Jaundice: an important, poorly recognized risk factor for diminished survival in patients with adenocarcinoma of the head of the pancreas

AbstractObjectivesJaundice impairs cellular immunity, an important defence against the dissemination of cancer. Jaundice is a common mode of presentation in pancreatic head adenocarcinoma. The purpose of this study was to determine whether there is an association between preoperative jaundice and survival in patients who have undergone resection of such tumours.MethodsThirty possible survival risk factors were evaluated in a database of over 400 resected patients. Univariate analysis was used to determine odds ratio for death. All factors for which a P‐value of <0.30 was obtained were entered into a multivariate analysis using the Cox model with backward selection.ResultsPreoperative jaundice, age, positive node status, poor differentiation and lymphatic invasion were significant indicators of poor outcome in multivariate analysis. Absence of jaundice was a highly favourable prognostic factor. Interaction emerged between jaundice and nodal status. The benefit conferred by the absence of jaundice was restricted to patients in whom negative node status was present. Five‐year overall survival in this group was 66%. Jaundiced patients who underwent preoperative stenting had a survival advantage.ConclusionsPreoperative jaundice is a negative risk factor in adenocarcinoma of the pancreas. Additional studies are required to determine the exact mechanism for this effect

Measuring Slepton Masses and Mixings at the LHC

Flavor physics may help us understand theories beyond the standard model. In the context of supersymmetry, if we can measure the masses and mixings of sleptons and squarks, we may learn something about supersymmetry and supersymmetry breaking. Here we consider a hybrid gauge-gravity supersymmetric model in which the observed masses and mixings of the standard model leptons are explained by a U(1) x U(1) flavor symmetry. In the supersymmetric sector, the charged sleptons have reasonably large flavor mixings, and the lightest is metastable. As a result, supersymmetric events are characterized not by missing energy, but by heavy metastable charged particles. Many supersymmetric events are therefore fully reconstructible, and we can reconstruct most of the charged sleptons by working up the long supersymmetric decay chains. We obtain promising results for both masses and mixings, and conclude that, given a favorable model, precise measurements at the LHC may help shed light not only on new physics, but also on the standard model flavor parameters.Comment: 24 pages; v2: fixed a typo in our computer program that led to some miscalculated branching ratios, various clarifications and minor improvements, conclusions unchanged, published versio

Depression Symptoms and Antidepressant Medicine Use in Diabetes Prevention Program Participants

OBJECTIVE: To assess depression markers (symptoms and antidepressant medicine use) in Diabetes Prevention Program (DPP) participants and to determine whether changes in depression markers during the course of the study were associated with treatment arm, weight change, physical activity level, or participant demographic characteristics. RESEARCH DESIGN AND METHODS: DPP participants (n = 3,187) in three treatment arms (intensive lifestyle, metformin, and placebo) completed the Beck Depression Inventory (BDI) and reported on use of antidepressant medicines at randomization and subsequently at each annual visit (average duration in study 3.2 years). RESULTS: On study entry, 10.3% of participants had BDI scores > or =11, which was used as a threshold for mild depression, 5.7% took antidepressant medicines, and 0.9% had both depression markers. During the DPP, the proportion of participants with elevated BDI scores declined (from 10.3% at baseline to 8.4% at year 3), while the proportion taking antidepressant medicines increased (from 5.7% at baseline to 8.7% at year 3), leaving the proportion with either marker unchanged. These time trends were not significantly associated with the DPP treatment arm. Depression markers throughout the study were associated with some participant demographic factors, adjusted for other factors. Men were less likely to have elevated depression scores and less likely to use antidepressant medicine at baseline (9.0% of men and 17.9% of women had at least one marker of depression) and throughout the study (P or =11 (P = 0.03), but white participants were more likely to be taking antidepressant medicine than any other racial/ethnic group (P <0.0001). CONCLUSIONS: DPP participation was not associated with changes in levels of depression. Countervailing trends in the proportion of DPP participants with elevated depression symptoms and the proportion taking antidepressant medicine resulted in no significant change in the proportion with either marker. The finding that those taking antidepressant medicine often do not have elevated depression symptoms indicates the value of assessing both markers when estimating overall depression rates

Disruption of Lateral Olivocochlear Neurons via a Dopaminergic Neurotoxin Depresses Sound-Evoked Auditory Nerve Activity

We applied the dopaminergic (DA) neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) to the guinea pig cochlear perilymph. Immunolabeling of lateral olivocochlear (LOC) neurons using antibodies against synaptophysin was reduced after the MPTP treatment. In contrast, labeling of the medial olivocochlear innervation remained intact. As after brainstem lesions of the lateral superior olive (LSO), the site of origin of the LOC neurons, the main effect of disrupting LOC innervation of the cochlea via MPTP was a depression of the amplitude of the compound action potential (CAP). CAP amplitude depression was similar to that produced by LSO lesions. Latency of the N1 component of the CAP, and distortion product otoacoustic emission amplitude and adaptation were unchanged by the MPTP treatment. This technique for selectively lesioning descending LOC efferents provides a new opportunity for examining LOC modulation of afferent activity and behavioral measures of perception.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41386/1/10162_2004_Article_2429.pd

Heart of Darkness: The Significance of the Zeptobarn Scale for Neutralino Direct Detection

The direct detection of dark matter through its elastic scattering off nucleons is among the most promising methods for establishing the particle identity of dark matter. The current bound on the spin-independent scattering cross section is sigma^SI < 10 zb for dark matter masses m_chi ~ 100 GeV, with improved sensitivities expected soon. We examine the implications of this progress for neutralino dark matter. We work in a supersymmetric framework well-suited to dark matter studies that is simple and transparent, with models defined in terms of four weak-scale parameters. We first show that robust constraints on electric dipole moments motivate large sfermion masses mtilde > 1 TeV, effectively decoupling squarks and sleptons from neutralino dark matter phenomenology. In this case, we find characteristic cross sections in the narrow range 1 zb 70 GeV. As sfermion masses are lowered to near their experimental limit mtilde ~ 400 GeV, the upper and lower limits of this range are extended, but only by factors of around two, and the lower limit is not significantly altered by relaxing many particle physics assumptions, varying the strange quark content of the nucleon, including the effects of galactic small-scale structure, or assuming other components of dark matter. Experiments are therefore rapidly entering the heart of dark matter-favored supersymmetry parameter space. If no signal is seen, supersymmetric models must contain some level of fine-tuning, and we identify and analyze several possibilities. Barring large cancellations, however, in a large and generic class of models, if thermal relic neutralinos are a significant component of dark matter, experiments will discover them as they probe down to the zeptobarn scale.Comment: 35 pages, 11 figures; v2: references added, figures extended to 2 TeV neutralino masses, XENON100 results included, published versio

Kentucky UST Field Manual

This study was undertaken to address the removal and closure of defective petroleum underground storage tanks in Kentucky. Goals for the study included: To address standards for levels of contamination requiring corrective action consistent with accepted scientific and technical principles. To recommend a matrix or scoring system to be used for (a) ranking sites as to actual or potential harm to human health and the environment caused by release of petroleum from a petroleum storage tank, and (2) establishing standards and procedures for corrective action that shall adequately protect human health and the environment. To address all compounds individually and collectively known as petroleum. To produce a report that shall be scientifically defensible

Status Report: Identification of Appropriate Standards for Corrective Action for a Release from Petroleum Underground Storage Tanks, Volume 1

This study was undertaken to address the removal and closure of defective petroleum underground storage tanks in Kentucky: To address standards for levels of contamination requiring corrective action consistent with accepted scientific and technical principles. To recommend a matrix or scoring system to be used for (a) ranking sites as to actual or potential harm to human health and the environment caused by a release of petroleum from a petroleum storage tank, and (b) establishing standards and procedures for corrective action that shall adequately protect human health and the environment. To address all compounds individually and collectively known as petroleum. To produce a report that shall be scientifically defensible