Determining the date of diagnosis – is it a simple matter? The impact of different approaches to dating diagnosis on estimates of delayed care for ovarian cancer in UK primary care

Background Studies of cancer incidence and early management will increasingly draw on routine electronic patient records. However, data may be incomplete or inaccurate. We developed a generalisable strategy for investigating presenting symptoms and delays in diagnosis using ovarian cancer as an example. Methods The General Practice Research Database was used to investigate the time between first report of symptom and diagnosis of 344 women diagnosed with ovarian cancer between 01/06/2002 and 31/05/2008. Effects of possible inaccuracies in dating of diagnosis on the frequencies and timing of the most commonly reported symptoms were investigated using four increasingly inclusive definitions of first diagnosis/suspicion: 1. "Definite diagnosis" 2. "Ambiguous diagnosis" 3. "First treatment or complication suggesting pre-existing diagnosis", 4 "First relevant test or referral". Results The most commonly coded symptoms before a definite diagnosis of ovarian cancer, were abdominal pain (41%), urogenital problems(25%), abdominal distension (24%), constipation/change in bowel habits (23%) with 70% of cases reporting at least one of these. The median time between first reporting each of these symptoms and diagnosis was 13, 21, 9.5 and 8.5 weeks respectively. 19% had a code for definitions 2 or 3 prior to definite diagnosis and 73% a code for 4. However, the proportion with symptoms and the delays were similar for all four definitions except 4, where the median delay was 8, 8, 3, 10 and 0 weeks respectively. Conclusion Symptoms recorded in the General Practice Research Database are similar to those reported in the literature, although their frequency is lower than in studies based on self-report. Generalisable strategies for exploring the impact of recording practice on date of diagnosis in electronic patient records are recommended, and studies which date diagnoses in GP records need to present sensitivity analyses based on investigation, referral and diagnosis data. Free text information may be essential in obtaining accurate estimates of incidence, and for accurate dating of diagnoses

The Real Combination Problem : Panpsychism, Micro-Subjects, and Emergence

Panpsychism harbors an unresolved tension, the seriousness of which has yet to be fully appreciated. I capture this tension as a dilemma, and offer panpsychists advice on how to resolve it. The dilemma, briefly, is as follows. Panpsychists are committed to the perspicuous explanation of macro-mentality in terms of micro-mentality. But panpsychists take the micro-material realm to feature not just mental properties, but also micro-subjects to whom these properties belong. Yet it is impossible to explain the constitution of a macro-subject (like one of us) in terms of the assembly of micro-subjects, for, I show, subjects cannot combine. Therefore the panpsychist explanatory project is derailed by the insistence that the world’s ultimate material constituents (ultimates) are subjects of experience. The panpsychist faces a choice of abandoning her explanatory project, or recanting the claim that the ultimates are subjects. This is the dilemma. I argue that the latter option is to be preferred. This needn’t constitute a wholesale abandonment of panpsychism, however, since panpsychists can maintain that the ultimates possess phenomenal qualities, despite not being subjects of those qualities. This proposal requires us to make sense of phenomenal qualities existing independently of experiencing subjects, a challenge I tackle in the penultimate section. The position eventually reached is a form of neutral monism, so another way to express the overall argument is to say that, keeping true to their philosophical motivations, panpsychists should really be neutral monists.Peer reviewedFinal Accepted Versio

Modern and possible paleotsunami deposits in Samenoura, Sanriku Coast, and their relation to tsunami source mechanisms

Samenoura is situated in the bay head of a small inlet on the Pacific coast of Oshika Peninsula, one of the nearest places to the epicenter of the 2011 Tohoku-oki Earthquake. According to the Joint Survey Group, wave heights were measured at more than 20 m near the coastline. This area was severely damaged as a result of both co-seismic subsidence and tsunami inundation. We carried out field surveys of the Tohoku-oki and paleotsunami deposits at Samenoura in March, May and October 2013. Sandy deposits laid down by the Tohoku-oki tsunami were up to 20 cm thick at locations with an elevation greater than 10 m, and were several cm thick within the forest higher up. The tsunami deposit also contained numerous shell fragments and foraminifera. Although some possible sources of the tsunami deposits can be attributed to narrow sandy beaches near the study area, the deposition of such a thick sandy deposit is more or less enigmatic, considering the steep Ria-type coastal topography.Using a gouge auger and geoslicer, we found at least two sand layers intercalated within muddy sediments. A volcanic ash layer, which corresponds to the AD 915 Towada-a tephra, was also identified from a horizon between these sand layers. The underlying sand layer was most probably laid down by the 869 Jogan earthquake tsunami, one of the large-scale events known to have affected the region. Previous studies of the Jogan tsunami have proposed several possible source models that involve an interplate thrust earthquake. Given that the local bathymetry and topography of Samenoura Bay may be sensitive to the waveform of a large-scale tsunami, paleotsunami deposits found from this area may be the key to determining the source mechanisms of events on the Sanriku Coast.In this presentation, the possible correlation of the sandy deposits with known paleotsunami events based on detailed radiocarbon dating is discussed. The hydrodynamic character and processes of tsunami sediment erosion and deposition in Samenoura Bay are analyzed using numerical modeling of both interplate and outer-rise earthquake scenarios.Copyright on Japan Geoscience Union Meeting, 2014

RNA editing regulates insect gamma-aminobutyric acid receptor function and insecticide sensitivity

A-to-I pre-mRNA editing by adenosine deaminase enzymes has been reported to enhance protein diversity in the nervous system. In Drosophila, the resistance to dieldrin (RDL) gamma-aminobutyric acid (GABA) receptor subunit displays an editing site (R122) that is close to the putative GABA-binding site. We assessed the functional effects of editing at this site by expressing homomeric RDL receptors in Xenopus oocytes. After replacement of arginine 122 with a glycine, both agonist and fipronil potencies were shifted to the right in either fipronil-sensitive receptors or mutated resistant receptors (A301G/T350M). These data provide the first insight on the influence of RNA editing on GABA receptor function

The phase diagram of the lattice Calogero-Sutherland model

We introduce a {\it lattice} version of the Calogero Sutherland model adapted to describe $1/d^2$ pairwise interacting steps with discrete positions on a vicinal surface. The configurational free energy is obtained within a transfer matrix method. The full phase diagram for attractive and for repulsive interaction is deduced. For attraction, critical temperatures of faceting transitions are found to depend on step density.Comment: latex PRBCalogSuth.tex, 6 files, 4 pages [SPEC-S00/900