Relationship between emergency presentation, systemic inflammatory response, and cancer-specific survival in patients undergoing potentially curative surgery for colon cancer

Background Emergency presentation is recognized to be associated with poorer cancer-specific survival following curative resection for colorectal cancer. The present study examined the hypothesis that an enhanced systemic inflammatory response, prior to surgery, might explain the impact of emergency presentation on survival. Methods In all, 188 patients undergoing potentially curative resection for colorectal cancer were studied. Of these, 55 (29%) presented as emergencies. The systemic inflammatory response was assessed using the Glasgow Prognostic Score (mGPS), which is the combination of an elevated C-reactive protein (>10 mg/L) and hypoalbuminemia (<35 g/L). Results In the emergency group, tumor stage was greater (P < 0.01), more patients received adjuvant therapy (P < 0.01) more patients had an elevated mGPS (P < 0.01), and more patients died of their disease (P < 0.05). The minimum follow-up was 12 months; the median follow-up of the survivors was 48 months. Emergency presentation was associated with poorer 3-year cancer-specific survival in those patients aged 65 to 74 years (P < 0.01), in both males and females (P < 0.05), in the deprived (P < 0.01), in patients with tumor-node-metastasis (TNM) stage II disease (P < 0.01), in those who received no adjuvant therapy (P < 0.01), and in the mGPS 0 and 1 groups (P < 0.05) groups. On multivariate survival analysis of patients undergoing potentially curative surgery for TNM stage II colon cancer, emergency presentation (P < 0.05) and mGPS (P < 0.05) were independently associated with cancer-specific survival. Conclusions These results suggest that emergency presentation and the presence of systemic inflammatory response prior to surgery are linked and account for poorer cancer-specific survival in patients undergoing potentially curative surgery for colon cancer. Both emergency presentation and an elevated mGPS should be taken into account when assessing the likely outcome of these patients

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

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

HI Narrow Self-Absorption in Dark Clouds: Correlations with Molecular Gas and Implications for Cloud Evolution and Star Formation

We present the results of a comparative study of HI narrow self-absorption (HINSA), OH, 13CO, and C18O in five dark clouds. The HINSA follows the distribution of the emission of the carbon monoxide isotopologues, and has a characteristic size close to that of 13CO. This confirms that the HINSA is produced by cold HI which is well mixed with molecular gas in well-shielded regions. The ratio of the atomic hydrogen density to total proton density for these sources is 5 to 27 x 10^{-4}. Using cloud temperatures and the density of HI, we set an upper limit to the cosmic ray ionization rate of 10^{-16} s^{-1}. Comparison of observed and modeled fractional HI abundances indicates ages for these clouds to be 10^{6.5} to 10^{7} yr. The low values of the HI density we have determined make it certain that the time scale for evolution from an atomic to an almost entirely molecular phase, must be a minimum of several million years. This clearly sets a lower limit to the overall time scale for star formation and the lifetime of molecular clouds

Second and third season QUaD CMB temperature and polarization power spectra

We report results from the second and third seasons of observation with the QUaD experiment. Angular power spectra of the Cosmic Microwave Background are derived for both temperature and polarization at both 100 GHz and 150 GHz, and as cross frequency spectra. All spectra are subjected to an extensive set of jackknife tests to probe for possible systematic contamination. For the implemented data cuts and processing technique such contamination is undetectable. We analyze the difference map formed between the 100 and 150 GHz bands and find no evidence of foreground contamination in polarization. The spectra are then combined to form a single set of results which are shown to be consistent with the prevailing LCDM model. The sensitivity of the polarization results is considerably better than that of any previous experiment -- for the first time multiple acoustic peaks are detected in the E-mode power spectrum at high significance.Comment: 24 pages, 23 figures, updated to reflect published versio

QUaD: A High-Resolution Cosmic Microwave Background Polarimeter

We describe the QUaD experiment, a millimeter-wavelength polarimeter designed to observe the Cosmic Microwave Background (CMB) from a site at the South Pole. The experiment comprises a 2.64 m Cassegrain telescope equipped with a cryogenically cooled receiver containing an array of 62 polarization-sensitive bolometers. The focal plane contains pixels at two different frequency bands, 100 GHz and 150 GHz, with angular resolutions of 5 arcmin and 3.5 arcmin, respectively. The high angular resolution allows observation of CMB temperature and polarization anisotropies over a wide range of scales. The instrument commenced operation in early 2005 and collected science data during three successive Austral winter seasons of observation.Comment: 23 pages, author list and text updated to reflect published versio

Quarkonia production at RHIC

Quarkonia (J/Psi, Psi', Upsilon) production provides a sensitive probe of gluon distributions and their modification in nuclei; and is a leading probe of the hot-dense (deconfined) matter created in high-energy collisions of heavy ions. I will discuss our current understanding of the modification of gluon distributions in nuclei and other cold-nuclear-matter effects in the context of recent p-p and p(d)-A quarkonia measurements. Then I will review the latest results for nucleus-nucleus collisions from RHIC, and together with the baseline results from d-A and p-p collisions, discuss several alternative explanations for the observed suppressions and future prospects for distinguishing these different pictures.Comment: 8 pages including figures, writeup of talk given at Strange Quark Matter 2006, UCLA 26-31 March, 200

A Multi-Wavelength Mass Analysis of RCS2 J232727.6-020437, a ~3x1015^{15}M⊙_{\odot} Galaxy Cluster at z=0.7

We present an initial study of the mass and evolutionary state of a massive and distant cluster, RCS2 J232727.6-020437. This cluster, at z=0.6986, is the richest cluster discovered in the RCS2 project. The mass measurements presented in this paper are derived from all possible mass proxies: X-ray measurements, weak-lensing shear, strong lensing, Sunyaev Zel'dovich effect decrement, the velocity distribution of cluster member galaxies, and galaxy richness. While each of these observables probe the mass of the cluster at a different radius, they all indicate that RCS2 J232727.6-020437 is among the most massive clusters at this redshift, with an estimated mass of M_200 ~3 x10^15 h^-1 Msun. In this paper, we demonstrate that the various observables are all reasonably consistent with each other to within their uncertainties. RCS2 J232727.6-020437 appears to be well relaxed -- with circular and concentric X-ray isophotes, with a cool core, and no indication of significant substructure in extensive galaxy velocity data.Comment: 19 pages, 15 figures, submitted to ApJ on March 5, 2015; in press. Manuscript revised following the referee revie

Genome biogeography reveals the intraspecific spread of adaptive mutations for a complex trait

Physiological novelties are often studied at macro-evolutionary scales such that their micro-evolutionary origins remain poorly understood. Here, we test the hypothesis that key components of a complex trait can evolve in isolation and later be combined by gene flow. We use C4 photosynthesis as a study system, a derived physiology that increases plant productivity in warm, dry conditions. The grass Alloteropsis semialata includes C4 and non-C4 genotypes, with some populations using laterally-acquired C4 -adaptive loci, providing an outstanding system to track the spread of novel adaptive mutations. Using genome data from C4 and non-C4 A. semialata individuals spanning the species' range, we infer and date past migrations of different parts of the genome. Our results show that photosynthetic types initially diverged in isolated populations, where key C4 components were acquired. However, rare but recurrent subsequent gene flow allowed the spread of adaptive loci across genetic pools. Indeed, laterally-acquired genes for key C4 functions were rapidly passed between populations with otherwise distinct gene pools. Thus, our intraspecific study of C4 -related genomic variation indicates that components of adaptive traits can evolve separately and later be combined through secondary gene flow, leading to the assembly and optimization of evolutionary innovations. This article is protected by copyright. All rights reserved