Estimation of screening test (Hemoccult®) sensitivity in colorectal cancer mass screening

3 controlled cohorts of mass-screening for colorectal cancer using a biennial faecal occult blood (HemoccultII®) test on well-defined European populations have demonstrated a 14% to 18% reduction in specific mortality. We aimed to estimate the sensitivity (S) of this HemoccultII®test and and also mean sojourn time (MST) from French colorectal mass-screening programme data. 6 biennial screening rounds were performed from 1988 to 1998 in 45 603 individuals aged 45–74 years in Saône-et-Loire (Burgundy, France). The prevalent/incidence ratio was calculated in order to obtain a direct estimate of the product S.MST. The analysis of the proportional incidence and its modelling was used to derive an indirect estimate of S and MST. The product S.MST was higher for males than females and higher for left colon than either the right colon or rectum. The analysis of the proportional incidence confirmed the result for subsites but no other significant differences were found. The sensitivity was estimated at 0.57 and the MST at 2.56 years. This study confirms that the sensitivity of the Hemoccult test is relatively low and that the relatively short sojourn time is in favour of annual screening. © 2001 Cancer Research Campaign http://www.bjcancer.co

Minimally invasive repair of pectus excavatum using the Nuss technique in children and adolescents: Indications, outcomes, and limitations

AbstractBackgroundPectus excavatum (PE) is a common congenital deformity. The Nuss technique for minimally invasive repair of PE involves thoracoscopy-assisted insertion of a bar or plate behind the deformity to displace the sternum anteriorly. Our objective here was to clarify the indications and limitations of the Nuss technique based on a review of 70 patients.Materials and methodsA retrospective review of children managed at two centres identified 70 patients who had completed their growth and had their plate removed. Mean age was 13.8 years (range, 6–19 years). The reason for surgery was cosmetic disfigurement in 66 (95%) patients. The original Nuss technique was used in 63 patients, whereas 7 patients required an additional sub-xiphoid approach. Time to implant removal ranged from 8 months to 3 years.ResultsThe cosmetic outcome was considered satisfactory by the patients in 64 (91%) cases and by the surgeon in 60 (85.7%) cases. Major complications requiring further surgery occurred in 6 (8.5%) patients and consisted of haemothorax (n=2), chest wall sepsis (n=2, including 1 after implant removal), allergy (n=1), and implant displacement (n=1). Early or delayed minor complications occurred in 46 (65%) patients and resolved either spontaneously or after non-surgical therapy.DiscussionThe minimal scarring and reliably good outcomes support the widespread use of the Nuss technique in children and adolescents. Our complication rates (minor, 65%; and major, 8.5%) are consistent with previous publications. In our opinion, contra-indications to thoracoscopic PE correction consist of a history of cardio-thoracic surgery and the finding by computed tomography of a sternum-to-spine distance of less than 5cm or of sternum rotation greater than 35°. In these situations, we recommend a sub- and retro-xiphoid approach to guide implant insertion or a classic sterno-chondroplasty procedure.Level of evidenceLevel IV, retrospective descriptive cohort study

Detection of ultra-weak magnetic fields in Am stars: beta UMa and theta Leo

An extremely weak circularly polarized signature was recently discovered in spectral lines of the chemically peculiar Am star Sirius A. A weak surface magnetic field was proposed to account for the observed polarized signal, but the shape of the phase-averaged signature, dominated by a prominent positive lobe, is not expected in the standard theory of the Zeeman effect. We aim at verifying the presence of weak circularly polarized signatures in two other bright Am stars, beta UMa and theta Leo, and investigating the physical origin of Sirius-like polarized signals further. We present here a set of deep spectropolarimetric observations of beta UMa and theta Leo, observed with the NARVAL spectropolarimeter. We analyzed all spectra with the Least Squares Deconvolution multiline procedure. To improve the signal-to-noise ratio and detect extremely weak signatures in Stokes V profiles, we co-added all available spectra of each star (around 150 observations each time). Finally, we ran several tests to evaluate whether the detected signatures are consistent with the behavior expected from the Zeeman effect. The line profiles of the two stars display circularly polarized signatures similar in shape and amplitude to the observations previously gathered for Sirius A. Our series of tests brings further evidence of a magnetic origin of the recorded signal. These new detections suggest that very weak magnetic fields may well be present in the photospheres of a significant fraction of intermediate-mass stars. The strongly asymmetric Zeeman signatures measured so far in Am stars (featuring a dominant single-sign lobe) are not expected in the standard theory of the Zeeman effect and may be linked to sharp vertical gradients in photospheric velocities and magnetic field strengths

Influence of clinical and gait analysis experience on reliability of observational gait analysis (Edinburgh Gait Score Reliability)

AbstractObjectivesTreatment complexity of cerebral palsy (CP) patients imposes outcome evaluation studies, which may include objective technical analysis and more subjective functional evaluation. The Edinburgh Gait Score (EGS) was proposed as an additive or alternative when complex instrumented three-dimensional gait analysis is not available. Our purposes were to apply a translated EGS to standard video recordings of independent walking spastic diplegic CP patients, to evaluate its intraobserver and interobserver reliability with respect to gait analysis familiar and not familiar observers.MethodsTen standard video recordings acquired during routine clinical gait analysis were examined by eight observers gait analysis interpretation experienced or not, out of various specialities, two times with a two weeks interval. Kappa statistics and intraclass correlation coefficient were calculated.ResultsBetter reliability was observed for foot and knee scores than in proximal segments with significant differences between stance and swing phase. Significantly better results in gait analysis trained observers underlines the importance to either be used to clinical gait analysis interpretation, or to benefit of video analysis training before observational scoring.ConclusionVisual evaluation may be used for outcome studies to explore clinical changes in CP patients over time and may be associated to other validated evaluation tools

Unbiased proteomic profiling of host cell extracellular vesicle composition and dynamics upon HIV-1 infection

Cells release diverse types of extracellular vesicles (EVs), which transfer complex signals to surrounding cells. Specific markers to distinguish different EVs (e.g. exosomes, ectosomes, enveloped viruses like HIV) are still lacking. We have developed a proteomic profiling approach for characterizing EV subtype composition and applied it to human Jurkat T cells. We generated an interactive database to define groups of proteins with similar profiles, suggesting release in similar EVs. Biochemical validation confirmed the presence of preferred partners of commonly used exosome markers in EVs: CD81/ADAM10/ITGB1, and CD63/syntenin. We then compared EVs from control and HIV-1-infected cells. HIV infection altered EV profiles of several cellular proteins, including MOV10 and SPN, which became incorporated into HIV virions, and SERINC3, which was re-routed to non-viral EVs in a Nef-dependent manner. Furthermore, we found that SERINC3 controls the surface composition of EVs. Our workflow provides an unbiased approach for identifying candidate markers and potential regulators of EV subtypes. It can be widely applied to in vitro experimental systems for investigating physiological or pathological modifications of EV release

Collimated dual species oven source and its characterisation via spatially resolved fluorescence spectroscopy

We describe the design, construction and characterisation of a collimated, dual-species oven source for generating intense beams of lithium and caesium in UHV environments. Our design produces full beam overlap for the two species. Using an aligned microtube array the FWHM of the output beam is restricted to ~ 75 milliradians, with an estimated axial brightness of 3.6x10[superscript]14 atoms s[superscript]-1 sr[superscript]-1 for Li and 7.4x10[superscript]15 atoms s[superscript]-1 sr[superscript]-1 for Cs. We measure the properties of the output beam using a spatially-resolved fluorescence technique, which allows for the extraction of additional information not accessible without spatial resolution

Interactions between magnetohydrodynamic shear instabilities and convective flows in the solar interior

Motivated by the interface model for the solar dynamo, this paper explores the complex magnetohydrodynamic interactions between convective flows and shear-driven instabilities. Initially, we consider the dynamics of a forced shear flow across a convectively-stable polytropic layer, in the presence of a vertical magnetic field. When the imposed magnetic field is weak, the dynamics are dominated by a shear flow (Kelvin-Helmholtz type) instability. For stronger fields, a magnetic buoyancy instability is preferred. If this stably stratified shear layer lies below a convectively unstable region, these two regions can interact. Once again, when the imposed field is very weak, the dynamical effects of the magnetic field are negligible and the interactions between the shear layer and the convective layer are relatively minor. However, if the magnetic field is strong enough to favour magnetic buoyancy instabilities in the shear layer, extended magnetic flux concentrations form and rise into the convective layer. These magnetic structures have a highly disruptive effect upon the convective motions in the upper layer.Comment: 11 pages, 10 figures, accepted for publication in MNRA

Full sphere hydrodynamic and dynamo benchmarks

Convection in planetary cores can generate fluid flow and magnetic fields, and a number of sophisticated codes exist to simulate the dynamic behaviour of such systems. We report on the first community activity to compare numerical results of computer codes designed to calculate fluid flow within a whole sphere. The flows are incompressible and rapidly rotating and the forcing of the flow is either due to thermal convection or due to moving boundaries. All problems defined have solutions that allow easy comparison, since they are either steady, slowly drifting or perfectly periodic. The first two benchmarks are defined based on uniform internal heating within the sphere under the Boussinesq approximation with boundary conditions that are uniform in temperature and stress-free for the flow. Benchmark 1 is purely hydrodynamic, and has a drifting solution. Benchmark 2 is a magnetohydrodynamic benchmark that can generate oscillatory, purely periodic, flows and magnetic fields. In contrast, Benchmark 3 is a hydrodynamic rotating bubble benchmark using no slip boundary conditions that has a stationary solution. Results from a variety of types of code are reported, including codes that are fully spectral (based on spherical harmonic expansions in angular coordinates and polynomial expansions in radius), mixed spectral and finite difference, finite volume, finite element and also a mixed Fourier–finite element code. There is good agreement between codes. It is found that in Benchmarks 1 and 2, the approximation of a whole sphere problem by a domain that is a spherical shell (a sphere possessing an inner core) does not represent an adequate approximation to the system, since the results differ from whole sphere results