Joint IARC/NCI International Cancer Seminar Series Report: expert consensus on future directions for ovarian carcinoma research.

Recently, ovarian cancer research has evolved considerably because of the emerging recognition that rather than a single disease, ovarian carcinomas comprise several different histotypes that vary by etiologic origin, risk factors, molecular profiles, therapeutic approaches and clinical outcome. Despite significant progress in our understanding of the etiologic heterogeneity of ovarian cancer, as well as important clinical advances, it remains the eighth most frequently diagnosed cancer in women worldwide and the most fatal gynecologic cancer. The International Agency for Research on Cancer and the United States National Cancer Institute jointly convened an expert panel on ovarian carcinoma to develop consensus research priorities based on evolving scientific discoveries. Expertise ranged from etiology, prevention, early detection, pathology, model systems, molecular characterization and treatment/clinical management. This report summarizes the current state of knowledge and highlights expert consensus on future directions to continue advancing etiologic, epidemiologic and prognostic research on ovarian carcinoma.

Pharmacotherapy of Autism Spectrum Disorder: Results from the Randomized BAART Clinical Trial.

The objective of this trial, Biomarkers in Autism of Aripiprazole and Risperidone Treatment (BAART), was to provide support and guidance for an evidence-based approach for the selection and monitoring of initial pharmacotherapy in patients with autism by assessing predictors of efficacy, tolerability, and safety. This randomized double-blind parallel-group study was conducted in three academic medical centers and a single private pediatric practice. Eighty children or adolescents (aged 6-17 yrs) with autistic disorder were enrolled, and 61 patients were randomized to the study drug. Of those patients, 51 completed the 10-week trial, and 31 completed an optional 12-week blinded extension phase. All patients were treated with 2 weeks of placebo before random assignment to receive aripiprazole (31 patients) or risperidone (30 patients) for 10 weeks. Sixteen placebo responders (20%) were excluded from further analysis. Drug dosing followed U.S. Food and Drug Administration (FDA) labeling, and weekly dosage adjustments were allowed until week 4; patients were then maintained on a fixed dose for 6 additional weeks. Safety, physical, and psychological assessments were recorded weekly or every 2 weeks. No significant differences in severity of illness between the aripiprazole and risperidone groups were noted at baseline. All patients significantly improved on the Aberrant Behavior Checklist-Irritability subscale after 1 week and continued for the remaining 9 weeks and the extension phase. Improvement was greatest in the risperidone group at every assessment period and was statistically significantly better than that in the aripiprazole group at weeks 3 and 6 (p<0.05). No dose-limiting adverse events occurred during the dose-titration period. Mean weight gain in the aripiprazole group was significantly less than that in the risperidone group at week 4 (0.62 vs 1.38 kg, p=0.033) and week 10 (1.61 vs 3.31 kg, p<0.001), but the difference became nonsignificant for the 31 patients completing the 3-month extension phase (4.36 vs 5.55 kg, p=0.26). Pharmacotherapy of patients with autism spectrum disorder resulted in behavioral improvement within 1 week and lasted at least 22 weeks. Weight gain occurred to a greater degree with risperidone than aripiprazole initially, but the differences became nonsignificant by the end of the trial. Our trial supports previous results of drug efficacy and safety in patients with autism spectrum disorder from other trials and extends the evidence-based support for choosing an FDA-approved drug for initial pharmacotherapy for autism spectrum disorder.

Neural Correlates of Enhanced Audiovisual Processing in the Bilingual Brain.

Bilingualism is associated with enhancements in perceptual and cognitive processing necessary for juggling multiple languages. Recent psychophysical studies demonstrate bilinguals also show enhanced multisensory processing and more restricted temporal binding windows for integrating audiovisual information. Here, we probed the neural mechanisms of bilinguals' audiovisual benefits. We recorded neuroelectric responses in mono- and bi-lingual listeners to the double-flash paradigm in which auditory beeps concurrent with a single visual flash induces the perceptual illusion of multiple flashes. Relative to monolinguals, bilinguals showed less susceptibility to the illusion (fewer false perceptual reports) coupled with stronger and faster event-related potentials to audiovisual information. Source analyses of EEG data revealed monolinguals' increased propensity for erroneously perceiving audiovisual stimuli was attributed to increased activity in primary visual (V1) and auditory cortex (PAC), increases in multisensory association areas (BA 37), but reduced frontal activity (BA 10). Regional activations were associated with an opposite pattern of behaviors: whereas stronger V1 and PAC activity predicted slower behavioral responses, stronger frontal BA10 responses elicited faster judgments. Our results suggest bilinguals' higher precision in audiovisual perception reflects more veridical sensory coding of physical cues coupled with superior top-down gating of sensory information to suppress the generation of false percepts. Findings underscore that the plasticity afforded by speaking multiple languages shapes extra-linguistic brain regions and can enhance audiovisual brain processing in a domain-general manner.

Improving the process of community-based student nurse practice through a high-fidelity simulated clinical experience.

Simulation can be used to facilitate knowledge and practice with clients/families in the community. Because student nurses appreciate the opportunity to practice skills in a nonthreatening environment, and faculty welcome the opportunity to observe all students providing a home visit to a similar type of client, the authors developed such a simulation. In this article, they outline the process taken to develop and evaluate a high-fidelity community simulated clinical experience.

A residential nursing camp program: effects on adolescent attitudes toward nursing careers.

Health policy experts predict that the current shortage of nurses will persist and perhaps worsen during the next 30 years. One of the most important causes of this problem is that too few youth choose nursing careers. A partnership was forged between university nursing faculty and nurse clinicians and administrators at a full-service hospital in northeastern Pennsylvania. The authors postulated that adolescent attitudes toward selecting nursing careers could improve after an intensive 4-day residential nursing camp program. We recruited local high school students generally interested in health care careers to attend the camp. Aggregate pre-camp and post-camp surveys obtained over 3 years demonstrated generally favorable attitudes toward nursing careers that improved at the conclusion of the camp. This camp program is an easily replicable intervention that successfully improves adolescents' attitudes toward pursuing nursing careers.

PCR for detection of cdt-III and the relative frequencies of cytolethal distending toxin variant-producing Escherichia coli isolates from humans and cattle.

A PCR assay that uses primers whose sequences were obtained from the published sequence of the cdt-III gene was developed to determine the frequencies of the cdt-I, cdt-II, and cdt-III genes in Escherichia coli isolates from humans and animals. E. coli isolates producing cytolethal distending toxin (CDT) were infrequently detected. The cdt-I gene was preferentially detected in strains with the cnf1 gene, while the cdt-III gene was found in strains carrying the cnf2 gene. The cdt-III genotype was more prevalent in animal isolates, while the cdt-I and cdt-II genotypes were more evident in human isolates. The presence of further cdt gene variants was indicated by the presence of toxin activity in cell culture in the absence of PCR amplification of the cdt-I, cdt-II, or cdt-III gene.

Validation of the NPI-Q, a brief clinical form of the Neuropsychiatric Inventory.

The Neuropsychiatric Inventory (NPI) is a validated clinical instrument for evaluating psychopathology in dementia. The authors developed a brief questionnaire form of the NPI (NPI-Q), intended for use in routine clinical practice, and cross-validated it with the NPI in 60 Alzheimer's patients. Test-retest reliability of the NPI-Q was acceptable. The prevalence of analogous symptoms reported on the NPI and NPI-Q differed on average by 5%; moderate or severe symptom ratings differed by less than 2%. The NPI-Q provides a brief, reliable, informant-based assessment of neuropsychiatric symptoms and associated caregiver distress that may be suitable for use in general clinical practice.

A flexible infusion micro-cannula for subretinal surgery.

Injection of fluids or drugs into the subretinal space is often necessary during subretinal surgery. The authors have developed a flexible micro-cannula for subretinal surgery that can be used for submacular injection of drugs or for atraumatic hydrodissection of the retina. The novel features of the soft tip include reduced diameter (200 microns), increased length, and material selection for resistance to tip buckling. The authors have used this cannula following pars plana vitrectomy for 14 patients with subfoveal choroidal neovascularization secondary to age-related macular degeneration (13 patients) and angioid streaks (1 patient). The cannula creates a relatively atraumatic retinotomy and allows an efficient, controlled injection of subretinal fluid. This micro-cannula seems to be a valuable tool for the subretinal infusion of fluids or drugs.

Biogeochemical assessment of natural attenuation of JP-4-contaminated ground water in the presence of fluorinated surfactants.

The biogeochemistry of the natural attenuation of petroleum-contaminated ground water was investigated in a field study. The focus of the study was a fire training site located on Tyndall Air Force Base in Florida. The site has been used by the Air Force for approximately 11 years in fire fighting exercises. An on-site above-ground tank of JP-4 provided fuel for setting controlled fires for the exercises. Various amounts of water and aqueous film forming foams (AFFF) were applied to extinguish the fires. The sources of contamination included leaks from pipelines transporting the fuel, leaks from an oil/water separator and runoff and percolation from the fire fighting activities. Previous investigations had identified jet fuel contamination at the site, however, no active remediation efforts have been conducted to date. The goal of this study was to use biogeochemical monitoring data to delineate redox zones within the site and to identify evidence of natural attenuation of JP-4 contamination. In addition to identifying several hydrocarbon metabolites, fluorinated surfactants (AFFF) were detected down-gradient of the hydrocarbon plume.

Use of a Plasmid DNA Probe To Monitor Populations of Bacillus pumilus Inoculant Strains in Hay.

We are evaluating naturally occurring isolates of Bacillus pumilus for use as microbial hay preservatives. Seven isolates of B. pumilus from hay contained a 42-kb cryptic plasmid (pMGD296). We wished to determine whether pMGD296 could be used as a molecular marker to follow populations of these isolates in hay over time. Southern blots and colony blots of 69 isolates of B. pumilus and other Bacillus spp. were probed with P-labeled pMGD296. Twenty-nine probe-positive isolates were identified; of these, 28 contained a plasmid with a restriction profile identical to that of pMGD296. One isolate from untreated hay contained a 40-kb plasmid (pMGD150) that was homologous to pMGD296 but had a different restriction fragment pattern. Regions of homology between the two plasmids were identified by Southern blotting, and a 1.9-kb HindIII-PstI fragment of pMGD296 lacking strong homology to pMGD150 was cloned in pUC18. The cloned fragment hybridized only with isolates containing pMGD296 and was used to estimate populations of these isolates in treated and untreated hay.

Effects of counselling on knowledge about HIV-1 among transfusion recipients and their partners. Transfusion Safety Study Group.

The present study determined how much HIV-1-positive persons knew about AIDS, and HIV-1 transmission and prevention, in comparison with HIV-1-negative controls in a predominantly heterosexual cohort. The subjects were blood donors, blood recipients, hemophiliacs, and their sexual partners. A 16-item questionnaire about AIDS, HIV-1 transmission, and knowledge of safe sexual practices was administered to 228 subjects to determine background information. The HIV-1-positive cohort answered more questions correctly (mean = 8.5) than did the HIV-1-negative cohort (mean = 6.5), largely as a result of general information about AIDS among those with steady sexual partners. All persons, however, were poorly informed about HIV-1 transmission and safe sexual practices. Thus, there is a great need for effective counselling.

Measurement of the fetal heart rate during pregnancy by a new electrocardiographic technique.

An external technique for recording the fetal heart rate (FHR) during pregnancy is described. The system is based upon the detection of the fetal electrocardiogram (ECG) from the maternal abdomen and elimination of the maternal QRS complexes by a new system of subtraction. Fetal QRS complexes with an amplitude of 10 microvolts or more were processed to produce heart rate recordings of much higher quality than previously obtained with the phonocardiographic and ultrasonic systems. The proportion of successful recordings was reduced between 27 and 34 weeks of gestation due to the decrease in size of the fetal QRS complex which occurred at this time; this was a major drawback of the ECG system.