Suppression of the postoperative neutrophil leucocytosis following neoadjuvant chemoradiotherapy for rectal cancer and implications for surgical morbidity

Objective: The extent to which neoadjuvant chemoradio- therapy for rectal cancer influences postoperative morbid- ity is controversial. This study investigated whether this treatment suppresses the normal perioperative inflamma- tory response and explored the clinical implications. Method: Prospective databases were queried to identify 37 consecutive study patients undergoing definitive surgery following 5-FU ⁄ capecitabine-based chemoradio- therapy and 35 consecutive untreated control patients operated upon for rectal or rectosigmoid cancer. Preop- erative (< 10 days) and postoperative (< 24 h) neutrophil counts, along with morbidity data, were confirmed retrospectively. Univariate and multivariate analyses assessed the apparent effect of chemoradiotherapy on change in neutrophil count. The latter’s association with postoperative morbidity was then examined. Results: Sufficient data were available for 34 study and 27 control patients. Repeated-measures ANCOVA revealed significant differences between their periopera- tive neutrophil counts (P = 0.02). Of the other charac- teristics which differed between the groups, only age and tumour location were prognostically significant regarding perioperative change in neutrophil count. Accounting for relevant covariates, chemoradiotherapy was significantly associated with a suppressed perioper- ative neutrophil leucocytosis. Local postoperative com- plications affected 25 of 61 patients, who had lower perioperative neutrophil increases than their counter- parts (P = 0.016). Conclusion: Chemoradiotherapy appears to suppress the perioperative inflammatory response, thereby increasing susceptibility to local postoperative complications

Use of an Online Crowdfunding Platform for Unmet Financial Obligations in Cancer Care.

This cross-sectional study identified characteristics of patients using an online crowdfunding platform for unmet financial obligations associated with cancer care

Use of GoFundMe® to crowdfund complementary and alternative medicine treatments for cancer.

PurposeComplementary and alternative medicine (CAM) use is common amongst cancer patients. However, there is growing concern about its safety and efficacy. Online crowdfunding campaigns represent a unique avenue to understand the cancer patient's perspective for using CAM or declining conventional cancer therapy (CCT).MethodsFive hundred GoFundMe campaigns from 2012 to 2019 detailing financial need for cancer treatment were randomly selected and reviewed for endorsement of CAM use, reasons for using CAM, and reasons for declining CCT. Descriptive statistics were used to compare patient and campaign characteristics between 250 CAM users and 250 non-CAM users.ResultsCompared to non-CAM users, CAM users were more likely to be female (70% vs. 54%, p &lt; 0.01), to report more stage IV cancer (54% vs. 12%, p &lt; 0.01), and to have a history of delayed, missed, or misdiagnosis (10% vs. 4%, p &lt; 0.01). Reasons for using CAM include endorsing curative/therapeutic effects 212 (85%), pain/stress reduction 137 (55%), and dissatisfaction with current or past medical treatment options 105 (42%). 87 (35%) CAM users that declined CCT reported that they wanted to try to fight off cancer using CAM first 57 (61%), that CCT was too "toxic" to the body 39 (42%), and cancer was already too advanced, so that CCT would be futile or too aggressive 25 (27%).ConclusionCancer patients on GoFundMe using CAM highly value quality of life, comfort, and autonomy. Physicians should educate themselves on CAM to set realistic expectations and provide comprehensive counseling of the risks and benefits of CAM usage to patients who choose to use CAM to either augment or completely replace CCT

A behavioral comparison of male and female adults with high functioning autism spectrum conditions

Autism spectrum conditions (ASC) affect more males than females in the general population. However, within ASC it is unclear if there are phenotypic sex differences. Testing for similarities and differences between the sexes is important not only for clinical assessment but also has implications for theories of typical sex differences and of autism. Using cognitive and behavioral measures, we investigated similarities and differences between the sexes in age- and IQ-matched adults with ASC (high-functioning autism or Asperger syndrome). Of the 83 (45 males and 38 females) participants, 62 (33 males and 29 females) met Autism Diagnostic Interview-Revised (ADI-R) cut-off criteria for autism in childhood and were included in all subsequent analyses. The severity of childhood core autism symptoms did not differ between the sexes. Males and females also did not differ in self-reported empathy, systemizing, anxiety, depression, and obsessive-compulsive traits/symptoms or mentalizing performance. However, adult females with ASC showed more lifetime sensory symptoms (p = 0.036), fewer current socio-communication difficulties (p = 0.001), and more self-reported autistic traits (p = 0.012) than males. In addition, females with ASC who also had developmental language delay had lower current performance IQ than those without developmental language delay (p<0.001), a pattern not seen in males. The absence of typical sex differences in empathizing-systemizing profiles within the autism spectrum confirms a prediction from the extreme male brain theory. Behavioral sex differences within ASC may also reflect different developmental mechanisms between males and females with ASC. We discuss the importance of the superficially better socio-communication ability in adult females with ASC in terms of why females with ASC may more often go under-recognized, and receive their diagnosis later, than males

Hidden benefits and risks of partial protection for coral reef fisheries

Partially protected areas are now the dominant global form of spatial management aimed at preserving ecosystem integrity and managing human use. However, most evaluations of their efficacy use only a narrow set of conservation indicators that reflect a fraction of ways in which protection can succeed or fail. In this paper, we examine three case studies of partially protected coral reef fishery systems to evaluate benefits and risks of their use as a management tool. We use data from community-based management arrangements in three Pacific Island countries to demonstrate three vignettes of how partial protection can boost fisheries production, enhance the ease with which fishers catch their prey, and alter the composition of fisheries yields. These changes in fisheries productivity, catchability, and vulnerability under partial protection carry substantial benefits for fishers. However, they also carry significant risks for ecosystems and fisheries livelihoods unless adaptively managed so as to confer the short to medium term benefits in resource performance without risking longer term sustainability

Replication factory activation can be decoupled from the replication timing program by modulating Cdk levels

In the metazoan replication timing program, clusters of replication origins located in different subchromosomal domains fire at different times during S phase. We have used Xenopus laevis egg extracts to drive an accelerated replication timing program in mammalian nuclei. Although replicative stress caused checkpoint-induced slowing of the timing program, inhibition of checkpoint kinases in an unperturbed S phase did not accelerate it. Lowering cyclin-dependent kinase (Cdk) activity slowed both replication rate and progression through the timing program, whereas raising Cdk activity increased them. Surprisingly, modest alteration of Cdk activity changed the amount of DNA synthesized during different stages of the timing program. This was associated with a change in the number of active replication factories, whereas the distribution of origins within active factories remained relatively normal. The ability of Cdks to differentially effect replication initiation, factory activation, and progression through the timing program provides new insights into the way that chromosomal DNA replication is organized during S phase

"Find Out Exactly What to Think-Next!": Chris Morris, Brass Eye, and Journalistic Authority

This article discusses Chris Morris's fake news TV series Brass Eye (1997, 2001). It concentrates on the ways in which Brass Eye exposed and undermined not only the textual conventions of TV news and current affairs, but also the ways in which the program deployed those textual conventions to highlight and sabotage the cultural authority of public figures who appeared on it. The article first introduces Morris and Brass Eye, before identifying some of the key textual strategies of broadcast news that are satirized in the program, including its mode of address, its music, and its visuals and graphics. It then examines how the program's use of those strategies enables it to exercise the authority of broadcast news to expose the accessed voices of public figures within the show

Variability in Infant Acute Pain Responding Meaningfully Obscured By Averaging Pain Responses

Given the inherent variability in pain responding, using an "average" pain score may pose serious threats to internal and external validity of current research findings. Using growth mixture modeling (GMM), the paper first examines if infants can be differentiated into stable groups based on their pain response patterns over a two-minute post-needle period. Secondary analyses, to specifically address the issue of averaging pain scores to represent a sample, qualitatively described clinically meaningful differences between pain scores of the discerned groups and the overall mean (irrespective of groups). Infants were part of Canadian longitudinal cohort naturalistically observed during their 2- , 4-, 6-, and/or 12-month immunization appointments (Ns = 458 to 574) at 3 pediatrician clinics between 2007 and 2012. At every age, GMM analyses discerned distinct groups of infants with significantly variable patterns of pain responding over the 2 minutes post-needle. Our secondary analyses suggested that the overall mean pain score immediately post-needle reflected most groups well at every age. However, for older infants (6 and 12 months, especially), the overall mean pain responses at 1 and 2 minutes post-needle significantly over or underestimated groups that contained 48% to 100% of the sample. These results combined highlight the significant variability of infant pain responding patterns between groups of infants and furthermore, calls into question the validity of using an overall mean in research with older infants during the regulatory phase post-needle

White matter microstructure associations with episodic memory in adults with Down syndrome: a tract-based spatial statistics study.

BACKGROUND: Nearly all persons with Down syndrome will show pathology of Alzheimer's disease in their 40s. There is a critical need for studies to identify early biomarkers of these various pathological changes of Alzheimer's disease in the Down syndrome population and understand the relationship of these biomarkers to cognitive symptoms in order to inform clinical trials. Although Alzheimer's disease is often considered a disease of gray matter, white matter degeneration has been documented during the preclinical stage of Alzheimer's disease. The current study examined the association between diffusion tensor imaging (DTI) measures of white matter microstructure and episodic memory performance in 52 adults with Down syndrome. METHODS: Seventy (N = 70) participants (M = 40.13, SD = 7.77 years) received baseline scans as part of the Neurodegeneration in Aging Down Syndrome (NiAD) study at two imaging facilities (36 at the University of Wisconsin-Madison [UW-Madison] and 34 at the University of Pittsburgh Medical Center [UPMC]). All participants had genetically confirmed trisomy 21. Fifty-two (N = 52) participants remained after QC. The DTI measures, fractional anisotropy (FA) and mean diffusivity (MD), were calculated for each participant. A combined measure of episodic memory was generated by summing the z-scores of (1) Free and Cued Recall test and (2) Rivermead Behavioural Memory Test for Children Picture Recognition. The DTI data were projected onto a population-derived FA skeleton and tract-based spatial statistics analysis was conducted using the FSL tool PALM to calculate Pearson's r values between FA and MD with episodic memory. RESULTS: A positive correlation of episodic memory with FA and a negative correlation of episodic memory and MD in the major association white matter tracts were observed. Results were significant (p < 0.05) after correction for chronological age, imaging site, and premorbid cognitive ability. CONCLUSION: These findings suggest that white matter degeneration may be implicated in early episodic memory declines prior to the onset of dementia in adults with Down syndrome. Further, our findings suggest a coupling of episodic memory and white matter microstructure independent of chronological age