Socioeconomic inequalities in attitudes towards cancer: an international cancer benchmarking partnership study.

Socioeconomic status (SES) differences in attitudes towards cancer have been implicated in the differential screening uptake and the timeliness of symptomatic presentation. However, the predominant emphasis of this work has been on cancer fatalism, and many studies focus on specific community subgroups. This study aimed to assess SES differences in positive and negative attitudes towards cancer in UK adults. A population-based sample of UK adults (n=6965, age≥50 years) completed the Awareness and Beliefs about Cancer scale, including six belief items: three positively framed (e.g. 'Cancer can often be cured') and three negatively framed (e.g. 'A cancer diagnosis is a death sentence'). SES was indexed by education. Analyses controlled for sex, ethnicity, marital status, age, self-rated health, and cancer experience. There were few education-level differences for the positive statements, and overall agreement was high (all>90%). In contrast, there were strong differences for negative statements (all Ps<0.001). Among respondents with lower education levels, 57% agreed that 'treatment is worse than cancer', 27% that cancer is 'a death sentence' and 16% 'would not want to know if I have cancer'. Among those with university education, the respective proportions were 34, 17 and 6%. Differences were not explained by cancer experience or health status. In conclusion, positive statements about cancer outcomes attract near-universal agreement. However, this optimistic perspective coexists alongside widespread fears about survival and treatment, especially among less-educated groups. Health education campaigns targeting socioeconomically disadvantaged groups might benefit from a focus on reducing negative attitudes, which is not necessarily achieved by promoting positive attitudes

Neutral competition of stem cells is skewed by proliferative changes downstream of Hh and Hpo.

Neutral competition, an emerging feature of stem cell homeostasis, posits that individual stem cells can be lost and replaced by their neighbors stochastically, resulting in chance dominance of a clone at the niche. A single stem cell with an oncogenic mutation could bias this process and clonally spread the mutation throughout the stem cell pool. The Drosophila testis provides an ideal system for testing this model. The niche supports two stem cell populations that compete for niche occupancy. Here, we show that cyst stem cells (CySCs) conform to the paradigm of neutral competition and that clonal deregulation of either the Hedgehog (Hh) or Hippo (Hpo) pathway allows a single CySC to colonize the niche. We find that the driving force behind such behavior is accelerated proliferation. Our results demonstrate that a single stem cell colonizes its niche through oncogenic mutation by co-opting an underlying homeostatic process.This is the final version. It was first published by Wiley at http://onlinelibrary.wiley.com/doi/10.15252/embj.201387500/abstract

Risk factors for delay in symptomatic presentation: a survey of cancer patients

Background: Delay in symptomatic presentation leading to advanced stage at diagnosis may contribute to poor cancer survival. To inform public health approaches to promoting early symptomatic presentation, we aimed to identify risk factors for delay in presentation across several cancers. Methods: We surveyed 2371 patients with 15 cancers about nature and duration of symptoms using a postal questionnaire. We calculated relative risks for delay in presentation (time from symptom onset to first presentation >3 months) by cancer, symptoms leading to diagnosis and reasons for putting off going to the doctor, controlling for age, sex and deprivation group. Results: Among 1999 cancer patients reporting symptoms, 21% delayed presentation for >3 months. Delay was associated with greater socioeconomic deprivation but not age or sex. Patients with prostate (44%) and rectal cancer (37%) were most likely to delay and patients with breast cancer least likely to delay (8%). Urinary difficulties, change of bowel habit, systemic symptoms (fatigue, weight loss and loss of appetite) and skin symptoms were all common and associated with delay. Overall, patients with bleeding symptoms were no more likely to delay presentation than patients who did not have bleeding symptoms. However, within the group of patients with bleeding symptoms, there were significant differences in risk of delay by source of bleeding: 35% of patients with rectal bleeding delayed presentation, but only 9% of patients with urinary bleeding. A lump was a common symptom but not associated with delay in presentation. Twenty-eight percent had not recognised their symptoms as serious and this was associated with a doubling in risk of delay. Embarrassment, worry about what the doctor might find, being too busy to go to the doctor and worry about wasting the doctor’s time were also strong risk factors for delay, but were much less commonly reported (<6%). Interpretation: Approaches to promote early presentation should aim to increase awareness of the significance of cancer symptoms and should be designed to work for people of the lowest socioeconomic status. In particular, awareness that rectal bleeding is a possible symptom of cancer should be raised

The SLUGGS survey: globular clusters and the dark matter content of early-type galaxies

A strong correlation exists between the total mass of a globular cluster (GC) system and the virial halo mass of the host galaxy. However, the total halo mass in this correlation is a statistical measure conducted on spatial scales that are some 10 times that of a typical GC system. Here we investigate the connection between GC systems and galaxy's dark matter on comparable spatial scales, using dynamical masses measured on a galaxy-by-galaxy basis. Our sample consists of 17 well-studied massive (~10 x 11 M☉) early-type galaxies from the SLUGGS survey. We find the strongest correlation to be that of the blue (metal-poor) GC subpopulation and the dark matter content. This correlation implies that the dark matter mass of a galaxy can be estimated to within a factor of 2 from careful imaging of its GC system. The ratio of the GC system mass to that of the enclosed dark matter is nearly constant. We also find a strong correlation between the fraction of blue GCs and the fraction of enclosed dark matter, so that a typical galaxy with a blue GC fraction of 60 per cent has a dark matter fraction of 86 per cent over similar spatial scales. Both halo growth and removal (via tidal stripping) may play some role in shaping this trend. In the context of the two-phase model for galaxy formation, we find galaxies with the highest fractions of accreted stars to have higher dark matter fractions for a given fraction of blue GCs

Recognition of cancer warning signs and anticipated time to help-seeking in a population sample of adults in the UK

Background: Not recognising a symptom as suspicious is a common reason given by cancer patients for delayed help-seeking; but inevitably this is retrospective. We therefore investigated associations between recognition of warning signs for breast, colorectal and lung cancer and anticipated time to help-seeking for symptoms of each cancer. Methods: Computer-assisted telephone interviews were conducted with a population-representative sample (N=6965) of UK adults age greater than or equal to50 years, using the Awareness and Beliefs about Cancer scale. Anticipated time to help-seeking for persistent cough, rectal bleeding and breast changes was categorised as >2 vs less than or equal to2 weeks. Recognition of persistent cough, unexplained bleeding and unexplained lump as cancer warning signs was assessed (yes/no). Associations between recognition and help-seeking were examined for each symptom controlling for demographics and perceived ease of health-care access. Results: For each symptom, the odds of waiting for >2 weeks were significantly increased in those who did not recognise the related warning sign: breast changes: OR=2.45, 95% CI 1.47–4.08; rectal bleeding: OR=1.77, 1.36–2.30; persistent cough: OR=1.30, 1.17–1.46, independent of demographics and health-care access. Conclusion: Recognition of warning signs was associated with anticipating faster help-seeking for potential symptoms of cancer. Strategies to improve recognition are likely to facilitate earlier diagnosis

The SLUGGS survey: the assembly histories of individual early-type galaxies

Early-type (E and S0) galaxies may have assembled via a variety of different evolutionary pathways. Here, we investigate these pathways by comparing the stellar kinematic properties of 24 early-type galaxies from the SAGES Legacy Unifying Globulars and GalaxieS (SLUGGS) survey with the hydrodynamical simulations of Naab et al. In particular, we use the kinematics of starlight up to 4 effective radii (Re) as diagnostics of galaxy inner and outer regions, and assign each galaxy to one of six Naab et al. assembly classes. The majority of our galaxies (14/24) have kinematic characteristics that indicate an assembly history dominated by gradual gas dissipation and accretion of many gas-rich minor mergers. Three galaxies, all S0s, indicate that they have experienced gas-rich major mergers in their more recent past. One additional elliptical galaxy is tentatively associated with a gas-rich merger which results in a remnant galaxy with low angular momentum. Pathways dominated by gas-poor (major or minor) mergers dominate the mass growth of six galaxies. Most SLUGGS galaxies appear to have grown in mass (and size) via the accretion of stars and gas from minor mergers, with late major mergers playing a much smaller role. We find that the fraction of accreted stars correlates with the stellar mean age and metallicity gradient, but not with the slope of the total mass density profile. We briefly mention future observational and modelling approaches that will enhance our ability to accurately reconstruct the assembly histories of individual present-day galaxies

Severe and predominantly active atopic eczema in adulthood and long term risk of cardiovascular disease: population based cohort study.

OBJECTIVE: To investigate whether adults with atopic eczema are at an increased risk of cardiovascular disease and whether the risk varies by atopic eczema severity and condition activity over time. DESIGN: Population based matched cohort study. SETTING: UK electronic health records from the Clinical Practice Research Datalink, Hospital Episode Statistics, and data from the Office for National Statistics, 1998-2015. PARTICIPANTS: Adults with a diagnosis of atopic eczema, matched (on age, sex, general practice, and calendar time) to up to five patients without atopic eczema. MAIN OUTCOME MEASURES: Cardiovascular outcomes (myocardial infarction, unstable angina, heart failure, atrial fibrillation, stroke, and cardiovascular death). RESULTS: 387 439 patients with atopic eczema were matched to 1 528 477 patients without atopic eczema. The median age was 43 at cohort entry and 66% were female. Median follow-up was 5.1 years. Evidence of a 10% to 20% increased hazard for the non-fatal primary outcomes for patients with atopic eczema was found by using Cox regression stratified by matched set. There was a strong dose-response relation with severity of atopic eczema. Patients with severe atopic eczema had a 20% increase in the risk of stroke (hazard ratio 1.22, 99% confidence interval 1.01 to 1.48), 40% to 50% increase in the risk of myocardial infarction, unstable angina, atrial fibrillation, and cardiovascular death, and 70% increase in the risk of heart failure (hazard ratio 1.69, 99% confidence interval 1.38 to 2.06). Patients with the most active atopic eczema (active >50% of follow-up) were also at a greater risk of cardiovascular outcomes. Additional adjustment for cardiovascular risk factors as potential mediators partially attenuated the point estimates, though associations persisted for severe atopic eczema. CONCLUSIONS: Severe and predominantly active atopic eczema are associated with an increased risk of cardiovascular outcomes. Targeting cardiovascular disease prevention strategies among these patients should be considered

Diminished temperature and vegetation seasonality over northern high latitudes

Global temperature is increasing, especially over northern lands (>50° N), owing to positive feedbacks1. As this increase is most pronounced in winter, temperature seasonality (ST)—conventionally defined as the difference between summer and winter temperatures—is diminishing over time2, a phenomenon that is analogous to its equatorward decline at an annual scale. The initiation, termination and performance of vegetation photosynthetic activity are tied to threshold temperatures3. Trends in the timing of these thresholds and cumulative temperatures above them may alter vegetation productivity, or modify vegetation seasonality (SV), over time. The relationship between ST and SV is critically examined here with newly improved ground and satellite data sets. The observed diminishment of ST and SV is equivalent to 4° and 7° (5° and 6°) latitudinal shift equatorward during the past 30 years in the Arctic (boreal) region. Analysis of simulations from 17 state-of-the-art climate models4 indicates an additional STdiminishment equivalent to a 20° equatorward shift could occur this century. How SV will change in response to such large projected ST declines and the impact this will have on ecosystem services5 are not well understood. Hence the need for continued monitoring6 of northern lands as their seasonal temperature profiles evolve to resemble thosefurther south.Lopullinen vertaisarvioitu käsikirjoitu

The AIMSS Project – III. The Stellar Populations of Compact Stellar Systems

In recent years, a growing zoo of compact stellar systems (CSSs) have been found whose physical properties (mass, size, velocity dispersion) place them between classical globular clusters (GCs) and true galaxies, leading to debates about their nature. Here we present results using a so far underutilized discriminant, their stellar population properties. Based on new spectroscopy from 8–10m telescopes, we derive ages, metallicities, and [α/Fe] of 29 CSSs. These range from GCs with sizes of merely a few parsec to compact ellipticals (cEs) larger than M32. Together with a literature compilation, this provides a panoramic view of the stellar population characteristics of early-type systems. We find that the CSSs are predominantly more metal rich than typical galaxies at the same stellar mass. At high mass, the cEs depart from the mass–metallicity relation of massive early-type galaxies, which forms a continuous sequence with dwarf galaxies. At lower mass, the metallicity distribution of ultracompact dwarfs (UCDs) changes at a few times 107 M⊙, which roughly coincides with the mass where luminosity function arguments previously suggested the GC population ends. The highest metallicities in CSSs are paralleled only by those of dwarf galaxy nuclei and the central parts of massive early types. These findings can be interpreted as CSSs previously being more massive and undergoing tidal interactions to obtain their current mass and compact size. Such an interpretation is supported by CSSs with direct evidence for tidal stripping, and by an examination of the CSS internal escape velocities

The SLUGGS Survey: stellar kinematics, kinemetry and trends at large radii in 25 early-type galaxies

Due to longer dynamical time-scales, the outskirts of early-type galaxies retain the footprint of their formation and assembly. Under the popular two-phase galaxy formation scenario, an initial in situ phase of star formation is followed by minor merging and accretion of ex situ stars leading to the expectation of observable transitions in the kinematics and stellar populations on large scales. However, observing the faint galactic outskirts is challenging, often leaving the transition unexplored. The large-scale, spatially resolved stellar kinematic data from the SAGES Legacy Unifying Galaxies and GlobularS (SLUGGS) survey are ideal for detecting kinematic transitions. We present kinematic maps out to 2.6 effective radii on average, kinemetry profiles, measurement of kinematic twists and misalignments, and the average outer intrinsic shape of 25 SLUGGS galaxies. We find good overall agreement in the kinematic maps and kinemetry radial profiles with literature. We are able to confirm significant radial modulations in rotational versus pressure support of galaxies with radius so that the central and outer rotational properties may be quite different. We also test the suggestion that galaxies may be more triaxial in their outskirts and find that while fast rotating galaxies were already shown to be axisymmetric in their inner regions, we are unable to rule out triaxiality in their outskirts.We compare our derived outer kinematic information to model predictions from a two-phase galaxy formation scenario. We find that the theoretical range of local outer angular momentum agrees well with our observations, but that radial modulations are much smaller than predicted