Can changes in health related quality of life scores predict survival in stages III and IV colorectal cancer?

<p>Abstract</p> <p>Background</p> <p>Several studies have demonstrated the predictive significance on survival of baseline quality of life (QoL) in colorectal cancer (CRC) with little information on the impact of changes in QoL scores on prognosis in CRC. We investigated whether changes in QoL during treatment could predict survival in CRC.</p> <p>Methods</p> <p>We evaluated 396 stages III-IV CRC patients available for a minimum follow-up of 3 months. QoL was evaluated at baseline and after 3 months of treatment using EORTC QLQ-C30. Cox regression evaluated the prognostic significance of baseline, 3-month and changes in QoL scores after adjusting for age, gender and stage at diagnosis.</p> <p>Results</p> <p>After adjusting for covariates, every 10-point increase in both baseline appetite loss and global QoL score was associated with a 7% increased risk of death with HR = 1.07 (95% CI, 1.01-1.14; <it>P </it>= 0.02) and (HR = 0.93 (95% CI, 0.87-0.98; <it>P </it>= 0.01) respectively. A lower risk of death was associated with a 10-point improvement in physical function at 3 months (HR, 0.86; 95% CI, 0.78-0.94; <it>P </it>= 0.001). Surprisingly, a higher risk of death was associated with a 10-point improvement in social function at 3 months (HR, 1.08; 95% CI, 1.02-1.13; <it>P </it>= 0.008).</p> <p>Conclusions</p> <p>This study provides preliminary evidence to indicate that CRC patients whose physical function improves within 3 months of treatment have a significantly increased probability of survival. These findings should be used in clinical practice to systematically address QoL-related problems of CRC patients throughout their treatment course.</p

Evaluation of the Long Term Effects of Irrigation with Wastewater

Introduction: Background: The application of municipal wastewater to the land or using the soil mantle as a wastewater treatment system has been practiced for many years. The history of land application dates back to ancient Athens. Sewage farming or the transportation of wastewater to rural areas for irrigation and disposal was practiced in Eurpose as early as 1559. The practice became fairly widespread in England, France, Germany, Poland, Austria, and the United States during the late 1800\u27s

Long-Term Effects of Land Application of Domestic Wastwater: Tooele, Utah, Slow-Rate Site, Volume 1: Field Investigation

Application of wastewater to the land has been designated a viable alternative for wastewater treatment by the Water Pollution Act Amendments of 1972 (PL 92-500). However, very little information is available concerning the long-term effects of applying wastewater to the land. The general objective of this study was to determine the long-term effects of employing secondary treated municipal wastewater as irrigation water. The study compared the quality of soils, crops, groundwater, and applied water to a site receiving normal irrigation water (control site) to a site (treated site) which had utilized seondary treated municipal effluent for irrigation water during a 20-year period. Similar management practices were employed at both sites

Shock-Boundary Layer Interactions in Supersonic Turbine Cascades

The physics of shock-boundary layer interactions in a supersonic turbine cascade is investigated through a wall-resolved large eddy simulation. Special attention is given to the characterization of the low-frequency dynamics of the separation bubbles using flow visualization, spectral analysis, space-time cross correlations, and flow modal decomposition. The mean flowfield shows different shock structures formed on both sides of the airfoil. On the suction side, an oblique shock impinges on the turbulent boundary layer, whereas a Mach reflection interacts with the pressure side boundary layer. Instantaneous flow visualizations illustrate elongated streamwise structures on the incoming boundary layers and their interactions with the shocks and separation bubbles. The passage of high-speed (low-speed) streaks through the recirculation bubbles leads to the downstream (upstream) motion of the separation point on both suction and pressure sides, resulting in spanwise modulation of the bubbles. Space-time cross-correlations reveal that the near-wall streaks drive the suction side separation bubble motion, which in turn promotes the oscillations of the reattachment shock and shear layer flapping. Space-time correlations also indicate the existence of a $\pi$ phase jump in the pressure fluctuations along the separation bubble on the suction side. After this phase jump, a downstream propagating pressure disturbance is observed, while prior to this point, the pressure disturbances dominantly propagate in the upstream direction. Finally, the organized motions in the shock-boundary layer interactions and their corresponding characteristic frequencies are identified using proper orthogonal decomposition.Comment: 40 pages, 19 figures. Submitted to Physical Review Fluid

Stability Walls in Heterotic Theories

We study the sub-structure of the heterotic Kahler moduli space due to the presence of non-Abelian internal gauge fields from the perspective of the four-dimensional effective theory. Internal gauge fields can be supersymmetric in some regions of the Kahler moduli space but break supersymmetry in others. In the context of the four-dimensional theory, we investigate what happens when the Kahler moduli are changed from the supersymmetric to the non-supersymmetric region. Our results provide a low-energy description of supersymmetry breaking by internal gauge fields as well as a physical picture for the mathematical notion of bundle stability. Specifically, we find that at the transition between the two regions an additional anomalous U(1) symmetry appears under which some of the states in the low-energy theory acquire charges. We compute the associated D-term contribution to the four-dimensional potential which contains a Kahler-moduli dependent Fayet-Iliopoulos term and contributions from the charged states. We show that this D-term correctly reproduces the expected physics. Several mathematical conclusions concerning vector bundle stability are drawn from our arguments. We also discuss possible physical applications of our results to heterotic model building and moduli stabilization.Comment: 37 pages, 4 figure

Testing the proposed link between cosmic rays and cloud cover

A decrease in the globally averaged low level cloud cover, deduced from the ISCCP infra red data, as the cosmic ray intensity decreased during the solar cycle 22 was observed by two groups. The groups went on to hypothesise that the decrease in ionization due to cosmic rays causes the decrease in cloud cover, thereby explaining a large part of the presently observed global warming. We have examined this hypothesis to look for evidence to corroborate it. None has been found and so our conclusions are to doubt it. From the absence of corroborative evidence, we estimate that less than 23%, at the 95% confidence level, of the 11-year cycle change in the globally averaged cloud cover observed in solar cycle 22 is due to the change in the rate of ionization from the solar modulation of cosmic rays

Development of an Integrated Immunology and Vaccines Pharmacy Elective

Objective: To describe an elective course on immunology and vaccines for pharmacy students that extends beyond basic immunization training. Design: A three credit-hour Immunology and Vaccines elective was developed and taught by an immunologist, policy research expert, and pharmacist. The learning objectives of the course included: understanding how the immune system works with vaccines to provide protection against infectious diseases, the history and policies involved in immunization practice, and how to counsel the vaccine hesitant individual. Classes were conducted using a variety of formats; group projects, lectures, films, literature reviews and guest speakers. An end-of-course evaluation was used to gauge student opinion on course value. Students were evaluated by four exams and a final group presentation. Conclusion: Students indicated that this course was valuable to their future pharmacy careers and provided insight into why people choose not to vaccinate and how they could use the course insight to properly educate such individuals. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties &nbsp; Type: Not

Panoramic Views of the Cygnus Loop

We present a complete atlas of the Cygnus Loop supernova remnant in the light of [O III] (5007), H alpha, and [S II] (6717, 6731). Despite its shell-like appearance, the Cygnus Loop is not a current example of a Sedov-Taylor blast wave. Rather, the optical emission traces interactions of the supernova blast wave with clumps of gas. The surrounding interstellar medium forms the walls of a cavity through which the blast wave now propagates, including a nearly complete shell in which non-radiative filaments are detected. The Cygnus Loop blast wave is not breaking out of a dense cloud, but is instead running into confining walls. The interstellar medium dominates not only the appearance of the Cygnus Loop but also the continued evolution of the blast wave. If this is a typical example of a supernova remnant, then global models of the interstellar medium must account for such significant blast wave deceleration.Comment: 28 pages AAS Latex, 28 black+white figures, 6 color figures. To be published in The Astrophysical Journal Supplement Serie

Causation events of stud laceration injuries in rugby union

Laceration injuries in rugby union account for approximately 6% of all injuries sustained during match play. Commentators often cite the design of studded footwear as a causal factor in laceration injuries. In order to assess the laceration injury risk of different stud designs, there is a need to develop a testing protocol that is able to replicate the laceration injury event. This study used a questionnaire to identify the play scenarios that result in laceration injuries. The questionnaire was answered by 191 rugby players, of which 72% had experienced one or more stud injuries during their career which hindered them playing rugby. Half of the laceration injuries described by the respondents came from the ruck, and 27% from a tackle. When analysing free-text responses, a deliberate stamp was described in 35% of the responses and a tackle from behind was described in 14% of responses. These injury scenarios are considered to be the dominant cause of laceration injuries. In future work the identified injury scenarios will be replicated in simulated play and kinetic and kinematic measurements will be recorded. This will inform test parameters for future assessment of laceration injury risk of stud designs

Development and Evaluation of Low-Cost CO2 Sensors for Buildings

There is a significant opportunity to improve building energy efficiency and indoor environmental quality by accurately monitoring CO2 levels. However, current CO2 sensors tend to be expensive or require regular recalibration. This work presents research related to the initial development and evaluation of two novel CO2 sensors based on chemiresistive and resonant mass sensing techniques. Prototype sensors were assessed in a bench-top test chamber at temperatures, humidity levels, and CO2 concentrations, typical of indoor environments. Under these conditions, prototype sensors required only 60 mW of power, or less. Further, each sensor was developed to have a footprint of less than 25 mm2 and a cost of less than $50. Given the relative low cost, small size, and potential for low power consumption, these sensors may serve as an attractive alternative to the commercial CO2 sensors that are currently available