The development and initial evaluation of the Diarrhoea Management Diary (DMD) in patients with metastatic breast cancer

Purpose Chemotherapy-induced diarrhoea (CID) is a common, but often underreported problem in patients with breast cancer that has a profound effect on quality of life. It is best measured from a patient’s perspective, but tools are limited. The aim of this study was to develop and evaluate the Diarrhoea Management Diary (DMD), a self-report measure to assess CID, use of self-management strategies and treatment adherence. Methods The DMD was constructed using an iterative process of instrument development: concept elicitation (literature review), item generation and reduction (cognitive debriefing), and pilot testing in the target population. After translation into eight languages, the DMD was used in an international randomised trial for women receiving lapatinib and capecitabine for metastatic breast cancer with or without prophylactic octreotide. Patterns of missing data and sensitivity to change were examined. Results The understandability and completeness of the 8-item DMD was confirmed in cognitive interviews and pilot testing. Practicability of the DMD was evaluated in 62 women with metastatic breast cancer (median age 57). Up to 68% reported CID at any given time-point, and 19% had diarrhoea at each time-point. Patients also described efficacy of different strategies for diarrhoea management. Missing data were associated with study discontinuation. DMD missing item response was 0.9%. Sensitivity to change was good at most assessment points. Conclusions Although further psychometric testing is recommended, initial evaluation of the DMD showed good content validity and practicability in international research with cancer patients

Molecular cloning and expression studies of a prolactin receptor in goldfish (Carassius auratus)

A full-length cDNA clone, of a size of 4.6 kb, for the goldfish prolactin receptor has been isolated. This cDNA clone encodes a protein of 600 amino acids homologous to prolactin receptors of other species. A Kyte- Doolittle hydropathy analysis of the receptor indicates that the translated protein consists of a signal peptide of 22 amino acids, an extracellular domain of 228 amino acids, a single transmembrane domain of 24 amino acids, and an intracellular domain of 346 amino acids. Several characteristic landmarks of prolactin receptor could be identified in this clone. These include the four conserved cysteine residues and the WS motif within the extracellular domain, and the box 1 and box 2 regions of the intracellular domain. Among all the prolactin receptor sequences known to date, this clone bears the closest resemblance to the tilapia prolactin receptor, although homology between these two fish prolactin receptors is rather low. There are only 57.4% of nucleotide and 48.3% of amino acid sequence identities between these two fish receptors. This receptor cDNA was transfected into CHO-K1 cells for functional analysis. RT-PCR analysis with a pair of gene specific primers indicate that the receptor was transcribed in the transfected cells. Using a cell proliferation assay based on the reduction of the tetrazolium salt 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide, the receptor transfected CHO-K1 cells can be stimulated to proliferate upon the addition of ovine prolactin in the culture medium. The tissue distribution of the prolactin receptor in goldfish was studied by RT-PCR/Southern analysis and by Northern analysis. The results indicated that the receptor is expressed mostly in the kidney, the gill and the intestine of goldfish, corroborating with the osmoregulatory role of prolactin in fish. In addition, an appreciable level of the receptor is also found in the brain and gonads of goldfish. Northern analysis showed that there are two transcript sizes, a major 4.6 kb and a minor 3.5 kb mRNAs, in the kidney, gill and intestine.link_to_subscribed_fulltex

Unusual anterior neck mass visible only during Valsalva's maneuver in a child

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Molecular cloning of a teleost growth hormone receptor and its functional interaction with human growth hormone

This paper reports the first full-length cDNA sequence of a growth hormone receptor (GHR) from a teleost fish and its functional expression in cultured eukaryotic cells. The cDNA sequence, from Carassius auratus (goldfish), encodes a protein of 602 amino acids (aa) akin in architecture to the GHRs of other species. Despite the presence of motifs characteristic of GHR, the overall homology between the goldfish GHR and other GHRs is very low (≈ 40% aa identity). CHO cells transfected with this receptor cDNA can be stimulated to proliferate by human growth hormone (hGH). In addition, the transfected cells can transactivate a co-expressed mammalian serine protease inhibitor (Spi) 2.1 promoter upon stimulation by hGH, indicating the successful interaction of the fish receptor with the mammalian ligand to evoke the down-stream post-receptor events. Tissue distribution studies indicated that the receptor is mostly expressed in the liver and hypothalamus of goldfish. A single mRNA transcript of a size of about 4 kb was found in the goldfish liver. © 2001 Elsevier Science B.V.link_to_subscribed_fulltex

Strain hardening behaviour of polyethylene fibre reinforced ambient air cured geopolymer composite

This paper presents experimental investigation on strain hardening and deflection hardening behaviour of polyethylene (PE) fibre reinforced ambient air cured geopolymer composite. Comparison is also made with its counterpart ordinary Portland cement (OPC) based composite. The effect of different volume fractions of PE fibre on compressive strength, strain hardening and deflection hardening behaviour of above two composites is evaluated and a critical volume fraction of PE fibre for strain hardening and multiple cracking behaviour is identified. Results show that ambient air cured geopolymer composites exhibited better strain hardening, deflection hardening and multiple cracking behaviour than its counterpart OPC based composite containing same volume fraction of PE fibre. Compressive strength of OPC composite is higher than that of geopolymer composite. PF fibre volume fraction of 0.75–1.0% exhibited optimum fibre content for strain and deflection hardening behaviour of both composites