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Serial sampling of st2 predicts 90-day mortality following destabilized heart failure

Journal of Cardiac Failure Vol. 14 No. 9 2008 Serial Sampling of ST2 Predicts 90-Day Mortality Following Destabilized Heart Failure SASKIA BOISOT, MD,JENNIFER BEEDE, SUSAN ISAKSON, BS,ALBERT CHIU, BS,PAUL CLOPTON, JAMES JANUZZI, MD,ALAN S. MAISEL, AND ROBERT L. FITZGERALD, PhD, San Diego, California; Boston, Massachusetts Background: To prospectively determine the prognostic utility of serial sampling of the interleukin-1receptor family member, ST2, for predicting 90-day mortality in patients with heart failure (HF) admittedto a Veteran Affairs Medical Center.Methods and Results: A total 150 patients hospitalized with acutely destabilized HF were followed atthe Veteran Affairs Healthcare System in San Diego, CA. Multiple cardiac-related parameters were mea-sured including ST2, B-type natriuretic peptide (BNP), NT-proBNP, and blood urea nitrogen (BUN).Plasma samples were collected at 6 time points between admission and discharge. Biomarker concentra-tions were correlated to survival at 90 days. Uni- and multivariate analyses were used to identify prognos-tic variables. From admission to discharge, percent change in ST2 was strongly predictive of 90-daymortality: those patients whose ST2 values decreased by 15.5% or more during the study period hada 7% chance of death, whereas patients whose ST2 levels failed to decrease by 15.5% in this time intervalhad a 33% chance of dying.Conclusions: Percent change in ST2 concentrations during acute HF treatment is predictive of 90-daymortality and was independent of BNP or NT-proBNP levels. ST2 may provide clinicians with an addi-tional tool for guiding treatment in patients with acute destabilized HF. (J Cardiac Fail 2008;14:732e738)Key Words: ST2, B-type natriuretic peptide, Pro-B-type natriuretic peptide, heart failure.

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Vol. 24, No. 21 Oct. 31, 2007 Good for Generics New guidelines on determining obviousness issued by the U.S. INSIDE THIS ISSUE Patent and Trademark Office (PTO) earlier this month might make itharder for brand companies to obtain and defend pharmaceutical Patents: GSK sues PTO patents, one legal expert says.


Duration of urination does not change with body sizePatricia J. Yanga, Jonathan Phama, Jerome Chooa, and David L. Hua,b,1 Schools of aMechanical Engineering and bBiology, Georgia Institute of Technology, Atlanta, GA 30332 Edited by David A. Weitz, Harvard University, Cambridge, MA, and approved May 14, 2014 (received for review February 6, 2014) Many urological studies rely on models of animals, such as rats and


L1/L7: Steckbrief Steckbrief von PASCAL Wohnort: Eltern: wohnt mit Mutter Aussehen: gross für sein Alter, etwas pummelig, muskulös (S. 62), schwarze Hautfarbe Eigenschaften: eher ruhig, wehrt sich kaum (S.47), introvertiert (S. 82), verschlossen (S. 89), zu faul für regelmässigen Sport, streitet nicht gerne (S.100), hat Angst vor Hunden (S. 102)


dans le traitement des Maladies InflammatoiresChroniques de l'Intestin • Maladie de Crohn • Rectocolite Hémorragique l'effet est obtenu, on diminue peu à peu la dose, en faisant des "paliers" de 10 Cette fiche rédigée en 2005 par ou 5 mg, chaque semaine. Il ne faut pas interrompre un traitement corticoïde les gastro-entérologues spécialistes du GETAID


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Green Tea, the "Asian Paradox,"and Cardiovascular Disease Bauer E Sumpio, MD, PhD, FACS, Alfredo C Cordova, MD, David W Berke-Schlessel, BS, Feng Qin, MD,Quan Hai Chen, MD Archeologic findings have revealed that infusions of 75% to 80%of the 140 million cups of tea consumed leaves from various wild plants, including the tea plant, might have been consumed for more than 500,000


NIH Public AccessAuthor ManuscriptBrain Res. Author manuscript; available in PMC 2013 August 01. NIH-PA Author Manuscript Published in final edited form as: Brain Res. 2013 June 13; 1514: 12–17. doi:10.1016/j.brainres.2013.04.011. Rationale and Design of the Kronos Early Estrogen Prevention Study (KEEPS) and the KEEPS Cognitive and Affective Sub

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2639 S. La Cienega Blvd Los Angeles, CA 90034 (310) 204-6010 Fax (310) 204-0891 President's Council on Bioethics September 12, 2008 Arlington, Virginia Testimony of Susan Berke Fogel, J.D. National Health Law Program Good morning. Thank you Dr. Pelegrino and Council members for the opportunity to offer comment this morning on the impact of refusal clauses and institutional restrictions in the delivery of health care services. I am Susan Berke Fogel, J.D. I am an attorney with the National Health Law Program, a national public interest law firm that seeks to improve health care for America's working and unemployed poor, minorities, the elderly and people with disabilities. NHeLP serves legal services programs, community-based organizations, policymakers, the private bar, providers and individuals who work to preserve a health care safety net for the millions of uninsured or underinsured low-income people. We approach refusal clauses and denials of care from this quality and access perspective. We also understand that low-income women and other marginalized populations experience greater health disparities that are exacerbated by restrictions on care. The basic principles of modern health care delivery are evidence-based practice, patient centeredness, and prevention, collectively ensuring quality care. Failure to adhere to prevailing "standards of care" harms the individual patient in real and concrete ways, undermines the medical system, and jeopardizes the health of the general public. These principles may be compromised by a range of structural factors such as lack of insurance, restricted geographic access, cost, language barriers, and immigration status. We are hoping that current political movements will be successful in promoting strategies to address these structural barriers to quality of care. At the same time, health care refusals and denials of care are proliferating in the U.S. based on personal religious and moral beliefs that have nothing to do with scientific evidence, good medical practice or the needs of the patient. These restrictions and denials of care, which most often are related to reproductive health and disproportionately affect women, should be scrutinized to assess their impact on quality health care and redressed when they fall below the standard of care. Analyses of health care denials traditionally construct the issue as a conflict of rights within the provider-patient relationship: the health care provider's right to exercise individual conscience


Annu. Rev. Genet. 2002. 36:153–73 ° 2002 by Annual Reviews. All rights reserved STUDYING GENE FUNCTION IN EUKARYOTES BYCONDITIONAL GENE INACTIVATION Manfred Gossen1 and Hermann Bujard2 1Max Delbr¨uck Centrum, Robert-R¨ossle-Strasse 10, D-13125 Berlin, Germany;e-mail: [email protected]; 2ZMBH, Universit¨at Heidelberg, Im NeuenheimerFeld 282, D-69120 Heidelberg, Germany; e-mail: [email protected]


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Das 5. Buch Mose oder TitelDer Titel »Deuteronomium« entstammt einem Übersetzungsfehler des Ausdrucks »Abschrift dieses Gesetzes« in 17,18 aus der gr. Septuaginta (LXX), wo sich die Übersetzung »zweites Gesetz« findet, was in der lateinischen Version (Vulgata) mit Deuteronomium wiedergegeben wurde. Der hebr. Titel des Buches lautet übersetzt: »Dies sind die Worte« und leitet sich von den beiden ersten hebr. Worten des Buches ab. Der hebr. Titel liefert eine bessere Beschreibung des Buches, da es nicht ein »zweites Gesetz« ist, sondern vielmehr eine Aufzeichnung der erklärenden Worte Moses über das Gesetz. Deuteronomium vervollständigt die fünfteilige literarische Einheit, die Pentateuch genannt wird.


Specialists In Reproductive Medicine & Surgery, P.A. www.DreamABaby.com • [email protected] Excellence, Experience & Ethics Gestational Surrogacy Price List (2016) We here at Specialists in Reproductive Medicine & Surgery, P.A., (SRMS) want to offer you a "Dreamy" option that will make it easier for you to achieve your goals of building your family. We call it our "Dream Discount Plus Program" offering 20%/30%/40%/50% off of our 2014 prices for nearly all of your Assisted Reproductive Technology (ART) procedures! Below is a breakdown of the estimated self-pay costs of our Gestational Surrogacy procedure under our new "Dream Discount Plus Program:" ART Procedures


Boron Compounds in the Breast Cancer Cells Chemoprevention and Chemotherapy Ion Romulus Scorei Biochemistry Department, University of Craiova, Craiova, Dolj, 1. Introduction Various biological functions of Boron (B) compounds are known (Blevins & Lukaszewski, 1994; Tariq & Mott, 2007; Nielsen, 2008). Boron is found in nuts, vegetables, dried/fresh fruits and red wine (Brown & Shelp, 1997). Boron is also present in bacterial antibiotics, such as tartrolon, borophycin, boromycin and aplasmomycin (Rezanka & Sigler, 2008); in the bacterial quorum sensing molecule auto-inducer AI-2 (Bemd et al., 2002); and in vibrioferrin, a B-containing siderophore produced by particular marine bacteria (Shady et al., 2007). In plants, the rigidity of the cell wall depends on the rhamnogalacturonan II complex (RG-II) formation, a pectic polysaccharide covalently linked by cis-diol bonds to apiosil residues of borate-esters (Ishii & Matsunaga, 1996, 2001). Several articles have provided information about transporters responsible for efficient B uptake by roots, xylem loading and B distribution among leaves. The transporters are required under B limitation for efficient acquisition and utilisation of B. Two types of transporters are involved in these processes: NIPs (nodulin-26-like intrinsic proteins) for boric acid channels and boron exporters encoded by BOR1 (Miwa & Fujiwara, 2010). The expression of the genes encoding these transporters has been shown to be finely regulated in the B availability response to ensure tissue B homeostasis. Furthermore, the tolerance of plants to the stress produced by low B or high B in the environment can be generated by altering the expression of these transporters (Tanaka & Fujiwara, 2007). All of these transporters are involved in boron transport regulation in plants. B is an essential element not only for vascular plants but also for diatoms, cyanobacteria and a number of marine algal flagellate species (Rezanka & Sigler, 2008). Recently, ATR1 has been found to be responsible for the high B tolerance in S. Cerevisiae. ATR1 encodes a multidrug resistance transporter and it is widely distributed in bacteria, archaea and lower eukaryotes (Miwa & Fujiwara, 2010). Animals such as zebra, fish, trout and frogs also require boron (Rowe & Eckert, 1999; Fort et al., 1999). Borate ions activate the mitogen-activated protein kinases pathway and stimulate the growth and the proliferation of human embryonic kidney 293 cells (Park et al., 2005). The B-transporter, NaBCl, controls plasma borate levels in human kidney cells (Park at al., 2004). The fact that B has such a broad range of physiological functions is not surprising. The electron structure of B and its position in the periodic table (adjacent to carbon) make B-containing molecules electrophilic with the trigonal

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Fact sheet  BT Wholesale American Share Fund ARSN: 087 594 509 About the Fund Performance The BT Wholesale American Share Fund (Fund) is an actively managed portfolio of North American shares. The Fund invests primarily in United States and Canadian shares. The Fund may also hold cash and may use derivatives.


Biochimica et Biophysica Acta 1628 (2003) 111 – 122 Characterization of ciprofloxacin binding to the linear single- and double-stranded DNA Igor D. Vilfana,b,1, Petra Drevensˇeka, Iztok Turela, Natasˇa Poklar Ulriha,c,* a Faculty of Chemistry and Chemical Technology, University of Ljubljana, Asˇkercˇeva 5, 1000 Ljubljana, Slovenia b School of Chemistry and Biochemistry, Georgia Institute of Technology, Atlanta, GA 30332-0400, USA

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Smoking Cessation in New York State August 2006 New York State Department of Health Corning Tower, Room 710 Albany, NY 12237-0676 Matthew Farrelly James Nonnemaker Mark Engelen Joanne Pais RTI International* 3040 Cornwallis Road Research Triangle Park, NC 27709


500ze MACHINE SPECIFICATIONS* CONSERVE NATURAL RESOURCES AND YOUR BUDGET • 8 hours full operation per charge CloudMaker benefi ts the environment by using up • Virtually silent in transit Cleaning path: minimum (brushes in) to 70% less water than traditional sweeper dust Maximum (brushes fully extended) • Zero CO and engine emissions control technologies. It reduces costs by eliminating


La combinación de fármacos en la artrosis: una realidad terapéutica. EDITORIAL LITERATURA INTERNACIONAL Ctra. Nacional II. km 680,608389 Palafolls (Barcelona) – EspañaTel. 93 490 49 08 Fax 93 490 97 11 • Eficacia de la combinación de hidrocloruro de glucosamina, condroitín sulfato sódico de bajo peso molecular y ascorbato de manganeso en el tratamiento de la artrosis de rodilla


www.usfitnesstrends.com Fachinformation zu Weight Gainer Konzentraten / Pulver, professioneller Ernährung im Krafttraining, Bodybuilding, Kraftaufbau, Fettabbau, Fettreduktion und Masseaufbau: Weight Gainer Konzentrate/Pulver 500 Kalorien…, 900 Kalorien…, 1300 Kalorien…, 3500 Kalorien…, wer bietet mehr? Der Wettbewerb unter den Weight Gainer Präparaten ist voll entbrannt. Gesucht wird die höchste Kalorienzahl pro Portionsgrösse. Lang ist es her, als Mitte der Siebziger Jahre mit Joe Weider s legendärem Crash Weight Gain No. 7 der erste sogenannte Weight Gainer auf den Kraftsport- und Budybuildingmarkt geworfen wurde. War das Pulverkonzentrat damals noch in drei kg schweren Büchsen abgepackt, so verwendet man/frau heute Plastikbecher oder Beutel von der Grösse Damentasche. Auch die Portionsgrössen haben sich etwas verändert. Der Esslöffel, ehemals Messstab für die Abmessung einer Einzelration, hat ausgedient und wurde durch die Kutterschaufel ersetzt. Denn anders ist es nicht möglich, die vom Hersteller/Verkäufer angegebene, teilweise immensen Kalorienzahlen pro Portion zusammen zu kriegen. So muss der/die Athlet/in z.B. bei einem populärem Weight Gainer mehr als 400 Gramm Pulver (über 10 gehäufte Esslöffel) mit einem halben Liter Vollmilch verrühren, damit die auf dem Etikett ausgewiesenen 2000 kcal pro Shake überhaupt möglich sind. Um nicht falsch verstanden zu werden, Weight Gainer können vielen Kraft- und Ausdauersportlern hilfreiche Zusatzpräparate sein, wie nachfolgend noch ausführlich erörtert wird, nur der eingangs erwähnte Kampf um die höchste Kalorienzahl ist nicht mehr als ein billiger Werbetrick. Eine einfache Rechnung genügt, um zu erkennen, dass die Menge der Kalorien pro Einnahme lediglich dadurch nach oben getrieben wird, dass sich die Portionengrösse erhöht. Das Etikett vieler Weight Gainer verrät nämlich, dass die Kalorienzahl pro 100 Gramm Pulverkonzentrat bei allen Produkten nahezu gleich ist. Da die meisten Weight Gainer kein oder nur sehr wenig Fett enthalten, kann der Brennwert nicht höher als 400 kcal je 100 Gramm Pulver liegen. Sowohl Protein als auch Kohlenhydrate besitzen praktisch die gleiche kcal pro Gramm, nämlich 4,1 kcal. Egal in welchem Verhältnis Protein und Kohlenhydrate in Ihrem Weight Gainer Präparat vorliegen, mehr als 100g dieser beiden Nährstoffe können 100 Gramm Pulver nun einmal nicht beigemischt werden. Multipliziert man das 100 Gramm schwere Protein/Kohlenhydrat Gemisch mit dem Brennwert von 4,1 Kalorien/Gramm, so ergeben sich die angesprochenen 400 Kalorien. Selbst durch die Zugabe einiger Gramm MCT-Öls auf Kosten des Protein-Kohlenhydrat-Gehaltes steigt der Kaloriengehalt pro 100 Gramm nicht signifikant an. Vollmundige Behauptungen wie 2000 Kalorien pro Portion bedeutet in der Praxis, fast ein halbes Kilogramm Pulverkonzentrat in sich hineinzuschaufeln. Die Kalorienzahl kann deshalb für die Auswahl eines guten Weight Gainers nicht als Kriterium herangezogen werden.


For Prostate Health Anatomy of Male Reproductive System  The prostate (from Greek- prostates, literally "one who stands before", "protector", "guardian") is an exocrine gland (secrete their products into ducts that lead directly into the external environment) of the male reproductive system in most mammals.

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Antidepressants - TCAs, MAOIs, SSRIs & SNRIs First generation antidepressants The discovery of antidepressants could be described as a ‘lucky accident'. During the 1950s, while carrying out trials on a new medication for tuberculosis (TB), researchers noticed that the medication also had a mood improving effect. This initial discovery led to the creation of two classes of first generation antidepressants:


Eur Child Adolesc Psychiatry (2011) 20:127–135 Open-label study comparing the efficacy and tolerabilityof aripiprazole and haloperidol in the treatmentof pediatric tic disorders Hanik K. Yoo • Joong-Sun Lee • Kyoung-Won Paik •Soon-Ho Choi • Sujung J. Yoon • Jieun E. Kim •Jin Pyo Hong Received: 29 March 2010 / Accepted: 15 December 2010 / Published online: 28 December 2010Ó The Author(s) 2010. This article is published with open access at Springerlink.com


Gulf report 4/5/07 09:33 Page 1 a legacy of suspicion Gulf report 4/5/07 09:33 Page 2 Gulf War: a legacy of suspicion "In essence, GWS [Gulf War Syndrome] merely is a convenient descriptive term thatdescribes a phenomenon: GWV [Gulf War veterans] reporting suffering from medicallyunexplained health related symptoms. In the sense, it shares much with the other medicallyunexplained syndromes encountered in practice. The real debate surrounding medicallyunexplained conditions is not whether or not they exist, but defining their cause. In thisregard, investigators fall into two camps. One camp insists that the conditions are causedby a yet-to-be-discovered medical problem, rejecting out of hand the possibility of apsychologic origin. The other camp insists the conditions are fundamentally psychogenic,rejecting the possibility of an undiscovered medical condition. The evidence shows,however, that the conditions exist, the suffering is real, and the causes are unknown."(Gronseth, 2005)


Prof. Dr. Ursula Rudnick Die Geschichte des Buches Esther spielt im persischen Reich „zu den Zeiten des Ahasveros, der König war vom Indus bis zum Nil über hundertundsiebenundzwanzig Länder" (Est. 1,1) Es handelt sich um einen mächtigen König, den Herrscher über ein großes Reich. Die Orts- und Zeitangaben des Textes sind präzise: sie sollen den Eindruck einer historischen Erzählung erwecken. König Ahasveros - mit seinem griechischen Namen als Xerxes I. bekannt- ist eine historische Person. Er regierte Persien von 486-465/4 v.d.Z.

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Int J Clin Exp Med (2009) 2, 1-16 Original Article Chronic fatigue syndrome and mitochondrial dysfunction Sarah Myhill1, Norman E. Booth2, John McLaren-Howard3 1Sarah Myhil Limited, Llangunl o, Knighton, Powys, Wales LD7 1SL, UK; 2Department of Physics and Mansfield Col ege, University of Oxford, Oxford OX1 3RH, UK; 3Acumen, PO Box 129, Tiverton, Devon EX16 0AJ, UK


Boulder Community Hospital Cancer Program 2012 Community RepoRtRefleCting statistiCal data foR 2011 Table of Conentsa note for the Community primary site Chart Breast Cancer: outcomes and Quality of Care at Boulder Community Hospital/Rocky mountain Cancer Center Community support activities 2012 BCH Cancer services Breast Cancer Center of excel ence giotto: the new dimension in digital mammography

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BETH TIKVAH C H A I L I G H T S PURIM 5776 MARCH 2016 FROM OUR RABBI There is a Jewish expression that says- "With the arrival of the comes to replace another one, until the other one comes back Jewish month of Adar, our happiness is greatly increased!" to replace the new one. And so on, and so on! The reference to "greatly increased happiness" is a reference to The story is told of a new rabbi officiating at his first religiousthe holiday of Purim celebrated on the 14th of Adar.

Hss 250: the social history of mental illness

HSS 250: The Social History of Mental Illness Hans Pols () Taught at the University of Pennsylvania, 1995, 1996 This course will explore the social construction of mental illness throughout American history, from the eighteenth century until the present time. It will consider changing definitions of insanity, as well as conceptions of the sane and normal, changing attitudes towards the mentally ill, and the development of institutional, medical, and cultural responses to the mentally ill. The course will start with the establishment of mental asylums in the 18th and 19th centuries in America as the prime method of dealing with mental illness. The rise of psychiatry as a medical specialty in relation the asylum care will be investigated as well.

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M&A: Using Uncertainty to Your AdvantageA Survey of European Companies' Merger and Acquisition Plans for 2012 André Kronimus, Peter Nowotnik, Alexander Roos, and Sebastian Stange This report was prepared by The Boston Consulting Group on the basis of a survey of corporate executives in Europe conducted jointly with UBS Investment Bank.December 2011


FIRST AID Have label with you when obtaining treatment advice. If swallowed • Call a poison control center, doctor, or 1 -800-222-1222 immediately for treatment advice. • Have person sip a glass of water if able to swallow. • Do not induce vomiting unless told to do so by the poison control center or doctor. If on skin or

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NEDA TOOLKIT for Parents Table of Contents Common myths about eating disorders………………………………………………………………………….6 Eating disorder signs, symptoms and behaviors………………………………………………………….9 Ways to start a discussion with a loved one…………………….………………….………………………13

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NamPower/Namibia Nature Foundation Strategic Partnership Newsletter No. 11: March 2013 IN THIS ISSUE Editorial: Progress with projects and update of our action plan . 1 Flamingos tracked by satellite to identify "hotspots" for conservation action .2 How do wetland birds find ephemeral pans so soon, after they fill up after rain? .3 Flamingo flight paths: progress with ground tracking .4 NamPower weaver birds project .5 Provisional feedback on our wildlife and power line incident database .7 Osprey mortality on Namdeb line .8 Other power line incidents/surveys .9 PROGRESS WITH PROJECTS AND UPDATE OF OUR ACTION PLAN


A REPORT FROM THE AMERICAN ACADEMY OF MICROBIOLOGY MYCOBACTERIUM AVIUM Infrequent Human Pathogen or Public Health Threat? A REPORT FROM THE AMERICAN ACADEMY OF MICROBIOLOGY MYCOBACTERIUM AVIUM PARATUBERCULOSIS: Infrequent Human Pathogen or Public Health Threat? BY CAROL NACY, PH.D., AND MERRY BUCKLEY, PH.D. This report is based on a colloquium, sponsored by the American Academy of Microbiology, convened June 15-17, 2007, in Salem, Massachusetts.


Original Investigation ASSOCIATION OF VA SURGEONS Effect of a Preoperative Decontamination Protocol onSurgical Site Infections in Patients Undergoing ElectiveOrthopedic Surgery With Hardware Implantation Serge P. Bebko, MD; David M. Green, MD; Samir S. Awad, MD, MPH IMPORTANCE Surgical site infections (SSIs), commonly caused by methicillin-resistantStaphylococcus aureus (MRSA), are associated with significant morbidity and mortality,specifically when hardware is implanted in the patient. Previously, we have demonstratedthat a preoperative decontamination protocol using chlorhexidine gluconate washcloths andintranasal antiseptic ointment is effective in eradicating MRSA in the nose and on the skin ofpatients.


The Three ‘Cs' of Biomarker DevelopmentDr Elizabeth Foot, CEO of London Genetics, argues that biomarker-driven drug development is the only way for biopharmaceutical companies to survive the changing face of healthcare, and outlines the three essentials for the successful development of targeted drugs. Comments are based on a paper given at the BioStorage Technologies first annual Global Sample Management Benchmarking Symposium, Germany, September 15 2010.


EMCDDA–Europol Joint Report on a new psychoactive substance: MDPV (3,4-methylenedioxypyrovalerone) In accordance with Article 5 of Council Decision 2005/387/JHA on the information exchange, risk assessment and control of new psychoactive substances About this seriesEMCDDA–Europol Joint Report publications examine the detailed information provided by the EU Member States on individual new psychoactive substances. Information is collected from the Reitox network, the Europol national units and the national competent authorities of the European Medicines Agency.Each Joint Report serves as the basis upon which the decision to conduct a risk assessment of the new psychoactive substance is taken. It is part of the three-step procedure involving information exchange, risk assessment and decision-making in the framework of the Council Decision 2005/387/JHA.


Expected Ratio of Relevant Units: A Measure for Structured Information Retrieval Benjamin Piwowarski Patrick Gallinari LIP 6, Paris, France LIP 6, Paris, France 1]. The expected search length [4] measures the amount Since the 60's, evaluation has been a key problem for In- of irrelevant documents a user will consult before finding formation Retrieval (IR) systems and has been extensively


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Chapter 2Metastasis and Drug Resistance Dominic Fan, Sun-Jin Kim, Robert L. Langley, and Isaiah J. Fidler Multidrug resistance (MDR) phenotype emerging from chemotherapy is a major problem in managing patients with metastatic cancers. The discovery thata cardiovascular drug, verapamil, can bind to P-glycoprotein and reverse MDR ini-tiated serious research efforts in MDR-reversal by various compounds and modesof pharmacological modifiers. Those include major calcium channel blockers suchas bepridil, diltiazem, felodipine, isradipine, nicardipine, nifedipine and nimodip-ine, verapamil and analogs; calmodulin antagonists; antibiotics and analogs; indolealkaloids; cyclosporins and analogs; hormones and antihormones; pharmaceuticalemulsifying surfactants; liposomal encapsulation; etc. The majority of the studiestargeted one of the MDR mechanisms, P-glycoprotein. These studies have beensuccessful under in vitro and limited in vivo animal conditions; the correlations forclinical trails are still lacking. Therefore, an effective MDR-reversing chemother-apy is not available. It is the purpose of this chapter to review the past and currentexperimental reversal of MDR and, in particular, the importance in targeting drugresistance in relevant cancer metastasis models.

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