Routinely collected infant feeding data:Time for global action

The importance of breastfeeding is clear. However, global action to support breastfeeding is hindered by the lack of reliable standard data, which continues to impede progress. Routinely collected data can monitor the effectiveness of health policy, evaluate interventions, and enhance international research collaboration and comparisons. Use of routine data to support effective public health initiatives such as smoking cessation has been demonstrated. However, the data collected about infant feeding practices worldwide is inconsistent in timing, methods, definitions, detail, storage, and consistency. Improvements to the reach and quality of routinely collected data about infant feeding are needed to strengthen the global evidence and policy base. An international collaborative effort is called for to progress this

Hashimoto's thyroiditis revisited: The association with thyroid cancer remains obscure

Hashimoto's thyroiditis (HT) is an autoimmune disease of the thyroid associated with goiter and hypothyroidism. Although there exists a clear association between HT and lymphomas of the thyroid, the association between HT and thyroid cancer remains unclear. To evaluate this further, we retrospectively reviewed the pathology reports for all thyroidectomy specimens as well as the records of patients admitted to the University of Michigan Medical Center, Ann Arbor, Michigan, U.S.A., over a 10-yearperiod (1975–1985) with the diagnosis of HT or chronic lymphocytic thyroiditis (CLT). Eight hundred and nine pathologic diagnoses were recorded for 816 thyroidectomy specimens from 793 patients. Furthermore, 180 of 228 patient chart records were available for review. Only 128 patients satisfied our criteria for the diagnosis of HT. HT or CLT were diagnosed in 147 (18.2%) of 809 thyroid specimens. HT occurred concurrently with thyroid cancer in 24% of all cases of HT, whereas, HT occurred concurrently with benign thyroid disease in 71% of all cases of HT in all thyroid specimens. Furthermore, HT was associated with 43 (22%) of 195 cases of thyroid cancer. There were 111 (87%) women and 17 (13%) men of 128 patients whose charts were reviewed. The mean age was 49±14 years. Ninety-eight (77%) of the patients presented with goiters and 57 (45%) presented with dominant thyroid masses, 38 (67%) of which were solitary nodules. One patient (0.8%) presented with a recurrent laryngeal nerve palsy (RLNP) and 12 (9%) presented with tracheal compression. Only 29 (38.2%) of 76 patients measured had positive antithyroglobulin (ATG) titers, whereas 65 (87%) of 75 patients measured had positive antimicrosomal (AM) titers. Seventy (55%) patients were evaluated with either a technetium or 131 I thyroid scan. There was a heterogeneous pattern to the scan in 75% of these patients. Niney-one (71%) patients were initially treated with thyroid suppression. However, 27 (21%) required thyroidectomy for initial management. Ultimately, 60% required thyroidectomy and 37% required none. The major indication for surgical intervention was the presence of a dominant mass in 40 (52%) of 77 patients. Only 17 (13%) patients were found to have thyroid cancer concomitant with HT and 3(2%) had lymphoma with HT. The incidence of minimal (occult) cancer in a study of 100 consecutive autopsies at this institution was 13%. We believe that these data suggest that the association of HT with thyroid cancer is relative, at best. It will be necessary to prospectively follow both a large group of patients with HT and a control group of patients without HT for the incidence of thyroid cancer in each before this issue can be appropriately addressed. La thyroïdite d'Hashimoto (TH) est une maladie autoimmune de la thyroïde qui provoque goitre et hyperthyroïdisme. Bien que l'association entre TH et lymphome de la thyroïde soit bien établie, celle entre TH et cancer de la thyroïde reste confuse. Pour essayer de mieux élucider cette question, les auteurs ont revu rétrospectivement les comptes rendus d'histologie de toutes les pièces de thyroïdectomie, et les dossiers de tous les patients admis pendant la période 1975–1985 avec le diagnostic de TH ou de thyroïdite lymphocytique chronique (TLC). Il y avait 809 diagnostics enrégistrés pour 816 pièces de thyroïdectomie provenant de 793 patients. En outre, 180 dossiers sur 228 étaient exploitables. Cent-vingt-huit patients seulement remplissaient les conditions diagnostiques de TH. TH ou TLC étaient diagnostiquées dans 147 (18.2%) pièces sur 809. La TH était associée avec un cancer dans 24% de tous les cas de TH, alors que la TH était associée à une maladie bénigne de la thyroïde dans 71% des cas de TH. La TH était présente dans 43 (22%) sur 195 des cas de cancer de la thyroïde. Il y avait 111 (87%) femmes et 17 hommes (13%). L'âge moyen était de 49±14 ans. Quatre-vingt-huit patients (77%) avaient un goitre et 57 (45%) une masse, 38 (67%) étant un nodule solitaire. Un patient (0.8%) avait d'emblée une paralysie récurrentielle et 12 (9%) avaient une compression trachéale. Vingt-neuf (38.2%) patients seulement sur 76 avaient des anticorps antithyroglobuline thyroïdiens, et 67 (87%) des 75 patients avaient des anticorps antimicrosomiaux. Soixante-dix patients (55%) ont eu une scintigraphie au technetium ou à l'I 131: la thyroïde était hétérogène pour 75% d'entre eux. Quatre-vingt un patients (71%) ont eu une hormonothérapie suppressive en premier, alors que 27 (21%) ont eu une thyroïdectomie première. Ultérieurement, 60% des patients ont été thyroïdectomisés. L'indication principale de la chirurgie était la présence d'une masse, trouvée chez 40 (52%) des 77 patients. Seuls 17 (13%) patients avec une TH avaient un cancer simultané de la thyroïde; 3 (2%) avaient un lymphome associé à une TH. La fréquence de cancer occulte dans une étude de 100 autopsies consécutives dans notre établissement était de 13%. Nous pensons que ces résultats suggèrent que l'association TH cancer de la thyroïde n'est que fortuite. Il est nécessaire de suivre prospectivement un grand nombre de patients, divisés en 2 groupes, les uns avec TH, les autres sans, pour déterminer avec précision l'incidence de cancer dans chaque groupe avant de résoudre ce problème. La tiroiditis de Hashimoto (TH) es una enfermedad autoinmune de la tiroides, asociada con bocio e hipotiroidismo. Aunque existe una clara relación entre TH y linfomas de la tiroides, la relación entre TH y cáncer tiroideo no aparece clara. Con el fín de evaluar este asunto, hemos revisado en forma retrospectiva tanto los informes de patología de todos los especímenes de tiroidectomía, así como las historias clínicas de los pacientes admitidos al Centro Médico de la Universidad de Michigan, Ann Arbor, Michigan, con el diagnóstico de TH o de tiroiditis linfocítica crónica (TLC) en un período de 10 años (1975–1985). Se registraron 809 diagnósticos patológicos de 816 especímenes de tiroidectomía en 793 pacientes. Además, se dispuso de 180 de 228 historias clínicas para revisión. Sólo 128 pacientes satisficieron nuestros criterios para el diagnóstico de TH. TH o TLC fueron diagnosticadas en 147 (18.2%) de 809 de los Especímenes tiroideos. La TH ocurrió en forma concurrente con el cáncer tiroideo en 24% de todos los casos de TH, en tanto que la TH ocurrió en forma concurrente con enfermedad benigna de la tiroides en 71% de la totalidad de los casos de TH en todos los especímenes tiroideos. Se encontraron 111 (87%) mujeres y 17 (13%) hombres de 128 pacientes cuyas historias clínicas fueron revisadas: la edad promedio fue 49±14 años. Noventa y ocho (77%) de los pacientes presentaban bocio y 57 (45%) presentaban masas tiroideas dominantes, de las cuales 38 (67%) eran nódulos solitarios. Un paciente (0.8%) se presentó con parálisis del nervio recurrente laríngeo y 12 (9%) con compresión traqueal. Sólo 29 (38.2%) de 76 pacientes investigados tenían títulos positivos de ATG, mientras 65 (87%) de 75 tenían títulos AM positivos. Setenta (55%) fueron evaluados mediante escanografía con tecnecio o con 131 I; se observó un patrón heterogéneo en la gamagrafía en 75% de ellos. Noventa y uno (71%) fueron tratados inicialmente con supresión tiroidea. Sin embargo, 27 (21%) requirieron tiroidectomía en su manejo inicial. Al final 60% requirieron tiroidectomía y 37% no la requirieron. La indicación mayor para intervención quirúrgica fue la presencia de una masa dominante en 40 (52%) de 77 pacientes. Sólo 17 (13%) pacientes exhibieron cáncer tiroideo concomitante con TH y 3 (2%) presentaron linfoma con TH. La incidencia de cáncer mínimo (oculto) en un estudio de 100 autopsias consecutivas en nuestra institución fue 13%. Consideramos que estos datos sugieren que la relación entre TH y cáncer tiroideo es apenas relativa, en el mejor de los casos. Será necesario hacer el seguimiento prospectivo de un grupo grande de pacientes con TH y de un grupo control sin TH para detectar la incidencia de cáncer tiroideo en cada grupo para poder enfocar en forma apropiada este asunto.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41280/1/268_2005_Article_BF01655435.pd

Label-free classification of cultured cells through diffraction imaging

Automated classification of biological cells according to their 3D morphology is highly desired in a flow cytometer setting. We have investigated this possibility experimentally and numerically using a diffraction imaging approach. A fast image analysis software based on the gray level co-occurrence matrix (GLCM) algorithm has been developed to extract feature parameters from measured diffraction images. The results of GLCM analysis and subsequent classification demonstrate the potential for rapid classification among six types of cultured cells. Combined with numerical results we show that the method of diffraction imaging flow cytometry has the capacity as a platform for high-throughput and label-free classification of biological cells

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Genomic–transcriptomic evolution in lung cancer and metastasis

Intratumour heterogeneity (ITH) fuels lung cancer evolution, which leads to immune evasion and resistance to therapy. Here, using paired whole-exome and RNA sequencing data, we investigate intratumour transcriptomic diversity in 354 non-small cell lung cancer tumours from 347 out of the first 421 patients prospectively recruited into the TRACERx study. Analyses of 947 tumour regions, representing both primary and metastatic disease, alongside 96 tumour-adjacent normal tissue samples implicate the transcriptome as a major source of phenotypic variation. Gene expression levels and ITH relate to patterns of positive and negative selection during tumour evolution. We observe frequent copy number-independent allele-specific expression that is linked to epigenomic dysfunction. Allele-specific expression can also result in genomic–transcriptomic parallel evolution, which converges on cancer gene disruption. We extract signatures of RNA single-base substitutions and link their aetiology to the activity of the RNA-editing enzymes ADAR and APOBEC3A, thereby revealing otherwise undetected ongoing APOBEC activity in tumours. Characterizing the transcriptomes of primary–metastatic tumour pairs, we combine multiple machine-learning approaches that leverage genomic and transcriptomic variables to link metastasis-seeding potential to the evolutionary context of mutations and increased proliferation within primary tumour regions. These results highlight the interplay between the genome and transcriptome in influencing ITH, lung cancer evolution and metastasis

Tools of Mass Consumption

Today, with cheaply produced plasticware introduced in the 1960s and foods that can be consumed directly out of the wrapper, our culture has essentially acknowledged the necessity for function and convenience when eating. I have embraced the idea of the positive effects of quality, married it with the abounding specialization found in Victorian flatware, and created a series of wares explicitly for the consumption of doughnuts and pizza. Using my eating utensils as an instrument for commentary, I encourage the scrutinizing examination of American eating habits

Integrative Complexity of Coastal Resources Management: Examining Tradeoffs Between Ecosystem Protection and Resource Use

The management dilemma of use versus protection is a complex issue , and like most complex issues , it does not lend itself to a simple or simplistic solution. This dissertation research examined the connection between integrative complexity , value orientations , and attitudes toward coastal resource use and protection. These are important topics within the human dimensions of coastal resources management that can help us understand the cognitive processes people use when thinking about acceptable tradeoffs regarding the biophysical environment and use of that environment. Integrative complexity is a concept that indicates the simplicity versus complexity of a person's thinking process. A person who perceives nuance and subtle differences typically scores higher on an integrative complexity measure , whereas those who view the world as black and white score low on integrative complexity. The limited research into the linkages between integrative complexity and components of the cognitive hierarchy , as applied to coastal resource management , inspired this research. Florida-licensed recreational saltwater anglers were sent an online questionnaire. Of the three quantitative integrative complexity measures that were developed , the self-classification vignettes best segmented the anglers into low to high levels of integrative complexity. These integrative complexity levels were used in hypothesis testing. Based on the literature , it was hypothesized that higher integrative complexity thinkers would hold pluralistic value orientations , moderate attitude extremity , and higher acceptability of tradeoffs between use and protection. While much of the results showed mixed support for the alternative hypotheses , there were consistent patterns in the direction of value orientations , attitudes and acceptability of tradeoffs across integrative complexity levels. Overall , high integrative complexity anglers demonstrated ecocentric value orientations , more support for protection-oriented management actions , and higher acceptability for tradeoffs involving an increase in resource protection. Low integrative complexity anglers demonstrated relatively more anthropocentric value orientations , more support for use-oriented management actions , and higher acceptability for tradeoffs involving an increase in resource use