The impact of population-based faecal occult blood test screening on colorectal cancer mortality:a matched cohort study

BACKGROUND: Randomised trials show reduced colorectal cancer (CRC) mortality with faecal occult blood testing (FOBT). This outcome is now examined in a routine, population-based, screening programme. METHODS: Three biennial rounds of the UK CRC screening pilot were completed in Scotland (2000–2007) before the roll out of a national programme. All residents (50–69 years) in the three pilot Health Boards were invited for screening. They received a FOBT test by post to complete at home and return for analysis. Positive tests were followed up with colonoscopy. Controls, selected from non-pilot Health Boards, were matched by age, gender, and deprivation and assigned the invitation date of matched invitee. Follow-up was from invitation date to 31 December 2009 or date of death if earlier. RESULTS: There were 379 655 people in each group (median age 55.6 years, 51.6% male). Participation was 60.6%. There were 961 (0.25%) CRC deaths in invitees, 1056 (0.28%) in controls, rate ratio (RR) 0.90 (95% confidence interval (CI) 0.83–0.99) overall and 0.73 (95% CI 0.65–0.82) for participants. Non-participants had increased CRC mortality compared with controls, RR 1.21 (95% CI 1.06–1.38). CONCLUSION: There was a 10% relative reduction in CRC mortality in a routine screening programme, rising to 27% in participants

Knowledge, attitudes, and practice of oncologists and oncology health care providers in promoting physical activity to cancer survivors: An international survey

Objective: To investigate knowledge, attitudes and practices of oncologists towards physical 2 activity (PA) in cancer survivors, and the association between oncologists’ own PA behavior 3 and PA promotion. Methods: Oncologists (n=123) completed a survey based on the Theory of 4 Planned Behavior (TPB). Participants reported PA promotion behavior, PA involvement, 5 attitudes, intentions, social norm, Perceived Behavioral Control (PBC), confidence and 6 knowledge of exercise prescription. Structural equation modelling (SEM) evaluated these 7 associations. Results: Less than half of oncologists reported regularly promoting PA to 8 patients (46%), with 20% providing written information and 23% referrals. Only 26% were 9 physically active. TPB SEM pathways explained 54.6% of the variance in PA promotion 10 (CFI=0.905, SRMR=0.040). Social norm was the only significant pathway to intention, but 11 also a significant indirect pathway to PA promotion (p=.007). Confidence to promote PA, 12 PBC and intentions were direct significant pathways to PA promotion (p\u3c.05). Exploratory 13 SEM pathways explained 19.6% of the variance of PA behavior, which in turn explained 14 13.1% Social Norm, 10.7% Attitude, 10.0% Confidence to Recommend and 17.8% PA 15 promotion behavior (CFI=0.921, SRMR=0.076). Instrumental-attitude was a direct significant 16 pathway to PA behavior (p=.001). PA behavior was a direct significant pathway to social 17 norms, attitude, confidence to recommend, and PA promotion (p \u3c 0.05). Conclusions: 18 Oncologists reported a modest ability to promote PA, low PA promotion rates and limited 19 knowledge of exercise prescription. Patient physical activity promotion may be improved 20 through strategies that increase oncologists’ PBC, confidence and their own personal PA 21 participation

Methods for discovering genomic loci exhibiting complex patterns of differential methylation.

BACKGROUND: Cytosine methylation is widespread in most eukaryotic genomes and is known to play a substantial role in various regulatory pathways. Unmethylated cytosines may be converted to uracil through the addition of sodium bisulphite, allowing genome-wide quantification of cytosine methylation via high-throughput sequencing. The data thus acquired allows the discovery of methylation 'loci'; contiguous regions of methylation consistently methylated across biological replicates. The mapping of these loci allows for associations with other genomic factors to be identified, and for analyses of differential methylation to take place. RESULTS: The segmentSeq R package is extended to identify methylation loci from high-throughput sequencing data from multiple experimental conditions. A statistical model is then developed that accounts for biological replication and variable rates of non-conversion of cytosines in each sample to compute posterior likelihoods of methylation at each locus within an empirical Bayesian framework. The same model is used as a basis for analysis of differential methylation between multiple experimental conditions with the baySeq R package. We demonstrate the capability of this method to analyse complex data sets in an analysis of data derived from multiple Dicer-like mutants in Arabidopsis. This reveals several novel behaviours at distinct sets of loci in response to loss of one or more of the Dicer-like proteins that indicate an antagonistic relationship between the Dicer-like proteins at at least some methylation loci. Finally, we show in simulation studies that this approach can be significantly more powerful in the detection of differential methylation than many existing methods in data derived from both mammalian and plant systems. CONCLUSIONS: The methods developed here make it possible to analyse high-throughput sequencing of the methylome of any given organism under a diverse set of experimental conditions. The methods are able to identify methylation loci and evaluate the likelihood that a region is truly methylated under any given experimental condition, allowing for downstream analyses that characterise differences between methylated and non-methylated regions of the genome. Futhermore, diverse patterns of differential methylation may also be characterised from these data

Population screening for colorectal cancer: the implications of an ageing population

Population screening for colorectal cancer (CRC) has recently commenced in the United Kingdom supported by the evidence of a number of randomised trials and pilot studies. Certain factors are known to influence screening cost-effectiveness (e.g. compliance), but it remains unclear whether an ageing population (i.e. demographic change) might also have an effect. The aim of this study was to simulate a population-based screening setting using a Markov model and assess the effect of increasing life expectancy on CRC screening cost-effectiveness. A Markov model was constructed that aimed, using a cohort simulation, to estimate the cost-effectiveness of CRC screening in an England and Wales population for two timescales: 2003 (early cohort) and 2033 (late cohort). Four model outcomes were calculated; screened and non-screened cohorts in 2003 and 2033. The screened cohort of men and women aged 60 years were offered biennial unhydrated faecal occult blood testing until the age of 69 years. Life expectancy was assumed to increase by 2.5 years per decade. There were 407 552 fewer people entering the model in the 2033 model due to a lower birth cohort, and population screening saw 30 345 fewer CRC-related deaths over the 50 years of the model. Screening the 2033 cohort cost £96 million with cost savings of £43 million in terms of detection and treatment and £28 million in palliative care costs. After 30 years of follow-up, the cost per life year saved was £1544. An identical screening programme in an early cohort (2003) saw a cost per life year saved of £1651. Population screening for CRC is costly but enables cost savings in certain areas and a considerable reduction in mortality from CRC. This Markov simulation suggests that the cost-effectiveness of population screening for CRC in the United Kingdom may actually be improved by rising life expectancies

Promotion of Intestinal Peristalsis by Bifidobacterium spp. Capable of Hydrolysing Sennosides in Mice

BACKGROUND:While there are a variety of identifiable causes of constipation, even idiopathic constipation has different possible mechanisms. Sennosides, the main laxative constituents of Daio, an ancient Kampo medicine, are prodrugs that are converted to an active principle, rheinanthrone, by intestinal microbiota. In this study, we aimed to determine the sennoside hydrolysis ability of lactic acid bacterial strains and bifidobacteria in the intestine and to investigate their effect on intestinal peristalsis in mice. METHODOLOGY/PRINCIPAL FINDINGS:A total of 88 lactic acid bacterial strains and 47 bifidobacterial strains were evaluated for their ability to hydrolyze sennosides. Our results revealed that 4 strains, all belonging to the genus Bifidobacterium, had strong sennoside hydrolysis ability, exhibiting a decrease of >70% of sennoside content. By thin-layer chromatography analysis, rheinanthrone was detected in the medium cultured with B. pseudocatenulatum LKM10070 and B. animalis subsp. lactis LKM512. The fecal sennoside contents significantly (P<0.001) decreased upon oral administration of these strains as compared with the control. Intestinal peristalsis activity was measured by the moved distance of the charcoal powder administered orally. The distance travelled by the charcoal powder in LKM512-treated mice was significantly longer than that of control (P<0.05). Intestinal microbiota were analysed by real-time PCR and terminal-restriction fragment length polymorphism. The diversity of the intestinal microbiota was reduced by kanamycin treatment and the diversity was not recovered by LKM512 treatment. CONCLUSION/SIGNIFICANCE:We demonstrated that intestinal peristalsis was promoted by rheinanthrone produced by hydrolysis of sennoside by strain LKM512 and LKM10070

Gene dispersion is the key determinant of the read count bias in differential expression analysis of RNA-seq data

Background: In differential expression analysis of RNA-sequencing (RNA-seq) read count data for two sample groups, it is known that highly expressed genes (or longer genes) are more likely to be differentially expressed which is called read count bias (or gene length bias). This bias had great effect on the downstream Gene Ontology over-representation analysis. However, such a bias has not been systematically analyzed for different replicate types of RNA-seq data. Results: We show that the dispersion coefficient of a gene in the negative binomial modeling of read counts is the critical determinant of the read count bias (and gene length bias) by mathematical inference and tests for a number of simulated and real RNA-seq datasets. We demonstrate that the read count bias is mostly confined to data with small gene dispersions (e.g., technical replicates and some of genetically identical replicates such as cell lines or inbred animals), and many biological replicate data from unrelated samples do not suffer from such a bias except for genes with some small counts. It is also shown that the sample-permuting GSEA method yields a considerable number of false positives caused by the read count bias, while the preranked method does not. Conclusion: We showed the small gene variance (similarly, dispersion) is the main cause of read count bias (and gene length bias) for the first time and analyzed the read count bias for different replicate types of RNA-seq data and its effect on gene-set enrichment analysis

The Hot and Energetic Universe: AGN feedback in galaxy clusters and groups

Mechanical feedback via Active Galactic Nuclei (AGN) jets in the centres of galaxy groups and clusters is a crucial ingredient in current models of galaxy formation and cluster evolution. Jet feedback is believed to regulate gas cooling and thus star formation in the most massive galaxies, but a robust physical understanding of this feedback mode is currently lacking. The large collecting area, excellent spectral resolution and high spatial resolution of Athena+ will provide the breakthrough diagnostic ability necessary to develop this understanding, via: (1) the first kinematic measurements on relevant spatial scales of the hot gas in galaxy, group and cluster haloes as it absorbs the impact of AGN jets, and (2) vastly improved ability to map thermodynamic conditions on scales well-matched to the jets, lobes and gas disturbances produced by them. Athena+ will therefore determine for the first time how jet energy is dissipated and distributed in group and cluster gas, and how a feedback loop operates in group/cluster cores to regulate gas cooling and AGN fuelling. Athena+ will also establish firmly the cumulative impact of powerful radio galaxies on the evolution of baryons from the epoch of group/cluster formation to the present day

Factors that contribute to faecal cyclooxygenase-2 mRNA expression in subjects with colorectal cancer

浜松医科大学学位論文　医博第600号（平成23年3月16日

The Hot and Energetic Universe: AGN feedback in galaxy clusters and groups

Mechanical feedback via Active Galactic Nuclei (AGN) jets in the centres of galaxy groups and clusters is a crucial ingredient in current models of galaxy formation and cluster evolution. Jet feedback is believed to regulate gas cooling and thus star formation in the most massive galaxies, but a robust physical understanding of this feedback mode is currently lacking. The large collecting area, excellent spectral resolution and high spatial resolution of Athena+ will provide the breakthrough diagnostic ability necessary to develop this understanding, via: (1) the first kinematic measurements on relevant spatial scales of the hot gas in galaxy, group and cluster haloes as it absorbs the impact of AGN jets, and (2) vastly improved ability to map thermodynamic conditions on scales well-matched to the jets, lobes and gas disturbances produced by them. Athena+ will therefore determine for the first time how jet energy is dissipated and distributed in group and cluster gas, and how a feedback loop operates in group/cluster cores to regulate gas cooling and AGN fuelling. Athena+ will also establish firmly the cumulative impact of powerful radio galaxies on the evolution of baryons from the epoch of group/cluster formation to the present day

Evaluation of serum CEA, CYFRA21-1 and CA125 for the early detection of colorectal cancer using longitudinal preclinical samples

Blood-borne biomarkers for early detection of colorectal cancer (CRC) could markedly increase screening uptake. The aim of this study was to evaluate serum carcinoembryonic antigen (CEA), CYFRA21-1 and CA125 for the early detection of CRC in an asymptomatic cohort