Common and rare EGFR and KRAS mutations in a Dutch non-small-cell lung cancer population and their clinical outcome.

INTRODUCTION: In randomly assigned studies with EGFR TKI only a minor proportion of patients with NSCLC have genetically profiled biopsies. Guidelines provide evidence to perform EGFR and KRAS mutation analysis in non-squamous NSCLC. We explored tumor biopsy quality offered for mutation testing, different mutations distribution, and outcome with EGFR TKI. PATIENT AND METHODS: Clinical data from 8 regional hospitals were studied for patient and tumor characteristics, treatment and overall survival. Biopsies sent to the central laboratory were evaluated for DNA quality and subsequently analyzed for mutations in exons 18-21 of EGFR and exon 2 of KRAS by bidirectional sequence analysis. RESULTS: Tumors from 442 subsequent patients were analyzed. For 74 patients (17%) tumors were unsuitable for mutation analysis. Thirty-eight patients (10.9%) had EGFR mutations with 79% known activating mutations. One hundred eight patients (30%) had functional KRAS mutations. The mutation spectrum was comparable to the Cosmic database. Following treatment in the first or second line with EGFR TKI median overall survival for patients with EGFR (n = 14), KRAS (n = 14) mutations and wild type EGFR/KRAS (n = 31) was not reached, 20 and 9 months, respectively. CONCLUSION: One out of every 6 tumor samples was inadequate for mutation analysis. Patients with EGFR activating mutations treated with EGFR-TKI have the longest survival.

The bionomics of an invasive species Sitona lepidus during its establishment in New Zealand.

The egg, larval, pupal and adult abundance of the clover root weevil Sitona lepidus Gyllenhal (Coleoptera: Curculionidae) was monitored at three sites for the first ten years following the discovery of this exotic pest in the Waikato region of New Zealand. The species went through an initial boom and bust cycle at two sites, with populations reaching up to 1800 larvae m-2. Thereafter, winter larval populations were relatively stable, ranging between 450-750 m-2. Unlike in the Northern Hemisphere, S. lepidus was found to have two generations a year in the Waikato region of New Zealand. Pasture white clover content at the time of peak adult numbers was positively related to the subsequent peak larval populations for each generation. The factors contributing to the emergence of S. lepidus as one of the most important pasture pests in New Zealand are discussed.

Resident-oriented care in nursing homes: effects on nurses.

BACKGROUND: In a resident-oriented care model the assignment of patients to primary nurses takes place. These primary nurses are responsible for the total nursing care of their patients and make use of the nursing process. According to job demand-control models, these enlarged and enriched jobs can be described in terms of autonomy, job demands and social support, and the presence of these work characteristics has a positive influence on workers' psychological and behavioural outcomes. AIMS: This paper reports a study to investigate the extent to which the various features of resident-oriented care were implemented and its effects nurses' on work characteristics and on psychological and behavioural outcomes in three Dutch nursing homes. METHODS: In a quasi-experimental design, experimental and control groups were followed over 22 months, using a pretest and two post-tests with questionnaires, interviews and qualitative observations. RESULTS: The quantitative data showed significant increases in resident assignment, the two variables measuring the nursing process and, in the psycho-geriatric experimental group, on resident-oriented tasks. The qualitative data showed that a partly task-oriented division of labour was still used and that the planned delegation of coordination tasks to primary nurses was not fully achieved. Effects on work perceptions were limited. After implementation of the new system, the experimental group showed an increase in job autonomy. CONCLUSIONS: The intervention appeared to be only partly successful. Most of the expected results regarding work characteristics and psychological and behavioural outcomes did not materialize. Theoretical and methodological reflections are presented in the light of these findings.

Hodgsonox, a new class of sesquiterpene from the liverwort Lepidolaena hodgsoniae. Isolation directed by insecticidal activity.

Hodgsonox (1), a new insecticidal sesquiterpene, has been isolated from the New Zealand liverwort Lepidolaena hodgsoniae. The structure was elucidated on the basis of 2D NMR analysis of 1 and a synthetic epoxide derivative (2). Hodgsonox represents a new class of sesquiterpene with a cyclopenta[5,1-c]pyran ring system fused to an oxirane ring. The combination of a mono- and a 1,1 disubstituted double bond flanking the oxygenated carbon of a the pyran ring is a unique structural feature. Hodgsonox is toxic to larvae of the blowfly Lucilia cuprina.