Localized prostate cancer in Norway, the United States, and Spain: between-country differences of variables before treatment among patients eligible for curative treatment

Between-country differences in medical and sociodemographic variables, and patient-related outcomes (PROs) before treatment might explain published variations of side effects after radical prostatecomy (RP) or radiotherapy (RAD) for prostate cancer (PCa). This hypothesis was tested among 1908 patients from the United States, Spain, and Norway. Significant between-country differences were observed for most factors investigated before treatment. The observations should be considered in comparison of the frequency and severity of internationally published studies. Background: In men with PCa, large variations of PROs after RP or high-dose RAD might be related to betweencountry differences of medical and sociodemographic variables, and differences in PROs before treatment in the sexual and urinary domains. Patients and Methods: In 1908 patients with localized PCa from Norway, the United States, or Spain, the relation between medical (prostate-specific antigen, Gleason score, cT-category) and sociodemographic variables (age, education, marital status) before treatment was investigated. Using the Expanded Prostate Cancer Index Composite questionnaire, PROs before treatment within the sexual and urinary domains were also considered. Results: Compared with the European patients, American patients were younger, fewer had comorbid conditions, and more had a high education level. Fifty-three percent of the US men eligible for RP had low-risk tumors compared with 42% and 31% among the Norwegian and the Spanish patients, respectively. Among the Spanish RAD patients, 54% had had low-risk tumors compared with 34% of the American and 21% of the Norwegian men planned for RAD, respectively. Compared with the European patients, significantly fewer US patients reported moderate or severe sexual dysfunction and related problems. In most subgroups, the number of patients with sexual or urinary dysfunction exceeded that of patients with bother related to the reported dysfunction. Conclusion: Statistically significant between-country differences were observed in medical and sociodemographic variables, and in PROs before treatment within the sexual and urinary domains. Large differences between reported dysfunction and related problems within the sexual and urinary domains indicate that dysfunction and bother should be reported separately in addition to calculation of summary scores. The documented differences, not at least regarding PROs, might in part explain the large variation of side effects after treatment evident in the medical literatur

Relationship between Juvenile Fish Condition and Survival to Adulthood in Steelhead

Understanding how individual characteristics are associated with survival is important to programs aimed at recovering fish populations of conservation concern. To evaluate whether individual fish characteristics observed during the juvenile life stage were associated with the probability of returning as an adult, juvenile steelhead Oncorhynchus mykiss from two distinct population segments (DPSs; Snake River and upper Columbia River) were captured, photographed to determine external condition (body injuries, descaling, signs of disease, fin damage, and ectoparasites), measured, classified by rearing type (hatchery, wild), marked with a PIT tag, and released to continue out-migration to the Pacific Ocean during 2007–2010. The PIT tags of returning adults were interrogated in fishways at hydroelectric dams on the lower Columbia River 1–3 years following release as juveniles. Juvenile-to-adult survival models were investigated independently for each DPS and indicated that similar individual fish characteristics were important predictors of survival to adulthood for both steelhead populations. The data analysis provided strong support for survival models that included explanatory variables for fish length, rearing type, and external condition, in addition to out-migration year and timing. The probability of a juvenile surviving to adulthood was positively related to length and was higher for wild fish compared with hatchery fish. Survival was lower for juveniles with body injuries, fin damage, and external signs of disease. Models that included variables for descaling and ectoparasite infestation, however, had less support than those that incorporated measures of body injuries, fin damage, and disease. Overall, results indicated that individual fish characteristics recorded during the juvenile life stage can be used to predict adult survivorship in multiple steelhead populations

Physical activity in Hodgkin's lymphoma survivors with and without chronic fatigue compared with the general population – a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Hodgkin's lymphoma survivors (HLSs) commonly report chronic fatigue, defined as high levels of fatigue for 6 months or more. Underlying mechanisms are poorly understood. Based upon knowledge from other populations, lifestyle parameters may be related to this increased and persistent fatigue. The primary objective of the present study was to assess self-reported levels of physical activity, smoking habits and sleep patterns in HLSs with and without chronic fatigue. The secondary objective was to compare these results with data from age and gender adjusted data from the general population (Gen-Pop).</p> <p>Methods</p> <p>The Fatigue Questionnaire (FQ) and questions about daily smoking, sleep patterns and level of physical activity were completed by 476 HLSs treated at Rikshospitalet-Radiumhospitalet Trust (RR). The Gen-Pop data was derived from 56.999 inhabitants in a Norwegian county responding to a mail survey. Fischer's exact test, chi square test and t-tests were used to compare groups. P-values < .05 were considered statistically significant. A logistic regression analysis was performed in comparing the Gen-Pop with the HLSs.</p> <p>Results</p> <p>Level of physical activity, smoking habits and sleep patterns did not differ significantly between HLSs with and without chronic fatigue. The multivariate logistic regression analysis adjusting for different covariates, showed significantly more physically active men among HLSs compared with the Gen-Pop (OR = 1.50, CI 1.04 – 2.17), p = .031. No significant difference was found among females (OR = 1.20, CI = 0.83 – 1.74), p = .33.</p> <p>Conclusion</p> <p>Lifestyle parameters did not seem to be related to increased and persistent fatigue among HLSs. The results may indicate that the experience of Hodgkin's lymphoma increases the level of physical activity among male HLSs.</p

A Shape Memory Polymer Dialysis Needle Adapter for the Reduction of Hemodynamic Stress within Arteriovenous Grafts

A deployable, shape memory polymer adapter is investigated for reducing the hemodynamic stress caused by a dialysis needle flow within an arteriovenous graft. Computational fluid dynamics simulations of dialysis sessions with and without the adapter demonstrate that the adapter provides a significant decrease in the wall shear stress. In vitro flow visualization measurements are made within a graft model following delivery and actuation of a prototype shape memory polymer adapter. Vascular access complications resulting from arteriovenous (AV) graft failures account for over $1 billion per year in the health care costs of dialysis patients in the U.S.[1] The primary mode of failure of arteriovenous fistulas (AVF's) and polytetrafluoroethylene (PTFE) grafts is the development of intimal hyperplasia (IH) and the subsequent formation of stenotic lesions, resulting in a graft flow decline. The hemodynamic stresses arising within AVF's and PTFE grafts play an important role in the pathogenesis of IH. Studies have shown that vascular damage can occur in regions where there is flow separation, oscillation, or extreme values of wall shear stress (WSS).[2] Nevaril et al.[3] show that exposure of red blood cells to WSS's on the order of 1500 dynes/cm2 can result in hemolysis. Hemodynamic stress from dialysis needle flow has recently been investigated for the role it plays in graft failure. Using laser Doppler velocimetry measurements, Unnikrishnan et al.[4] show that turbulence intensities are 5-6 times greater in the AV flow when the needle flow is present and that increased levels of turbulence exist for approximately 7-8cm downstream of the needle. Since the AVF or PTFE graft is exposed to these high levels of hemodynamic stress several hours each week during dialysis sessions, it is quite possible that needle flow is an important contributor to vascular access occlusion.[4] We present a method for reducing the hemodynamic stress in an AV graft by tailoring the fluid dynamics of the dialysis needle flow using a deployable shape memory polymer (SMP) dialysis needle adapter. Such an adapter is deployed through the needle into the graft where it is actuated into an expanded shape using thermal energy. The expanded adapter has a tube-like shape, in which the distal end has a larger cross-sectional area than that of the needle. When the dialysis session is completed, the adapter is retracted through the needle. In this initial study, we conduct computational fluid dynamics (CFD) simulations to assess the changes in the hemodynamic stress on a graft wall when the SMP adapter is utilized. Additionally, we fabricate a prototype SMP adapter and deploy it in an in vitro model of an AV graft

Fabrication and Characterization of Cylindrical Light Diffusers Comprised of Shape Memory Polymer

We have developed a technique for constructing light diffusing devices comprised of a flexible shape memory polymer (SMP) cylindrical diffuser attached to the tip of an optical fiber. Devices were fabricated by casting an SMP rod over the cleaved tip of an optical fiber and media blasting the SMP rod to create a light diffusing surface. The axial and polar emission profiles and circumferential (azimuthal) uniformity were characterized for various blasting pressures, nozzle-to-sample distances, and nozzle translation speeds. The diffusers were generally strongly forward-directed and consistently withstood over 8 W of incident infrared laser light without suffering damage when immersed in water. These devices are suitable for various endoluminal and interstitial biomedical applications

Development of an automated DNA purification module using a micro-fabricated pillar chip

We present a fully automated DNA purification module comprised of a micro-fabricated chip and sequential injection analysis system that is designed for use within autonomous instruments that continuously monitor the environment for the presence of biological threat agents. The chip has an elliptical flow channel containing a bed (3.5 &times; 3.5 mm) of silica-coated pillars with height, width and center-to-center spacing of 200, 15, and 30 &micro;m, respectively, which provides a relatively large surface area (ca. 3 cm2) for DNA capture in the presence of chaotropic agents. We have characterized the effect of various fluidic parameters on extraction performance, including sample input volume, capture flow rate, and elution volume. The flow-through design made the pillar chip completely reusable; carryover was eliminated by flushing lines with sodium hypochlorite and deionized water between assays. A mass balance was conducted to determine the fate of input DNA not recovered in the eluent. The device was capable of purifying and recovering Bacillus anthracis genomic DNA (input masses from 0.32 to 320 pg) from spiked environmental aerosol samples, for subsequent analysis using polymerase chain reaction-based assays.<br /