Cutaneous Angiosarcoma of the Scalp: A Case Report of Sustained Complete Response Following Liposomal Doxorubicin and Radiation Therapy

Cutaneous angiosarcomas of the head and neck are aggressive cancers with a mean overall survival of 30 months. We add to the literature a case report of a 65-year-old man with a large, >10 cm, unresectable, angiosarcoma of the scalp who was treated with two cycles of liposomal doxorubicin (Caelyx®) followed by electron beam radiation therapy (30 Gy in 10 fractions over 2 weeks) who has sustained a complete response with a 4-year follow-up. The dose and fractionation of the radiation therapy in this case was palliative and was not expected to give lasting local control of this lesion. It is therefore possible that either the genetic profile of the tumour conferred radiosensitivity or that the radiation therapy induced a recall phenomenon of the liposomal doxorubicin

Geographic and socioeconomic variations in adolescent toothbrushing: a multilevel cross-sectional study of 15 year olds in Scotland

Background: This study examined urban–rural and socioeconomic differences in adolescent toothbrushing. Methods: The data were modelled using logistic multilevel modelling and the Markov Chain Monte Carlo method of estimation. Twice-a-day toothbrushing was regressed upon age, family affluence, family structure, school type, area-level deprivation and rurality, for boys and girls separately. Results: Boys’ toothbrushing was associated with area-level deprivation but not rurality. Variance at the school level remained significant in the final model for boys' toothbrushing. The association between toothbrushing and area-level deprivation was particularly strong for girls, after adjustment for individuals’ family affluence and type of school attended. Rurality too was independently significant with lower odds of brushing teeth in accessible rural areas. Conclusion: The findings are at odds with the results of a previous study which showed lower caries prevalence among children living in rural Scotland. A further study concluded that adolescents have a better diet in rural Scotland. In total, these studies highlight the need for an examination into the relative importance of diet and oral health on caries, as increases are observed in population obesity and consumption of sugars

Avian community changes following drought-induced canopy collapse in a Mediterranean-type forest

Context: Extreme drought can result in the widespread die-off of forests and dramatically altered ecosystem structure. Such changes are likly to influence fauna using resouces within these forests. Aims: Following a record hot and dry year/summer in 2010/11, large-scale canopy collapse occurred within a Mediterranean-type mixed jarrah (Eucalyptus marginata)–marri (Corymbia calophylla) forest in south-west Western Australia. We investigated the effects of this collapse on bird assemblages in 2016, 5 years after the initial collapse. Methods: We carried out bird surveys using a standardised search method for five paired drought-affected and adjacent healthy forest plots. Key results: A total of 3042 records of 51 bird species were observed across all surveys. Overall, the pooled (mean ± s.d.) reporting rates for drought-affected plots (13.84 ± 0.60 individuals/survey) were significantly less than the reporting rates for healthy plots (34.44 ± 1.03 individuals/survey) (PERMANOVA: F1 = 54.94, R2 = 0.31, P = 0.001). Species diversity was also higher in healthy plots (t26 = 11.21, P < 0.001). Foliage-searching birds were the most abundant guild across all plots and were reported less often in drought-affected plots (t6 = 2.70, P < 0.04). Conclusions: Drought-affected jarrah forest plots exhibited significant differences in bird assemblages compared to healthy plots. Overall, the drought-affected forest provides a less favourable habitat for birds compared to healthy forest. Implications: With marked variability and extreme climate events predicted for the future, understanding the impacts of such changes will contribute to how we manage forest ecosystems

Crater population and resurfacing of the Martian north polar layered deposits

Present-day accumulation in the north polar layered deposits (NPLD) is thought to occur via deposition on the north polar residual cap. Understanding current mass balance in relation to current climate would provide insight into the climatic record of the NPLD. To constrain processes and rates of NPLD resurfacing, a search for craters was conducted using images from the Mars Reconnaissance Orbiter Context Camera. One hundred thirty craters have been identified on the NPLD, 95 of which are located within a region defined to represent recent accumulation. High Resolution Imaging Science Experiment images of craters in this region reveal a morphological sequence of crater degradation that provides a qualitative understanding of processes involved in crater removal. A classification system for these craters was developed based on the amount of apparent degradation and infilling and where possible depth/diameter ratios were determined. The temporal and spatial distribution of crater degradation is interpreted to be close to uniform. Through comparison of the size-frequency distribution of these craters with the expected production function, the craters are interpreted to be an equilibrium population with a crater of diameter D meters having a lifetime of ~30.75D^(1.14) years. Accumulation rates within these craters are estimated at 7.2D^(−0.14) mm/yr, which corresponds to values of ~3–4 mm/yr and are much higher than rates thought to apply to the surrounding flat terrain. The current crater population is estimated to have accumulated in the last ~20 kyr or less

Inequalities in all-cause and cause-specific mortality across the life course by wealth and income in Sweden: a register-based cohort study

Background: Wealth inequalities are increasing in many countries, but their relationship to health is little studied. We investigated the association between individual wealth and mortality across the adult life course in Sweden. Methods: We studied the Swedish adult population using national registers. The amount of wealth tax paid in 1990 was the main exposure of interest and the cohort was followed up for 18 years. Relative indices of inequality (RII) summarize health inequalities across a population and were calculated for all-cause and cause-specific mortality for six different age groups, stratified by sex, using Poisson regression. Mortality inequalities by wealth were contrasted with those assessed by individual and household income. Attenuation by four other measures of socio-economic position and other covariates was investigated. Results: Large inequalities in mortality by wealth were observed and their association with mortality remained more stable across the adult life course than inequalities by income-based measures. Men experienced greater inequalities across all ages (e.g. the RII for wealth was 2.58 [95% confidence interval (CI) 2.54–2.63) in men aged 55–64 years compared with 2.29 (95% CI 2.24–2.34) for women aged 55–64 years), except among the over 85s. Adjustment for covariates, including four other measures of socio-economic position, led to only modest reductions in the association between wealth and mortality. Conclusions: Wealth is strongly associated with mortality throughout the adult life course, including early adulthood. Income redistribution may be insufficient to narrow health inequalities—addressing the increasingly unequal distribution of wealth in high-income countries should be considered

Evaluation of health in pregnancy grants in Scotland: A protocol for a natural experiment

Introduction: A substantial proportion of low birth weight is attributable to the mother's cultural and socioeconomic circumstances. Early childhood programmes have been widely developed to improve child outcomes. In the UK, the Health in Pregnancy (HiP) grant, a universal conditional cash transfer of £190, was introduced for women reaching the 25th week of pregnancy with a due date on/or after 6 April 2009 and subsequently withdrawn for women reaching the 25th week of pregnancy on/or after 1 January 2011. The current study focuses on the evaluation of the effectiveness and cost-effectiveness of the HiP grant.&lt;p&gt;&lt;/p&gt; Methods and analysis: The population under study will be all singleton births in Scotland over the periods of January 2004 to March 2009 (preintervention), April 2009 to April 2011 (intervention) and May 2011 to December 2013 (postintervention). Data will be extracted from the Scottish maternity and neonatal database. The analysis period 2004–2013 should yield over 585 000 births. The primary outcome will be birth weight among singleton births. Other secondary outcomes will include gestation at booking, booking before 25 weeks; measures of size and stage; gestational age at delivery; weight-for-dates, term at birth; birth outcomes and maternal smoking. The main statistical method we will use is interrupted time series. Outcomes will be measured on individual births nested within mothers, with mothers themselves clustered within data zones. Multilevel regression models will be used to determine whether the outcomes changed during the period in which the HiP grants was in effect. Subgroup analyses will be conducted for those groups most likely to benefit from the payments.&lt;p&gt;&lt;/p&gt; Ethics and dissemination: Approval for data collection, storage and release for research purpose has been given (6 May 2014, PAC38A/13) by the Privacy Advisory Committee. The results of this study will be disseminated through peer-reviewed publications in journals, national and international conferences

Correlates of exercise motivation and behavior in a population-based sample of endometrial cancer survivors: an application of the Theory of Planned Behavior

<p>Abstract</p> <p>Background</p> <p>Despite evidence of the benefits of exercise in cancer survivors, exercise participation rates tend to decline after treatments. Few studies have examined the determinants of exercise in less common cancer sites. In this study, we examined medical, demographic, and social cognitive correlates of exercise in endometrial cancer survivors using the Theory of Planned Behavior (TPB).</p> <p>Methods</p> <p>A mailed survey was completed by 354 endometrial cancer survivors (1 to 10 years postdiagnosis) residing in Alberta, Canada. The study was cross-sectional. Exercise behavior was assessed using the Godin Leisure Time Exercise Questionnaire and the TPB constructs were assessed with standard self-report scales. Multiple regression analyses were used to determine the independent associations of the TPB constructs with intention and behavior.</p> <p>Results</p> <p>Chi-square analyses indicated that marital status (<it>p </it>= .003), income level (<it>p </it>= .013), and body mass index (BMI) (<it>p </it>= .020) were associated with exercise. The TPB explained 34.1% of the variance in exercise behavior with intention (<it>β </it>= .38, <it>p </it>< .001) and self-efficacy (<it>β </it>= .18, <it>p </it>= .029) being independent correlates. For intention, 38.3% of the variance was explained by the TPB with self-efficacy (<it>β </it>= .34, <it>p </it>< .001) and affective attitude (<it>β </it>= .30, <it>p </it>< .001) being the independent correlates. The TPB mediated the associations of marital status and BMI with exercise but not income level. Age and BMI moderated the associations of the TPB with intention and behavior.</p> <p>Conclusion</p> <p>The TPB may be a useful framework for understanding exercise in endometrial cancer survivors. Exercise behavior change interventions based on the TPB should be tested in this growing population.</p

The formation of gullies on Mars today

A decade of high-resolution monitoring has revealed extensive activity in fresh Martian gullies. Flows within the gullies are diverse: they can be relatively light, neutral or dark, colourful or bland, and range from superficial deposits to 10 m-scale topographic changes. We observed erosion and transport of material within gullies, new terraces, freshly eroded channel segments, migrating sinuous curves, channel abandonment, and lobate deposits. We also observed early stages of gully initiation, demonstrating that these processes are not merely modifying pre-existing land-forms. The timing of activity closely correlates with the presence of seasonal CO2 frost, so the current changes must be part of ongoing gully formation that is driven largely by its presence. We suggest that the cumulative effect of many flows erodes alcoves and channels, and builds lobate aprons, with no involvement of liquid water. Instead, flows may be fluidized by sublimation of entrained CO2 ice or other mechanisms. The frequent activity is likely to have erased any features dating from high-obliquity periods, so fresh gully geomorphology at middle and high latitudes is not evidence for past liquid water. CO2 ice-driven processes may have been important throughout Martian geological history and their deposits could exist in the rock record, perhaps resembling debris-flow sediments.Mars Data Analysis Program [NNH13AV85I]; Mars Reconnaissance Orbiter HiRISE project12 month embargo; published 27 November 2017This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Theorising social class and its application to the study of health inequalities

The literature on health inequalities often uses measures of socio-economic position pragmatically to rank the population to describe inequalities in health rather than to understand social and economic relationships between groups. Theoretical considerations about the meaning of different measures, the social processes they describe, and how these might link to health are often limited. This paper builds upon Wright’s synthesis of social class theories to propose a new integrated model for understanding social class as applied to health. This model incorporates several social class mechanisms: social background and early years’ circumstances; Bourdieu’s habitus and distinction; social closure and opportunity hoarding; Marxist conflict over production (domination and exploitation); and Weberian conflict over distribution. The importance of discrimination and prejudice in determining the opportunities for groups is also explicitly recognised, as is the relationship with health behaviours. In linking the different social class processes we have created an integrated theory of how and why social class causes inequalities in health. Further work is required to test this approach, to promote greater understanding of researchers of the social processes underlying different measures, and to understand how better and more comprehensive data on the range of social class processes these might be collected in the future