1,673 research outputs found

    Preoperative systemic inflammation predicts postoperative infectious complications in patients undergoing curative resection for colorectal cancer

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    The presence of systemic inflammation before surgery, as evidenced by the glasgow prognostic score (mGPS), predicts poor long-term survival in colorectal cancer. The aim was to examine the relationship between the preoperative mGPS and the development of postoperative complications in patients undergoing potentially curative resection for colorectal cancer. Patients (n=455) who underwent potentially curative resections between 2003 and 2007 were assessed consecutively, and details were recorded in a database. The majority of patients presented for elective surgery (85%) were over the age of 65 years (70%), were male (58%), were deprived (53%), and had TNM stage I/II disease (61%), had preoperative haemoglobin (56%), white cell count (87%) and mGPS 0 (58%) in the normal range. After surgery, 86 (19%) patients developed a postoperative complication; 70 (81%) of which were infectious complications. On multivariate analysis, peritoneal soiling (P<0.01), elevated preoperative white cell count (P<0.05) and mGPS (P<0.01) were independently associated with increased risk of developing a postoperative infection. In elective patients, only the mGPS (OR=1.75, 95% CI=1.17-2.63, P=0.007) was significantly associated with increased risk of developing a postoperative infection. Preoperative elevated mGPS predicts increased postoperative infectious complications in patients undergoing potentially curative resection for colorectal cancer

    Challenges in modelling the random structure correctly in growth mixture models and the impact this has on model mixtures

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    Lifecourse trajectories of clinical or anthropological attributes are useful for identifying how our early-life experiences influence later-life morbidity and mortality. Researchers often use growth mixture models (GMMs) to estimate such phenomena. It is common to place constrains on the random part of the GMM to improve parsimony or to aid convergence, but this can lead to an autoregressive structure that distorts the nature of the mixtures and subsequent model interpretation. This is especially true if changes in the outcome within individuals are gradual compared with the magnitude of differences between individuals. This is not widely appreciated, nor is its impact well understood. Using repeat measures of body mass index (BMI) for 1528 US adolescents, we estimated GMMs that required variance-covariance constraints to attain convergence. We contrasted constrained models with and without an autocorrelation structure to assess the impact this had on the ideal number of latent classes, their size and composition. We also contrasted model options using simulations. When the GMM variance-covariance structure was constrained, a within-class autocorrelation structure emerged. When not modelled explicitly, this led to poorer model fit and models that differed substantially in the ideal number of latent classes, as well as class size and composition. Failure to carefully consider the random structure of data within a GMM framework may lead to erroneous model inferences, especially for outcomes with greater within-person than between-person homogeneity, such as BMI. It is crucial to reflect on the underlying data generation processes when building such models

    Comparison of tumour-based (Petersen Index) and inflammation-based (Glasgow Prognostic Score) scoring systems in patients undergoing curative resection for colon cancer

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    After resection, it is important to identify colon cancer patients, who are at a high risk of recurrence and who may benefit from adjuvant treatment. The Petersen Index (PI), a prognostic model based on pathological criteria is validated in Dukes' B and C disease. Similarly, the modified Glasgow Prognostic Score (mGPS) based on biochemical criteria has also been validated. This study compares both the scores in patients undergoing curative resection of colon cancer. A total of 244 patients underwent elective resection between 1997 and 2005. The PI was constructed from pathological reports; the mGPS was measured pre-operatively. The median follow-up was 67 months (minimum 36 months) during which 109 patients died; 68 of them from cancer. On multivariate analysis of age, Dukes' stage, PI and mGPS, age (hazard ratio, HR, 1.74, P=0.001), Dukes' stage (HR, 3.63, P<0.001), PI (HR, 2.05, P=0.010) and mGPS (HR, 2.34, P<0.001) were associated independently with cancer-specific survival. Three-year cancer-specific survival rates for Dukes' B patients with the low-risk PI were 98, 92 and 82% for the mGPS of 0, 1 and 2, respectively (P<0.05). The high-risk PI population is small, in particular for Dukes' B disease (9%). The mGPS further stratifies those patients classified as low risk by the PI. Combining both the scoring systems could identify patients who have undergone curative surgery but are at high-risk of cancer-related death, therefore guiding management and trial stratification

    The holy blood and the holy grail: Myths of scientific racism and the pursuit of excellence in sport

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    Despite the continuing publication of research that suggests there is no scientific basis to 'race' as a biological category, theories of racial difference continue to be invoked within sport to explain the perceived dominance of black athletes. In the case of John Entine's controversial 'Taboo: why black athletes dominate sports and why we are afraid to talk about it' or undergraduate textbooks that suggest 'racial differences' in physique may significantly affect athletic performance, scientific racism is normalised in sport. In this article, the relationship between scientific racism and sport will be examined. Qualitative research with current sport scientists is used to investigate the socio-ethical tensions within the subject field of sport science between professionalism, scientism and the demand from external interests to produce results that help people in sport win medals. It will be shown that these tensions, combined with the history of race as a category in sport science, combine to create the discourse of scientific knowledge that reflects, rather than challenges, folk genetics of black athletic physicality

    Virtual Distillation for Quantum Error Mitigation

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    Contemporary quantum computers have relatively high levels of noise, making it difficult to use them to perform useful calculations, even with a large number of qubits. Quantum error correction is expected to eventually enable fault-tolerant quantum computation at large scales, but until then it will be necessary to use alternative strategies to mitigate the impact of errors. We propose a near-term friendly strategy to mitigate errors by entangling and measuring MM copies of a noisy state ρ\rho. This enables us to estimate expectation values with respect to a state with dramatically reduced error, ρM/Tr(ρM)\rho^M/ \mathrm{Tr}(\rho^M), without explicitly preparing it, hence the name "virtual distillation". As MM increases, this state approaches the closest pure state to ρ\rho, exponentially quickly. We analyze the effectiveness of virtual distillation and find that it is governed in many regimes by the behavior of this pure state (corresponding to the dominant eigenvector of ρ\rho). We numerically demonstrate that virtual distillation is capable of suppressing errors by multiple orders of magnitude and explain how this effect is enhanced as the system size grows. Finally, we show that this technique can improve the convergence of randomized quantum algorithms, even in the absence of device noise

    Multi-omic analysis of two common p53 mutations: Proteins regulated by mutated p53 as potential targets for immunotherapy

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    The p53 protein is mutated in more than 50% of human cancers. Mutated p53 proteins not only lose their normal function but often acquire novel oncogenic functions, a phenomenon termed mutant p53 gain-of-function. Mutant p53 has been shown to affect the transcription of a range of genes, as well as protein–protein interactions with transcription factors and other effectors; however, no one has intensively investigated and identified these proteins, or their MHC presented epitopes, from the viewpoint of their ability to act as targets for immunotherapeutic interventions. We investigated the molecular changes that occurred after the TP53 null osteosarcoma cells, SaOS-2, were transfected with one of two conformational p53-mutants, either R175H or R273H. We then examined the phenotypic and functional changes using macroscopic observations, proliferation, gene expression and proteomics alongside immunopeptidome profiling of peptide antigen presentation in the context of major histocompatibility complex (MHC) class I molecules. We identified several candidate proteins in both TP53 mutant cell lines with differential expression when compared to the TP53 null vector control, SaOS-V. Quantitative SWATH proteomics combined with immune-peptidome analysis of the class-I eluted peptides identified several epitopes presented on pMHC and in silico analysis shortlisted which antigens were expressed in a range of cancerous but not adjacent healthy tissues. Out of all the candidates, KLC1 and TOP2A showed high levels of expression in every tumor type examined. From these proteins, three A2 and four pan HLA-A epitopes were identified in both R175H and R273H from TOP2A. We have now provided a short list of future immunotherapy targets for the treatment of cancers harboring mutated TP53

    Urban agriculture: a global analysis of the space constraint to meet urban vegetable demand

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    Urban agriculture (UA) has been drawing a lot of attention recently for several reasons: the majority of the world population has shifted from living in rural to urban areas; the environmental impact of agriculture is a matter of rising concern; and food insecurity, especially the accessibility of food, remains a major challenge. UA has often been proposed as a solution to some of these issues, for example by producing food in places where population density is highest, reducing transportation costs, connecting people directly to food systems and using urban areas efficiently. However, to date no study has examined how much food could actually be produced in urban areas at the global scale. Here we use a simple approach, based on different global-scale datasets, to assess to what extent UA is constrained by the existing amount of urban space. Our results suggest that UA would require roughly one third of the total global urban area to meet the global vegetable consumption of urban dwellers. This estimate does not consider how much urban area may actually be suitable and available for UA, which likely varies substantially around the world and according to the type of UA performed. Further, this global average value masks variations of more than two orders of magnitude among individual countries. The variations in the space required across countries derive mostly from variations in urban population density, and much less from variations in yields or per capita consumption. Overall, the space required is regrettably the highest where UA is most needed, i.e., in more food insecure countries. We also show that smaller urban clusters (i.e., <100 km2 each) together represent about two thirds of the global urban extent; thus UA discourse and policies should not focus on large cities exclusively, but should also target smaller urban areas that offer the greatest potential in terms of physical space

    An Investigation of sexuality and life satisfaction of institutionalized aged

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    One concern of this study is sexuality among the aged, since every person, regardless of age, is a sexual being. Society, however, has been slow to recognize this fact and has not accepted sexual activity among the aged. Along with the lack of social sanctioning, elderly persons are very susceptible to the myriad of myths, half-truths, misinformation, and incomplete data which affect their attitudes toward sexuality. Furthermore, older persons are susceptible to negative stereotypes of themselves as sexual beings. However, the effect of actual sexual activity upon overall life satisfaction among the aged has yet to be determined. Because there has been no empirical evidence concerning this, the degree of relationship between sexual activity and life satisfaction remains unknown. Since human beings remain sexual throughout life, and a large proportion of the elderly are institutionalized, this study will focus attention on the relationship between life satisfaction and sexuality among the institutionalized aged. It is important for social workers to explore these concepts, as empirically validated knowledge can be used as guidelines for professional values and practice

    2015 Olympia oyster, Ostrea lurida, brooding results from northern Puget Sound

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    The Swinomish Indian Tribal Community recently began a restoration project to establish, expand, and research Olympia oyster, Ostrea lurida, populations on reservation tidelands. For our pilot project, we evenly distributed seeded cultch in two pocket estuaries in Similk and northern Skagit Bays during the summer of 2012 and spring of 2013. Subsequently, we initiated a long-term monitoring program that included measuring reproductive benchmarks to determine population expansion potential. While brooding data have been collected at one other site in northern Puget Sound (i.e. Fidalgo Bay), it is likely that oysters in pocket estuaries will be exposed to different environmental conditions than the Fidalgo Bay oysters. Our goal was to quantify the timing and environmental conditions for peak brooding of oysters in pocket estuaries. Brooding status was recorded from May to early September 2015 and water temperature was continuously logged at each of the two restoration sites. Our data clearly indicate that northern Puget Sound oysters located in pocket estuaries can begin brooding before May when daily minimum water temperatures reach 11°C, 2°C below the published thermal threshold. Managers and scientists working with native oysters in pocket estuaries should target early to mid-April as the optimal time for restoration expansion efforts

    The relationship between T-lymphocyte infiltration, stage, tumour grade and survival in patients undergoing curative surgery for renal cell cancer

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    The present study examined the relationship between tumour stage, grade, T-lymphocyte subset infiltration and survival in patients who had undergone potentially curative surgery for renal clear-cell cancer (n=73). Intratumoural CD4+ T-lymphocyte infiltrate was associated with poor cancer-specific survival, independent of grade, in this cohort
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