Spin vectors in the Koronis family: V. Resolving the ambiguous rotation period of (3032) Evans

A sidereal rotation counting approach is demonstrated by resolving an ambiguity in the synodic rotation period of Koronis family member (3032) Evans, whose rotation lightcurves' features did not easily distinguish between doubly- and quadruply-periodic. It confirms that Evans's spin rate does not exceed the rubble-pile spin barrier and thus presents no inconsistency with being a ~14-km reaccumulated object. The full spin vector solution for Evans is comparable to those for the known prograde low-obliquity comparably-fast rotators in the Koronis family, consistent with having been spun up by YORP thermal radiation torques.Comment: 8 pages, 6 figures, accepted for publication in Icaru

Completely resected N1 non–small cell lung cancer: Factors affecting recurrence and long-term survival

ObjectiveN1 disease in non–small cell lung cancer represents a heterogeneous patient subgroup with a 5-year survival of approximately 40%. Few reports have evaluated the correlation between N1 disease and tumor recurrence or which subgroup of patients would most benefit from adjuvant chemotherapy.MethodsFrom 1997 through 2002, all patients with pathologic T1-4 N1 M0 non–small cell lung cancer who had a complete resection with systematic mediastinal lymphadenectomy were retrospectively analyzed and evaluated for factors associated with recurrence and long-term survival.ResultsOne hundred eighty patients with N1 disease were evaluated. Sixty-six (37%) patients had either locoregional recurrence (n = 39 [22%]), distant metastasis (n = 41 [23%]), or both during follow-up. Univariate analysis demonstrated that visceral pleural invasion and age were associated with locoregional recurrence, whereas visceral pleural invasion, distinct N1 metastasis (as opposed to direct N1 invasion by the primary tumor), and multistation lymph node involvement were associated with distant metastasis (P < .05). Multivariable analysis demonstrated that visceral pleural invasion, multistation N1 involvement, and distinct N1 metastasis were the only independent predisposing factors for locoregional recurrence and distant metastasis. Overall 5-year survival was 42.5%. Survival was significantly decreased by advanced pathologic T classification (P = .015), visceral pleural invasion (P < .0001), and higher tumor grade (P = .014).ConclusionsIn patients with N1-positive non–small cell lung cancer, visceral pleural invasion, multistation N1 disease, and distinct N1 metastasis are independent predictors of subsequent locoregional recurrence and distant metastasis. Advanced T classification, visceral pleural invasion, and higher tumor grade were predictors of poor survival. These patients represent a subgroup of patients with N1 disease who might benefit from additional therapy, including adjuvant chemotherapy

The impact of the lung allocation score on short-term transplantation outcomes: A multicenter study

ObjectiveThe lung allocation score restructured the distribution of scarce donor lungs for transplantation. The algorithm ranks waiting list patients according to medical urgency and expected benefit after transplantation. The purpose of this study was to evaluate the impact of the lung allocation score on short-term outcomes after lung transplantation.MethodsA multicenter retrospective cohort study was performed with data from 5 academic medical centers. Results of patients undergoing transplantation on the basis of the lung allocation score (May 4, 2005 to May 3, 2006) were compared with those of patients receiving transplants the preceding year before the lung allocation score was implemented (May 4, 2004, to May 3, 2005).ResultsThe study reports on 341 patients (170 before the lung allocation score and 171 after). Waiting time decreased from 680.9 ± 528.3 days to 445.6 ± 516.9 days (P < .001). Recipient diagnoses changed with an increase in idiopathic pulmonary fibrosis and a decrease in emphysema and cystic fibrosis (P = .002). Postoperatively, primary graft dysfunction increased from 14.1% (24/170) to 22.9% (39/171) (P = .04) and intensive care unit length of stay increased from 5.7 ± 6.7 days to 7.8 ± 9.6 days (P = .04). Hospital mortality and 1-year survival were the same between groups (5.3% vs 5.3% and 90% vs 89%, respectively; P > .6)ConclusionsThis multicenter retrospective review of short-term outcomes supports the fact that the lung allocation score is achieving its objectives. The lung allocation score reduced waiting time and altered the distribution of lung diseases for which transplantation was done on the basis of medical necessity. After transplantation, recipients have significantly higher rates of primary graft dysfunction and intensive care unit lengths of stay. However, hospital mortality and 1-year survival have not been adversely affected

Effect of Massage on Pain Management for Thoracic Surgery Patients

Background: Integrative therapies such as massage have gained support as interventions that improve the overall patient experience during hospitalization. Thoracic surgery patients undergo long procedures and commonly have postoperative back, neck, and shoulder pain. Purpose: Given the promising effects of massage therapy for alleviation of pain, we studied the effectiveness and feasibility of massage therapy delivered in the postoperative thoracic surgery setting. Methods: Patients who received massage in the postoperative setting had pain scores evaluated pre and post massage on a rating scale of 0 to 10 (0 = no pain, 10 = worst possible pain). Results: In total, 160 patients completed the pilot study and received massage therapy that was individualized. Patients receiving massage therapy had significantly decreased pain scores after massage (p < .001), and patients’ comments were very favorable. Patients and staff were highly satisfied with having massage therapy available, and no major barriers to implementing massage therapy were identified. Conclusions: Massage therapy may be an important additional pain management component of the healing experience for patients after thoracic surgery

Adenoviral-mediated Gene Therapy in Lung Transplantation

grantor: University of TorontoGene therapy provides the potential to modify donor organs to better withstand the process of transplantation, although successful application in this setting has yet to be realized. In vivo adenoviral-mediated gene transfer induces a host immune response producing inflammation and limiting the amount and duration of transgene expression. By administering triple-immunosuppression, as is routine in lung transplantation, transgene expression can be increased and prolonged following both initial and repeat transfection, making transplantation a viable setting for the application of gene therapy. Intratracheal adenoviral-mediated gene transfection of the donor lungs produces positive transgene expression in the lungs at the time of reperfusion and following lung transplantation. Donor transfection produces higher levels of transgene expression than ex vivo transfection of the previously harvested organ, without affecting other transplantable organs. Lung transplantation, therefore, with its obligate immunosuppression and ability to achieve local transfection, provides an unique and advantageous setting for the application of gene therapy strategies.M.Sc

The attitudes of teachers towards teacher training in the Province of Nova Scotia

viii, 275 leaves ; 28 cm.Bibliography: leaves 266-275.Online version unavailable; print version available from Patrick Power Library.Abstract unavailable