm outflow for the first time in an ultra-luminous infrared galaxy. The observations reveal a compact, high-ionization outflow region (r max ∼ 0.9 kpc) set in a more extensive (r max ∼ 1.4 kpc) halo that is kinematically quiescent and has a lower ionization state. A large line width (600 < FWHM < 1500 km s−1) is measured throughout the outflow region, and the outflowing gas shows a steep velocity gradient with radius, with the magnitude of the blueshifted velocities increasing from ∼500 to 1800 km s−1 from the inner to the outer part of the outflow. We interpret the observations in terms of the local acceleration, and hydrodynamic destruction, of dense clouds as they are swept up in a hot, low-density wind driven by the AGN. We discuss the implications for measuring the mass outflow rates and kinetic powers for the AGN-driven outflows in such objects. [ABSTRACT FROM AUTHOR]

Frameless, gated, image-guided, Cobalt60-based hypofractionated stereotactic radiosurgery (Co60-HSRS) is a novel technical paradigm in the treatment of brain metastases that allows for both the dosimetric benefits of the Co60 based stereotactic radiosurgery (SRS) platform as well as the biologic benefits of fractionation. We report mature local control (LC) and adverse radiation effects (ARE) outcomes following 5 fraction Co60-HSRS for intact brain metastases. All patients with intact brain metastases treated with 5-fraction Co60-HSRS between 2017-2020 were retrospectively reviewed. Patients were typically selected for HSRS as opposed to single fraction SRS if the metastases were larger (>2cm diameter), were in eloquent areas, or were in proximity to another lesion receiving HSRS. Survival estimates were determined per patient using Kaplan Meier methods, and LC as well as symptomatic ARE rates were determined per lesion using competing risk methods. Univariable competing risk regression using Fine and Gray's methods were performed, and subsequent multivariable (MVA) regression using a backwards step-wise selection technique generated the final adjusted models. In total 299 metastases in 146 patients were identified. The median clinical and radiologic follow-up was 10.6 (range 0.5-49.9) and 10.7 months (range 0.5-47.6), respectively. The median maximum tumor diameter and volume were 1.7 cm (range, 0.2-3.9 cm) and 2.38 cc (range, 0.004-24.92 cc), respectively. The median total dose and prescription isodose was 27.5 Gy (range, 20-27.5 Gy) in 5 daily fractions and 52% (range, 45%-93%), respectively. The median overall survival (OS) was 12.7 months and the 1-year LC rate was 85%. MVA identified a total dose of 27.5 Gy vs. ≤25 Gy (hazard ratio [HR] 0.59, p = 0.042), and prior chemotherapy exposure (HR 1.99, p = 0.015), as significant predictors of LC. The 1-year ARE rate was 10.8% and the symptomatic ARE rate was 1.8%. MVA identified a gross tumor volume of ≥4.5cc (HR 7.29, p < 0.001) and a mean intra-tumoral dose of ≥39 Gy (HR 3.17, p = 0.034) as significant predictors of symptomatic ARE. Moderate total doses in 5 daily fractions of Co60-HSRS were associated with high rates of LC and a low incidence of symptomatic ARE. A prescription dose of 27.5 Gy was superior with respect to local control versus ≤25 Gy in 5 daily fractions. Target volumes of 4.5cc or larger as well as mean dose >39 Gy, were associated with higher rates of symptomatic necrosis. Further study will help refine the optimal dosimetric constraints for Co60-HSRS. [ABSTRACT FROM AUTHOR]

Traditional processing of Global Navigation Satellite System (GNSS) data using dedicated scientific software has provided the highest levels of positional accuracy, and has been used extensively in geophysical deformation studies. To achieve these accuracies a significant level of understanding and training is required, limiting their availability to the general scientific community. Various online GNSS processing services, now freely available, address some of these difficulties and allow users to easily process their own GNSS data and potentially obtain high quality results. Previous research into these services has focused on Continually Operating Reference Station (CORS) GNSS data. Less research exists on the results achievable with these services using large campaign GNSS data sets, which are inherently noisier than CORS data. Even less research exists on the quality of velocity fields derived from campaign GNSS data processed through online precise point positioning services. Particularly, whether they are suitable for geodynamic and deformation studies where precise and reliable velocities are needed. In this research, we process a very large campaign GPS data set (spanning 10 yr) with the online Jet Propulsion Laboratory Automated Precise Positioning Service. This data set is taken from a GNSS network specifically designed and surveyed to measure deformation through the central North Island of New Zealand. This includes regional CORS stations. We then use these coordinates to derive a horizontal and vertical velocity field. This is the first time that a large campaign GPS data set has been processed solely using an online service and the solutions used to determine a horizontal and vertical velocity field. We compared this velocity field to that of another well utilized GNSS scientific software package. The results show a good agreement between the CORS positions and campaign station velocities obtained from the two approaches. We discuss the implications of these results for how future GNSS campaign field surveys might be conducted and how their data might be processed. [ABSTRACT FROM AUTHOR]

The voice of diverse communities continues to be minimal in academic research. Few models exist for education and training of new research topics and terminology and building partnership capacity in community-engaged research. Little is known about integrative education and training when building participatory research partnerships for sustainability and developing trust and rapport. Community partners at an Asian community-based health and social services center in a large metropolitan area wanted to explore the cultural context of a health-assistive smart home that monitors and auto-alerts with changes in health. With historical and recent rising trends in culturally insensitive research in several diverse communities, the concept of technology-enabled monitoring in the privacy of one’s home brings uncertainty. Academic nurse researchers and community partners co-created a culturally safe integrative education and training curriculum, the Interactive CO-learning for Research Engagement and Education (I-COREE). The purpose was to design, implement, and evaluate the curriculum to respond to the community partners’ needs to create a culturally safe space through an integrative education and training to facilitate building partnership capacity for research engagement including developing trust and rapport and addressing uncertainties in health-assistive technologies. Popular education tenets informed the curriculum. Twelve academic and community partners participated, four were team teachers who co-led the session. Implementation of the experiential, multimodal co-learning activities were conducted within a half-day. The curriculum evaluation indicated it helped bridge critical conversations about partners’ fears of the unknown, approach culturally sensitive topics safely, and trust and rapport. Key elements may be translatable to other partnerships.

The Taupo Volcanic Zone (TVZ) is one of the world's most productive regions of rhyolitic volcanism and contains the highly active Okataina Volcanic Centre (OVC). Within the TVZ, intra-arc extension is expressed as normal faulting within a zone known as the Taupo Rift. The OVC is located within a complex part of the rift, where volcanism and deformation is considered influenced by rift structure and kinematics. There has been significant research on the structural, volcanic and geophysical properties of the rift and OVC, but less focus on deformation using geodetic data. The limited studies that have utilized geodetic data do not clearly resolve the distribution of deformation and strain rates within the rift and OVC. This is essential to ensure that deformation signals from volcanic processes at the OVC are correctly identified and distinguished from those related to regional tectonic or local hydrothermal processes within the rift. In this paper, we present a picture of contemporary deformation at the OVC and within the surrounding rift in detail, using existing and new GPS campaign and continuous GPS (cGPS) data collected between 1998 and 2011. The results show a highly heterogeneous deformation and strain rate field (both extension and shortening) through the study area, partitioned into different parts of the rift. Our results agree well with earlier geodetic studies, as well as identify new features, but some deformation patterns conflict with long-term geological observations. In the OVC, we observe a locally rotated horizontal velocity field, significant vertical deformation and variable strain rates across the caldera. In the Tarawera Rift, we identify elevated extension and shear rates, which may have significant implications for volcanism there. A shortening pattern is identified through the central rift, which is unexpected in an intra-arc rifting environment. We attempt to explain the source/s of shortening and extension and discuss their implications for geodetic monitoring efforts in the OVC. [ABSTRACT FROM AUTHOR]

Feed is generally the greatest expense for milk production. With volatility in feed and milk markets, income over feed cost (IOFC) is a more advantageous measure of profit than simply feed cost per cow. The objective of this study was to evaluate the effects of ration cost and ingredient composition on IOFC and milk yield. The Pennsylvania State Extension Dairy Team IOFC tool (http://extension.psu.edu/animals/dairy/business-management/financial-tools/income-over-feed-cost/ introduction-to-iofc) was used to collect data from 95 Pennsylvania lactating dairy cow herds from 2009 to 2012 and to determine the IOFC per cow per day. The data collected included average milk yield, milk income, purchased feed cost, ration ingredients, ingredient cost per ton, and amount of each ingredient fed. Feed costs for home-raised feeds for each ration were based on market values rather than on-farm cost. Actual costs were used for purchased feed for each ration. Mean lactating herd size was 170 ± 10.5 and daily milk yield per cow was 31.7 ± 0.19 kg. The mean IOFC was $7.71 ± $1.01 cost per cow, ranging from -$0.33 in March 2009 to $16.60 in September 2011. Data were analyzed using a one-way ANOVA in SPSS (IBM Corp., Armonk, NY). Values were grouped by quartiles and analyzed with all years combined as well as by individual year. Purchased feed cost per cow per day averaged $3.16 ± $1.07 for 2009 to 2012. For 2009 to 2012 combined, milk yield and IOFC did not differ with purchased feed cost. Intermediate levels (quartiles 2 and 3) of forage cost per cow per day between $1.45 and $1.97 per cow per day resulted in the greatest average IOFC of $8.19 and the greatest average milk yield of 32.3 kg. Total feed costs in the fourth quartile ($6.27 or more per cow per day) resulted in the highest IOFC. Thus, minimizing feed cost per cow per day did not maximize IOFC. In 2010, the IOFC was highest at $8.09 for dairies that fed 1 or more commodity by-products. Results of the study indicated that intermediate levels of forage cost and higher levels of total feed cost per cow per day resulted in both higher milk yield and higher IOFC. This suggests that optimal ration formulation rather than least cost strategies may be key to increasing milk yield and IOFC, and that profit margin may be affected more by quality of the feed rather than the cost. [ABSTRACT FROM AUTHOR]

Objective We set out to review the Rapid Response Radiotherapy Program (RRRP). Methods We retrospectively reviewed a prospective database of patients referred to the RRRP between August 1, 2008, and June 30, 2012, extracting patient demographics, case dispositions, and wait times in days from referral to consultation and from consultation to treatment. Results Of 2742 patients referred to the RRRP, 1458 (53%) were men, and 1284 (47%) were women. Median age was 64 years. The most prevalent primary cancer sites were lung (33%), breast (21%), and prostate (17%). The most common reasons for referral were bone metastases (53%) and brain metastases (21%). Palliative radiation therapy was given to 1890 patients. The median wait time from referral to consultation was 3 days. Among treated patients, 60% were treated on the day of their consultation, and 33%, within 1-6 days. Conclusions The RRRP continues to deliver timely palliative radiation therapy to patients, comparable to earlier reviews. The continued success of the RRRP will remain a model for future rapid-access palliative radiation therapy clinics. [ABSTRACT FROM AUTHOR]

Postapplication exposure assessment related to indoor residential application of pesticide products requires consideration of product use information, application methods, chemical-specific deposition, time-dependent availability and transferability of surface residues, reentry time, and temporal location and macro- and microactivity/behavior patterns (Baker et al., 2000). Children's mouthing behavior results in potential postapplication exposure to available pesticides in treated microenvironments through the nondietary ingestion route, in addition to the dermal or inhalation routes. Children's activities and associated behaviors may result in multiple or repeat contact of dermal areas (clothed and unclothed body areas and hands) with treated surfaces, or surfaces that may have indirect sources of residues. Further, some surfaces contacted may have transferable pesticide residues and others may not. Transfer of residues from the indoor residential environment to the dermal surface (e.g., hands) of an individual has been assumed to be linear as a function of time and number of contacts. However, studies suggest that this transfer process to the hands and other body areas may be rapidly saturable. In the most recent U.S. Environmental Protection Agency (EPA), Office of Pesticide Programs (OPP) “Residential Exposure Assessment Standard Operating Procedures” (U.S. EPA, 2012), the input variable for the number of dermal contacts (with treated surfaces) is an exponent, making the relationship nonlinear. Further, removal processes such as hand washing and transfer to untreated surfaces are important to consider. Predictive algorithms for estimating children's hand-to-mouth-related incidental ingestion exposures post pesticide application have been developed by the EPA/OPP and incorporated into probabilistic models. A review of literature addressing variables used to estimate potential incidental ingestion exposure is presented. Data relevant to input variables for predictive algorithms are discussed, including the results of a multiyear, pesticide transferable residue measurement program conducted by the Non-Dietary Exposure Task Force (NDETF) and the associated distributional characterization for this key variable. Sources of conservative bias in current hand-to-mouth, incidental ingestion exposure estimation and the role of biomonitoring to evaluate predicted exposures are discussed. [ABSTRACT FROM PUBLISHER]

Purpose: The aims of this study were to determine whether symptom clusters in patients with bone metastases varied when derived using three different statistical methods and to compare the presentation of symptom clusters over time in responders and nonresponders to palliative radiation treatment (RT).Methods: Secondary analysis of a previously reported data set compiled using the brief pain inventory from 348 patients with bone metastases. Hierarchical cluster analysis (HCA) and exploratory factor analysis (EFA) were performed to identify symptom clusters at baseline, 1, 2, and 3 months following radiation treatment. Clusters derived were compared with the findings obtained using principal component analysis (PCA) in our previous study. The total patient sample was further separated into two subgroups: responders and nonresponders to RT. PCA, HCA, and EFA identified symptom clusters experienced by each subgroup at the same time points as before.Results: Little correlation was observed in the symptom cluster findings of PCA, EFA, and HCA in the total patient sample. Absolute consensus among all three statistical methods was never reached at any assessment time point in the present study. Varying patterns of symptom cluster presentation over time were observed in the responders versus nonresponders subgroups regardless of the analytical method employed. A core cluster of symptoms composed of worst pain, general activity, walking ability, normal work, and enjoyment of life frequently presented in the same cluster.Conclusion: The presence and composition of symptom clusters derived varied depending on which statistical analysis method was employed. A key step in attaining consistency in symptom cluster research necessitates the utilization of a common method. [ABSTRACT FROM AUTHOR]

Introduction The primary objective of this pilot study was to examine the inter-rater reliability in scoring the computed tomography (CT) imaging features of spinal metastases in patients referred for radiotherapy (RT) for bone pain. Methods In a retrospective review, 3 musculoskeletal radiologists and 2 orthopedic spinal surgeons independently evaluated ct imaging features for 41 patients with spinal metastases treated with rt in an outpatient radiation clinic from January 2007 to October 2008. The evaluation used spinal assessment criteria that had been developed in-house, with reference to • osseous and soft tissue tumour extent, • presence of a pathologic fracture, • severity of vertebral height loss, and • presence of kyphosis. The Cohen kappa coefficient between the two specialties was calculated. Results Mean patient age was 69.2 years (30 men, 11 women). The mean total daily oral morphine equivalent was 73.4 mg. Treatment dose-fractionation schedules included 8 Gy/1 (n = 28), 20 Gy/5 (n = 12), and 20 Gy/8 (n = 1). Areas of moderate agreement in identifying the ct imaging appearance of spinal metastasis included extent of vertebral body involvement (κ = 0.48) and soft-tissue component (κ = 0.59). Areas of fair agreement included extent of pedicle involvement (κ = 0.28), extent of lamina involvement (κ = 0.35), and presence of pathologic fracture (κ = 0.20). Areas of poor agreement included nerve-root compression (κ = 0.14) and vertebral body height loss (κ = 0.19). Conclusions The range of agreement between musculoskeletal radiologists and orthopedic surgeons for most spinal assessment criteria is moderate to poor. A consensus for managing challenging vertebral injuries secondary to spinal metastases needs to be established so as to best triage patients to the most appropriate therapeutic modality. [ABSTRACT FROM AUTHOR]

Summary Reasons for performing study: Although beach training is commonly used in horses, limb loading on beach sand has never been investigated. A dynamometric horseshoe (DHS) is well adapted for this purpose. Objectives: To compare ground reaction force (GRF) and fetlock kinematics measured in harness trotters on 2 tracks of beach sand with different water content. Methods: Two linear sand tracks were compared: firm wet sand (FWS, 19% moisture) vs. deep wet sand (DWS, 13.5% moisture). Four French trotters (550 ± 22 kg) were used. Their right forelimb was equipped with a DHS and skin markers. Each track was tested 3 times at 7 m/s. Each trial was filmed by a high-speed camera (600 Hz); DHS and speed data acquisition was performed at 10 kHz on 10 consecutive strides. All recordings were synchronised. The components Fx (parallel to the hoof solar surface) and Fz (perpendicular) of the GRF were considered. For 3 horses the fetlock angle and forelimb axis-track angle at landing were measured. Statistical differences were tested using the GLM procedure (SAS; P<0.05). Results: Stance duration was increased on DWS compared to FWS. Fzmax and Fxmax (oriented, respectively, downwards and forwards relatively to the solar surface) and the corresponding loading rates, were decreased on DWS and these force peaks occurred later. Fxmin (backwards) was not significantly different between both surfaces; the propulsive phase (Fx negative) was longer and the corresponding impulse higher, on DWS compared to FWS. The forelimb was more oblique to the track at landing and maximal fetlock extension was less and delayed on DWS. Conclusions: This study confirms that trotting on deep sand overall reduces maximal GRF and induces a more progressive limb loading. However, it increases the propulsive effort and likely superficial digital flexor tendon tension at the end of stance, which should be taken into account in beach training. [ABSTRACT FROM AUTHOR]

Summary Reasons for performing study: Sandy beaches are often considered good training surfaces for trotter horses. However, their biomechanical effects on locomotion are insufficiently documented. Events at hoof impact have mostly been studied under laboratory conditions with accelerometers, but there is lack of data (acceleration, force, movement) on events occurring under every day practical conditions in the field. Objectives: To investigate hoof landing and stride parameters on different tracks (from wet to dry) of a sand beach and on an asphalt road. Methods: The right front hoof of 4 trotter horses was equipped with a triaxial accelerometer and a dynamometric horseshoe. Acceleration and force recordings (10 kHz) were synchronised with a high speed movie (600 Hz). Horses were driven on a sand beach where 3 tracks of decreasing water content had been delimited (from the sea to the shore): firm wet sand (FWS), deep wet sand (DWS) and deep dry sand (DDS). Firm wet sand and DWS were compared at 25 km/h and DDS compared to an asphalt road at 15 km/h. Recordings (10 strides) were randomly repeated 3 times. Statistical differences were tested using a GLM procedure (P<0.05). Results: Main significant results were 1) a decrease in the amplitude of the vertical deceleration (and force) of the hoof during impact on a softer surface (about 59% between DWS and FWS and 95% between DDS and asphalt), 2) a decrease in the longitudinal braking deceleration (and force) on softer grounds (50% for DWS vs. FWS and 55% for DDS vs. asphalt), 3) a decrease in the stride length and an increase in the stride frequency on a softer surface. Conclusions and clinical relevance: Drier sand surfaces reduce shock and impact forces during landing. For daily training, it should, however, be realised that improved damping characteristics are associated with a shorter stride length and a higher stride frequency. [ABSTRACT FROM AUTHOR]

This study investigates the effect of the Nucleus CI24RE implant's neural response telemetry (NRT) system, which has less internal noise compared to its predecessor, the CI24M/R implant, on the NRT threshold (TNRT) profile across the array. CI24M/R measurements were simulated by ignoring CI24RE measurements with response amplitudes below 50 uV. Comparisons of the estimated TNRTs from the CI24RE measurements and the CI24M/R simulations suggest that, apart from a constant level difference, the TNRT profiles from the newer implant generally would not have differed very much from those of its predecessor. This view was also reflected by principal component analysis (PCA) results which revealed a 'shift' component similar to that reported by Smoorenburg et al (2002). On the whole, there is no indication that current practices of using the TNRT profiles for assisting with speech processor programming need to be revised for the CI24RE implant. [ABSTRACT FROM AUTHOR]

Aim: The aim of the present pilot study was to investigate to what extent children in Norway sensitized to lupin had clinical lupin allergy, and to compare sensitization to lupin with sensitization to other legumes. Methods: Thirty-five children with food allergy referred to a national referral hospital were evaluated with skin prick test (SPT) and analysis of serum-specific IgE to lupin, peanut, pea and soy. The children with positive SPTs to lupin were offered oral food challenges with lupin flour. Results: Fifteen children (43%) had positive SPT and 17 children (49%) had serum-specific IgE to lupin. Ten SPT-positive children underwent oral food challenges and one experienced an allergic reaction to lupin flour. This child was one of six challenged children with IgE antibodies to peanut >15 kUA/L. There was a strong relationship between positive SPT to lupin flour and positive SPT to soy and between positive SPT to lupin and specific IgE to soy, pea and peanut. Conclusions: Children with sensitization to lupin are not likely to have a clinical lupin allergy. Avoidance of lupin on the basis of lupin sensitization or peanut allergy would lead to unnecessarily strict diets. Food challenge is currently necessary to diagnose lupin allergy. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To determine the cerebrospinal fluid concentrations and the functional and pain outcomes after a single intravenous infusion of erythropoietin at the start of a standard radiotherapy and steroid protocol. Materials and methods: Ten paraparetic patients with malignant extradural spinal cord compression who were eligible for radiotherapy, lumbar puncture and intravenous epoetin alpha were enrolled. The patients received epoetin alpha 1500IU/kg intravenously over 30min followed by a standardised dexamethasone and radiotherapy protocol. A lumbar puncture and venipuncture were carried out 24–30h after the epoetin alpha infusion. The patients were followed closely at defined intervals. Results: Erythropoietin was detectable in the cerebrospinal fluid in all eight patients sampled (median 92.5mIU/ml, range 17.8–214.0mIU/ml). Before treatment, eight patients were non-ambulatory and two patients were ambulatory with assistance. After treatment, eight (80%, 95% confidence interval [CI] 44–97%) improved at least one functional class and recovered or maintained ambulation. Five of seven patients (71%; 95% CI 29–96%) with objective sensory deficits and one of seven (14%; 95% CI 0–58%) catheter-dependent patients recovered. Overall, 78% (95% CI 40–97%) had a pain response. Conclusions: After an intravenous infusion of epoetin alpha, radiotherapy and steroids, high concentrations of erythropoietin were detectable in the cerebrospinal fluid. Patients with malignant extradural spinal cord compression showed encouraging improvements in neurological function and pain. [Copyright &y& Elsevier]

Abstract: Allergy to hazelnut is one of the most prevalent causes of severe food-allergic reactions in Norway, as recorded by The Norwegian National Reporting System and Register of Severe Allergic Reactions to Food. In the majority of the reported cases, there is “hidden”, unlabelled hazelnut protein in processed foods like chocolate, cookies and cereal mixtures the eliciting agent. For a food survey study performed to evaluate the labelling practices with regards to hazelnut on behalf of the Norwegian Food Safety Authority, a new sensitive time-resolved fluoroimmunoassay (TR-FIA) for the detection of hazelnut protein traces in food matrices was developed and validated. The unique fluorometric properties of the europium-chelates used improved the signal-to-noise ratio because of low matrix interference and led to an enhanced sensitivity. The limit of detection was 0.1 mg/kg and the limit of quantitation was 0.33 mg/kg hazelnut protein. The recovery ranged from 73% to 123% in cookies and cereals, and from 50 to 77% in chocolate. The intra-assay precision was 7% and the inter-assay precision was 19%. Of 100 randomly chosen retail food products in Norway labelled “may contain hazelnut”, 36 contained <0.2 mg/kg and seven >10 mg/kg hazelnut protein, demonstrating how differently this precautionary label is used. [Copyright &y& Elsevier]