Genetic intra-tumour heterogeneity fuels clonal evolution, but our understanding of clinically relevant clonal dynamics remain limited. We investigated spatial and temporal features of clonal ...diversification in clear cell renal cell carcinoma through a combination of modelling and real tumour analysis. We observe that the mode of tumour growth, surface or volume, impacts the extent of subclonal diversification, enabling interpretation of clonal diversity in patient tumours. Specific patterns of proliferation and necrosis explain clonal expansion and emergence of parallel evolution and microdiversity in tumours. In silico time-course studies reveal the appearance of budding structures before detectable subclonal diversification. Intriguingly, we observe radiological evidence of budding structures in early-stage clear cell renal cell carcinoma, indicating that future clonal evolution may be predictable from imaging. Our findings offer a window into the temporal and spatial features of clinically relevant clonal evolution.
To cite this article: Barnett J, Leftwich J, Muncer K, Grimshaw K, Shepherd R, Raats MM, Gowland MH, Lucas JS. How do peanut and nut‐allergic consumers use information on the packaging to avoid ...allergens? Allergy 2011; 66: 969–978.
Background: Recent legislation has sought to improve the information printed on packaged foods relevant to the safety of food allergic consumers. We aimed to understand the complex risk assessment decisions made by peanut and nut‐allergic adults when purchasing food, with particular reference to use of printed package information.
Methods: The behaviour and ‘thinking aloud’ of 32 participants were recorded during their normal food shop, followed by a semi‐structured interview. During the interview they were given 13 potentially problematic packaged foods, and asked if they would purchase the product and what their reasons were. Transcribed data from the shop, interview and 13‐product task were analysed to explore use of allergy advice boxes, ingredients lists and other packaging information.
Results: Some participants used the ingredients list as their primary check for allergens, but most used the allergy advice box. Package‐based information was generally considered reliable, but some supermarket and brand labels were trusted more than others. Images and product names were used to draw inferences about the presence of nuts. A number of improvements were suggested by participants, particularly a request for more ‘nut free’ labelling.
Conclusions: Food labels were used in conjunction with nonpacket‐based strategies (e.g. previous experience) to make choices. External factors (e.g. trust of manufacturer) informed interpretation of and confidence in labels. Images and product names, not intended by manufacturers as an allergen risk assessment aid, were also used to inform choices.
We present measurements of the H-like potassium (K xix) X-ray spectrum and its He-like (K xviii) satellite lines, which are situated in the wavelength region between 3.34 and 3.39 , which has been of ...interest for the detection of dark matter. The measurements were taken with a high-resolution X-ray spectrometer from targets irradiated by a long-pulse (2 ns) beam from the Orion laser facility. We obtain experimental wavelength values of dielectronic recombination satellite lines and show that the ratio of the Ly lines and their dielectronic satellite lines can be used to estimate the electron temperature, which in our case was about 1.5 0.3 keV.
In the ongoing debate on optimum methods for identification of Indigenous people within linked administrative data, few studies have examined the impacts of method on population counts and outcomes ...in family-based linkage studies of Aboriginal children.
To quantify differences between three algorithms in ascertaining Aboriginal and Torres Strait Islander children in linked administrative data.
Linked administrative health data for children born in Western Australia (WA) from 2000-2013, were used to examine the cohorts identified by three methods: A) the Indigenous Status Flag (ISF, derived by the WA Data Linkage Branch using a multistage-median approach) for the children alone; B) the ISF of the children, their parents and grandparents; and C) Indigenous status of the child, mother or father on either of the child's perinatal records (Midwives or birth registration), to determine differing characteristics of each cohort.
Method B established a larger cohort (33,489) than Method C (33,306) and Method A (27,279), with all methods identifying a core group of 26,790 children (80-98%). Compared with children identified by Method A, additional children identified by Methods B or C, were from less-disadvantaged and more urban areas, and had better perinatal outcomes (e.g. lower proportions of small-for-gestational age, 10% vs 16%). Differences in demographics and health outcomes between Methods C and B were minimal.
Demographic and perinatal health characteristics differ by Aboriginal identification method. Using perinatal records or the ISF of parents and grandparents (in addition to the ISF of the child) appear to be more inclusive methods for identifying young Indigenous children in administrative datasets.
Aboriginal health, identification, data linkage, Indigenous, child, methodology.
Cite this as: J. Leftwich, J. Barnett, K. Muncer, R. Shepherd, M. M. Raats, M. Hazel Gowland and J. S. Lucas, Clinical & Experimental Allergy, 2011 (41) 243–249.
Summary
Cite this as: J. Leftwich, J. ...Barnett,K. Muncer, R. Shepherd,M. M. Raats, M. Hazel Gowland and J. S. Lucas, Clinical & Experimental Allergy, 2011 (41) 243–249.
Background
For individuals with a nut allergy, the avoidance of allergens is particularly challenging in situations where they are not preparing their own food. Many allergic reactions occur when eating outside the home.
Objective
To identify and explore the challenges faced by nut‐allergic individuals (NAIs) when they are eating in restaurants and other eating establishments.
Methods
A qualitative interview study was conducted with 32 adults with a clinical history of allergy to peanuts and/or tree nuts.
Results
The main strategies that participants adopted to manage the risk of allergic reactions when eating outside the home were avoidance and communication. They avoided types of restaurants, meal courses or particular foods. Seeking familiarity was a key strategy that enabled NAIs to reduce uncertainty and anxiety. Language differences were a major barrier to confident communication about food content. The need to check whether the food on offer may contain nuts was a source of social embarrassment for many participants and the desire to avoid this sometimes led to increased risk taking. Some did not disclose their allergy to restaurant staff as they feared a conservative reaction that would further constrain food choices. NAIs often have to plan where to eat out. The consequent lack of spontaneity was a source of regret to some.
Conclusion and Clinical Relevance
Communication patterns of nut‐allergic adults are often grounded in legitimate everyday social considerations around embarrassment, choice and spontaneity. Education and training strategies are needed that recognize and take account of this. Focusing on communication deficits of NAIs may be unhelpful; responsibility for food safety must be shared with the food industry.
The past decade has seen human leukocyte antigen (HLA) typing emerge as a remarkably popular test for the diagnostic work‐up of coeliac disease with high patient acceptance. Although limited in its ...positive predictive value for coeliac disease, the strong disease association with specific HLA genes imparts exceptional negative predictive value to HLA typing, enabling a negative result to exclude coeliac disease confidently. In response to mounting evidence that the clinical use and interpretation of HLA typing often deviates from best practice, this article outlines an evidence‐based approach to guide clinically appropriate use of HLA typing, and establishes a reporting template for pathology providers to improve communication of results.
Vertical coupling in the low‐latitude atmosphere‐ionosphere system driven by the 2‐day wave in the tropical MLT region has been investigated. The problem is studied from an observational point of ...view. Three different types of data were analyzed in order to detect and extract the 2‐day wave signals. The 2‐day wave event during the period from 1 December 2002 to 28 February 2003 was identified in the neutral winds by radar measurements located at four tropical stations. The 2‐day variations in the ionospheric electric currents (registered by perturbations in the geomagnetic field) and in the F‐region electron densities were detected in the data from 23 magnetometer and seven ionosonde stations situated at low latitudes. Two features for each kind of wave were investigated in detail: the variation with time of the wave amplitude and the zonal wave number. The results show that the westward propagating global 2‐day wave with zonal wave number 2 seen in the ionospheric currents and in F‐region plasma is forced by the simultaneous 2‐day wave activity in the MLT region. The main forcing agent in this atmosphere‐ionosphere coupling seems to be the modulated tides, particularly the semidiurnal tide. This tide has a larger vertical wavelength than the diurnal tide and propagates well into the thermosphere. The parameter that appears to be affected, and thus drives the observed 2‐day wave response of the ionosphere, is the dynamo electric field.
Summary
Background
Preliminary data have suggested that interleukin‐2 receptor blockade with basiliximab may increase steroid sensitivity. We have previously reported a small case series ...demonstrating the potential of basiliximab as a novel agent for the treatment of steroid‐resistant ulcerative colitis.
Aim
To report further experience of the efficacy and safety of treatment with the interleukin‐2 receptor blocking monoclonal antibody basiliximab, in addition to steroids, for the treatment of severe and moderate steroid‐resistant ulcerative colitis.
Methods
Twenty patients were enrolled – 13 patients with moderate steroid‐resistant ulcerative colitis (Ulcerative Colitis Symptom Score: ≥6) and seven patients with severe steroid‐resistant ulcerative colitis. All were given a single dose of 40 mg basiliximab plus standard steroid therapy in an open‐label, uncontrolled trial. Primary end point was clinical remission within 8 weeks (Ulcerative Colitis Symptom Score: ≤2).
Results
Within 8 weeks, 10 of 20 (50%) patients achieved clinical remission (seven of 13 moderate, and three of seven severe). At 24 weeks, 13 of 20 (65%) patients were in clinical remission. Five patients required colectomy (four severe, one moderate ulcerative colitis) and one required rescue ciclosporin (moderate ulcerative colitis). Two patients developed herpes zoster, but treatment was generally well tolerated.
Conclusions
Basiliximab appears to promote prolonged remission after a single treatment. Taken in combination with previously reported data, basiliximab shows particular promise in moderate steroid‐resistant ulcerative colitis.
The performance of the GlueX Forward Calorimeter was studied using a small version of the detector and a variable energy electron beam derived from the Hall B tagger at Jefferson Lab. For electron ...energies from 110MeV to 260MeV, which are near the lower-limits of the design sensitivity, the fractional energy resolution was measured to range from 20% to 14%, which meets the design goals. The use of custom 250MHz flash ADCs for readout allowed precise measurements of signal arrival times. The detector achieved timing resolutions of 0.38ns for a single 100mV pulse, which will allow timing discrimination of photon beam bunches and out-of-time background during the operation of the GlueX detector.
•A beam test was conducted for a miniature of the GlueX Forward Calorimeter.•The energy resolution at low energies was found to be consistent with design goals.•The timing resolution of the incidence of events was measured with flash ADCs.•The timing resolution was confirmed to be adequate for discriminating beam bunches.
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