Background: Due to the low incidence of pancreatic adenocarcinoma (PC) in the general population, surveillance for this disease is reserved to those patients from PC-prone families in whom there is an increased prevalence of PC.Endoscopic Ultrasound (EUS) is currently used to screen these high risk patients and has detected resectable PC and pre-malignant pancreatic cysts in a minority (4-23%) of patients.SOMAmers are a unique class of DNA aptamers that bind their protein targets with high selectivity.We have reported that a plasma SOMApanel consisting of 10 SOMAmers and a risk score algorithm can detect resectable PC in a multi-center case-control study with an AUC of 0.91 for training and 0.90 in independent validation.The aim of this study was to apply this SOMApanel to a high risk familial cohort and compare the results to EUS findings to determine its value in predicting the need for EUS.Methods: A blinded set of plasma samples from 67 asymptomatic individuals from kindreds consisting of 22 known carriers of mutations associated with an increased risk of PC and 50 from families with two or more cases of PC were analyzed with the SOMApanel and CA 19-9.SOMApanel scores were classified into 3 risk categories: low, high or PC.EUS was determined as needed if a patient had at least one pancreatic cyst > 1 cm or a PC.Results: Eleven patients met the SOMApanel criteria for a needed EUS.Four of 67 patients on EUS had a cyst > 1 cm or a PC.The panel correctly classified three patients and misclassified 8 patients with cysts < 1 cm or an unremarkable pancreas exam by EUS.Of the 3 patients correctly classified as needing an EUS, one patient had a 2.6 cm cyst and was found to have metastatic PC on laparotomy 6 months later; one patient who had several cysts with the largest 1.1 cm was found on subsequent exam six months later to have a 7 mm PC not arising from a cyst; and a patient with a 1.3 cm cyst who is still under surveillance.The algorithm correctly identified 56/64 (88%) of the low risk patients.A low risk score was correctly assigned to a patient with a 2.4 cm cyst in the setting of an APC mutation who elected to undergo resection and was found to have a benign microcystadenoma.No PC or high-risk cyst patients had an elevated CA19-9 (>40 U/ml) and one patient with a normal pancreas had a CA19-9 level of >300 U/ml.Conclusion: The 10 marker SOMApanel appears quite promising in predicting the need for EUS with an overall accuracy of 88%.Importantly the 3 patients with a cyst > 1 cm or a PC who required EUS were identified.The SOMApanel followed by EUS improved the PPV of EUS alone from 3/67 (4%) to 3/11 (27%) resulting in 56 patients avoiding this invasive and costly procedure.CA 19-9 levels were not useful in this setting.Further studies are warranted to validate and expand on these findings.

Much has been written on the devasting effects of the 2004 tsunami in general but no report has reviewed the epidemiological data concerning major psychiatric disorders in Thai survivors. Therefore, this article aims to review the prevalence of tsunami-related mental disorders, especially posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). The data came from searching PUBMED and unindexed journals, and also from contacting researchers or authors. The prevalence of PTSD and PTSD symptoms varied from 6.3% to 13% while the prevalence of MDD and depressive symptoms varied from 1.1% to 30%. The rate of PTSD in affected students in two schools was 57.3% at 6 weeks but decreased to 7.6% at 2 years after the disaster. The rate of PTSD in children and PTSD symptoms in adults decreased over time, while MDD in children did not, and the depressive symptoms in adults showed a modest decrease at 9 months of follow-up. It is rather difficult to compare data from these reports as methodologies and reference sources of population from these studies were quite different. Therefore, further research on this topic, including protective factors, has been recommended.

increased numbers of both DCAMKL-1 (3.1 fold, p<0.001) and CD24 (2.1 fold, p<0.01) positive cells.Pericryptal myofibroblasts were also found in greater abundance in bak-null compared with C57BL/6 colonic mucosa.No differences in crypt length, proliferation, DCAMKL-1, CD24 or α-SMA abundance were shown in the small intestinal epithelia of bak-null mice, consistent with the previous lack of small intestinal phenotype described in these animals.Conclusions: Bak plays a role in regulating epithelial cell dynamics in the murine colon, but not the small intestine.Deletion of bak appears to alter the composition of the colonic stem cell niche.This may be responsible for development of the observed phenotype in these animals of crypt hyperplasia and altered epithelial differentiation.Deletion of bak may also have similar effects in colorectal cancer stem cells, thus contributing towards tumour development.

Our research is focused on developing an ecoinformatics platform to support climate change adaptation in Victoria. A multi-disciplinary, cross-organisational approach was taken in developing a platform of collaboration to support the understanding of climate change impact and the formulation of adaptation strategies.The platform comprises a number of components including: (i) a metadata discovery tool to support modelling, (ii) a workflow framework for connecting climate change models, (iii) geographical visualisation tools for communicating landscape and farm impacts, (iv) a landscape object library for storing and sharing digital objects, (v) a landscape constructor tool to support participatory decision-making, and (vi) an online collaboration space for supporting multi-disciplinary research and cross-organisational collaboration.In this paper we present the platform as it has been developed to support collaborative research and to inform stakeholders of the likely impacts of climate change in southwest Victoria, Australia. We discuss some of the drivers for research in developing the ecoinformatics platform and its components. We conclude by identifying some future research directions in better connecting researchers and communicating scientific outcomes in the context of climate change impact and adaptation. Crown Copyright (C) 2011 Published by Elsevier B.V. All rights reserved.

The acceptance and use of either surrogate end points (SEPs) or efficient clinical end points are associated with greater and more rapid availability of new medicines as compared with disease situations for which clinical end points are inefficient or no surrogates exist. This review of the history of the development, qualification, and acceptance of key SEPs shows that both successes and failures had three key characteristics: (i) apparent biologic plausibility, (ii) prognostic value for the outcome of the disease, and (iii) an association between changes in the SEP and changes in outcome with therapeutic intervention-the three factors recommended for SEPs in the International Conference on Harmonisation's "Statistical Principles for Clinical Trials." We recommend that only prognostic value be an absolute prerequisite for surrogacy, because therapeutic interventions may not exist a priori, and biological plausibility can be subjective. Ideally, all three of these factors would be traded off against one another in a consistent and transparent risk-management process.