Oxycodone for Cancer Pain in Adult Patients

Clinical Question: Is oxycodone associated with greater efficacy and fewer adverse events compared with alternative analgesics for cancer pain? Bottom Line: Oxycodone was not associated with superior cancer pain relief or fewer adverse effects compared with other strong opioids, such as morphine or oxymorphone. However, the quality of the evidence was low. Many patients with cancer experience moderate or severe pain requiring treatment with strong opioids. However, not all opioids are well tolerated by all patients. This JAMA Clinical Evidence Synopsis summarizes a published Cochrane review1 that examined the association of oxycodone (any formulation or route of administration) compared with placebo or an active drug (including alternative forms of oxycodone) for treating cancer pain in adults

Carrier-envelope phase effects on the strong-field photoemission of electrons from metallic nanostructures

Sharp metallic nanotapers irradiated with few-cycle laser pulses are emerging as a source of highly confined coherent electron wavepackets with attosecond duration and strong directivity. The possibility to steer, control or switch such electron wavepackets by light is expected to pave the way towards direct visualization of nanoplasmonic field dynamics and real-time probing of electron motion in solid state nanostructures. Such pulses can be generated by strong-field induced tunneling and acceleration of electrons in the near-field of sharp gold tapers within one half-cycle of the driving laser field. Here, we show the effect of the carrier-envelope phase of the laser field on the generation and motion of strong-field emitted electrons from such tips. This is a step forward towards controlling the coherent electron motion in and around metallic nanostructures on ultrashort length and time scales

(Ga0.71B0.29)PO4 with a high-cristobalite-type structure refined from powder data

Gallium boron phosphate, (Ga0.71B0.29)PO4, was synthesized by a high-temperature solid-state reaction method. The crystal structure is isostructural with the tetra­gonal high-cristobalite structure with space group P which is built from alternating Ga(B)O4 and PO4 tetra­hedra inter­connected by sharing the common O-atom vertices, resulting in a three-dimensional structure with two-dimensional six-membered-ring tunnels running along the a and b axes

A New Method of Probing the Phonon Mechanism in Superconductors including MgB2_{2}

Weak localization has a strong influence on both the normal and superconducting properties of metals. In particular, since weak localization leads to the decoupling of electrons and phonons, the temperature dependence of resistance (i.e., $\lambda_{tr}$) is decreasing with increasing disorder, as manifested by Mooij's empirical rule. In addition, Testardi's universal correlation of $T_{c}$ (i.e., $\lambda$) and the resistance ratio (i.e., $\lambda_{tr}$) follows. This understanding provides a new means to probe the phonon mechanism in superconductors including MgB$_{2}$. The merits of this method are its applicability to any superconductors and its reliability because the McMillan's electron-phonon coupling constant $\lambda$ and $\lambda_{tr}$ change in a broad range, from finite values to zero, due to weak localization. Karkin et al's preliminary data of irradiated MgB$_{2}$ show the Testardi correlation, indicating that the dominant pairing mechanism in MgB$_{2}$ is the phonon-mediated interaction.Comment: 9 pages, latex, 3 figure

Perturbation theory for very long-range potentials

Systems with very long-range interactions (that decay at large distances like $U(r)\sim r^{-l}$ with $l\le d$ where $d$ is the space dimensionality) are difficult to study by conventional statistical mechanics perturbation methods. Examples of these systems are gravitational and charged (non-electroneutral). In this work we propose two alternative methodologies to avoid these difficulties and capture some of the properties of the original potential. The first one consists in expressing the original potential in terms of a finite sum of hard-core Yukawa potentials. In the second one, the potential is rewritten as a damped potential, using a damping function with a parameter that controls the range of the interaction. These new potentials, which mimic the original one, can now be treated by conventional statistical mechanics methods.Comment: 25 pages, 11 figure

The usefulness of rapid diagnostic tests in the new context of low malaria transmission in zanzibar.

BACKGROUND\ud \ud We assessed if histidine-rich-protein-2 (HRP2) based rapid diagnostic test (RDT) remains an efficient tool for Plasmodium falciparum case detection among fever patients in Zanzibar and if primary health care workers continue to adhere to RDT results in the new epidemiological context of low malaria transmission. Further, we evaluated the performance of RDT within the newly adopted integrated management of childhood illness (IMCI) algorithm in Zanzibar.\ud \ud METHODS AND FINDINGS\ud \ud We enrolled 3890 patients aged ≥2 months with uncomplicated febrile illness in this health facility based observational study conducted in 12 primary health care facilities in Zanzibar, between May-July 2010. One patient had an inconclusive RDT result. Overall 121/3889 (3.1%) patients were RDT positive. The highest RDT positivity rate, 32/528 (6.1%), was found in children aged 5-14 years. RDT sensitivity and specificity against PCR was 76.5% (95% CI 69.0-83.9%) and 99.9% (95% CI 99.7-100%), and against blood smear microscopy 78.6% (95% CI 70.8-85.1%) and 99.7% (95% CI 99.6-99.9%), respectively. All RDT positive, but only 3/3768 RDT negative patients received anti-malarial treatment. Adherence to RDT results was thus 3887/3889 (99.9%). RDT performed well in the IMCI algorithm with equally high adherence among children <5 years as compared with other age groups.\ud \ud CONCLUSIONS\ud \ud The sensitivity of HRP-2 based RDT in the hands of health care workers compared with both PCR and microscopy for P. falciparum case detection was relatively low, whereas adherence to test results with anti-malarial treatment was excellent. Moreover, the results provide evidence that RDT can be reliably integrated in IMCI as a tool for improved childhood fever management. However, the relatively low RDT sensitivity highlights the need for improved quality control of RDT use in primary health care facilities, but also for more sensitive point-of-care malaria diagnostic tools in the new epidemiological context of low malaria transmission in Zanzibar.\ud \ud TRIAL REGISTRATION\ud \ud ClinicalTrials.gov NCT01002066

Atmospheric science: the self-cleansing ability of prehistoric air

Isotopic data from an ice core have been used to estimate atmospheric oxidant levels during past climate transitions — pointing to relatively unexplored climate feedbacks as drivers of atmospheric composition

Rapid diagnostic tests for molecular surveillance of Plasmodium falciparum malaria -assessment of DNA extraction methods and field applicability

Background: The need for new malaria surveillance tools and strategies is critical, given improved global malaria control and regional elimination efforts. High quality Plasmodium falciparum DNA can reliably be extracted from malaria rapid diagnostic tests (RDTs). Together with highly sensitive molecular assays, wide scale collection of used RDTs may serve as a modern tool for improved malaria case detection and drug resistance surveillance. However, comparative studies of DNA extraction efficiency from RDTs and the field applicability are lacking. The aim of this study was to compare and evaluate different methods of DNA extraction from RDTs and to test the field applicability for the purpose of molecular epidemiological investigations. Methods: DNA was extracted from two RDT devices (Paracheck-PfW and SD Bioline Malaria Pf/Pan (R)), seeded in vitro with 10-fold dilutions of cultured 3D7 P. falciparum parasites diluted in malaria negative whole blood. The level of P. falciparum detection was determined for each extraction method and RDT device with multiple nested-PCR and real-time PCR assays. The field applicability was tested on 855 paired RDT (Paracheck-Pf) and filter paper (Whatman (R) 3MM) blood samples (734 RDT negative and 121 RDT positive samples) collected from febrile patients in Zanzibar 2010. RDT positive samples were genotyped at four key single nucleotide polymorphisms (SNPs) in pfmdr1 and pfcrt as well as for pfmdr1 copy number, all associated with anti-malarial drug resistance. Results: The P. falciparum DNA detection limit varied with RDT device and extraction method. Chelex-100 extraction performed best for all extraction matrixes. There was no statistically significant difference in PCR detection rates in DNA extracted from RDTs and filter paper field samples. Similarly there were no significant differences in the PCR success rates and genotyping outcomes for the respective SNPs in the 121 RDT positive samples. Conclusions: The results support RDTs as a valuable source of parasite DNA and provide evidence for RDT-DNA extraction for improved malaria case detection, molecular drug resistance surveillance, and RDT quality control.ACT Consortium through Bill and Melinda Gates Foundation; Swedish International Development Agency (SIDA) [SWE 2009-193]; Swedish Civil Contingencies Agency (MSB) [2010-7991]; Swedish Medical Research Council (VR) [2009-3785]; Goljes Foundationinfo:eu-repo/semantics/publishedVersio

Extraskeletal Ewing's Sarcoma of the Hard Palate

Extraskeletal Ewing's sarcoma (EES) is a rare soft tissue tumor morphologically indistinguishable from the more common Ewing's sarcoma of bone. We report a case of EES arising in the hard palate of 34-yr-old male patient. Microscopically, the monotonous small round cells without neuronal differentiation showed membranous positive immunoreactivity for MIC2/CD99 and vimentin. Ultrastructurally, the tumor cells showed a few intracytoplasmic organelles without evidence of neurosecretory granules or neurofilaments. The EWS-FLI1 chimeric gene was identified using the nested reverse transcriptase-polymerase chain reaction