Tumour invasiveness, the local and systemic environment and the basis of staging systems in colorectal cancer

background: The present study aimed to examine the relationship between tumour invasiveness (T stage), the local and systemic environment and cancer-specific survival (CSS) of patients with primary operable colorectal cancer. methods: The tumour microenvironment was examined using measures of the inflammatory infiltrate (Klintrup-Makinen (KM) grade and Immunoscore), tumour stroma percentage (TSP) and tumour budding. The systemic inflammatory environment was examined using modified Glasgow Prognostic Score (mGPS) and neutrophil:lymphocyte ratio (NLR). A 5-year CSS was examined. results: A total of 331 patients were included. Increasing T stage was associated with colonic primary, N stage, poor differentiation, margin involvement and venous invasion (P<0.05). T stage was significantly associated with KM grade (P=0.001), Immunoscore (P=0.016), TSP (P=0.006), tumour budding (P<0.001), and elevated mGPS and NLR (both P<0.05). In patients with T3 cancer, N stage stratified survival from 88 to 64%, whereas Immunoscore and budding stratified survival from 100 to 70% and from 91 to 56%, respectively. The Glasgow Microenvironment Score, a score based on KM grade and TSP, stratified survival from 93 to 58%. conclusions: Although associated with increasing T stage, local and systemic tumour environment characteristics, and in particular Immunoscore, budding, TSP and mGPS, are stage-independent determinants of survival and may be utilised in the staging of patients with primary operable colorectal cancer

Coral larvae move toward reef sounds

Free-swimming larvae of tropical corals go through a critical life-phase when they return from the open ocean to select a suitable settlement substrate. During the planktonic phase of their life cycle, the behaviours of small coral larvae (<1 mm) that influence settlement success are difficult to observe in situ and are therefore largely unknown. Here, we show that coral larvae respond to acoustic cues that may facilitate detection of habitat from large distances and from upcurrent of preferred settlement locations. Using in situ choice chambers, we found that settling coral larvae were attracted to reef sounds, produced mainly by fish and crustaceans, which we broadcast underwater using loudspeakers. Our discovery that coral larvae can detect and respond to sound is the first description of an auditory response in the invertebrate phylum Cnidaria, which includes jellyfish, anemones, and hydroids as well as corals. If, like settlement-stage reef fish and crustaceans, coral larvae use reef noise as a cue for orientation, the alleviation of noise pollution in the marine environment may gain further urgency.Mark J. A. Vermeij, Kristen L. Marhaver, Chantal M. Huijbers, Ivan Nagelkerken and Stephen D. Simpso

Minimally invasive and computer-navigated total hip arthroplasty: a qualitative and systematic review of the literature

ABSTRACT: BACKGROUND: Both minimally invasive surgery (MIS) and computer-assisted surgery (CAS) for total hip arthroplasty (THA) have gained popularity in recent years. We conducted a qualitative and systematic review to assess the effectiveness of MIS, CAS and computer-assisted MIS for THA. METHODS: An extensive computerised literature search of PubMed, Medline, Embase and OVIDSP was conducted. Both randomised clinical trials and controlled clinical trials on the effectiveness of MIS, CAS and computer-assisted MIS for THA were included. Methodological quality was independently assessed by two reviewers. Effect estimates were calculated and a best-evidence synthesis was performed. RESULTS: Four high-quality and 14 medium-quality studies with MIS THA as study contrast, and three high-quality and four medium-quality studies with CAS THA as study contrast were included. No studies with computer-assisted MIS for THA as study contrast were identified. Strong evidence was found for a decrease in operative time and intraoperative blood loss for MIS THA, with no difference in complication rates and risk for acetabular outliers. Strong evidence exists that there is no difference in physical functioning, measured either by questionnaires or by gait analysis. Moderate evidence was found for a shorter length of hospital stay after MIS THA. Conflicting evidence was found for a positive effect of MIS THA on pain in the early postoperative period, but that effect diminished after three months postoperatively. Strong evidence was found for an increase in operative time for CAS THA, and limited evidence was found for a decrease in intraoperative blood loss. Furthermore, strong evidence was found for no difference in complication rates, as well as for a significantly lower risk for acetabular outliers. CONCLUSIONS: The results indicate that MIS THA is a safe surgical procedure, without increases in operative time, blood loss, operative complication rates and component malposition rates. However, the beneficial effect of MIS THA on functional recovery has to be proven. The results also indicate that CAS THA, though resulting in an increase in operative time, may have a positive effect on operative blood loss and operative complication rates. More importantly, the use of CAS results in better positioning of acetabular component of the prosthesis

Effectiveness of self-compassion related therapies:A systematic review and meta-analysis

This systematic review and meta-analysis investigated whether self-compassion-related therapies, including compassion-focussed therapy, mindfulness-based cognitive therapy and acceptance and commitment therapy, are effective in promoting self-compassion and reducing psychopathology in clinical and subclinical populations. A total of 22 randomised controlled trials met inclusion criteria, with data from up to 1172 individuals included in each quantitative analysis. Effect sizes were the standardised difference in change scores between intervention and control groups. Results indicated that self-compassion-related therapies produced greater improvements in all three outcomes examined: self-compassion (g = 0.52, 95% CIs [0.32, 0.71]), anxiety (g = 0.46, 95% CIs [0.25, 0.66]) and depressive symptoms (g = 0.40, 95% CIs [0.23, 0.57]). However, when analysis was restricted to studies that compared self-compassion-related therapies to active control conditions, change scores were not significantly different between the intervention and control groups for any of the outcomes. Patient status (clinical vs. subclinical) and type of therapy (explicitly compassion-based vs. other compassion-related therapies, e.g. mindfulness) were not moderators of outcome. There was some evidence that self-compassion-related therapies brought about greater improvements in the negative than the positive subscales of the Self-Compassion Scale, although a statistical comparison was not possible. The methodological quality of studies was generally good, although risk of performance bias due to a lack of blinding of participants and therapists was a concern. A narrative synthesis found that changes in self-compassion and psychopathology were correlated in several studies, but this relationship was observed in both intervention and control groups. Overall, this review presents evidence that third-wave therapies bring about improvements in self-compassion and psychopathology, although not over and beyond other interventions

Endo180 modulation by bisphosphonates and diagnostic accuracy in metastatic breast cancer

We thank the patients who participated in this study; Professor Gerry Thomas and the Imperial College Healthcare NHS Trust, Human Biomaterials Resource Centre (Tissue Bank); Professor Clare M Isacke (Institute of Cancer Research, London) for Endo180 antibodies; Dr Richard Harvey (Department of Medical Oncology, Imperial College Healthcare NHS Trust) for CA 15-3 antigen measurement. The Division of Cancer at Imperial College London, Imperial College Healthcare NHS Trust is an Experimental Cancer Medicine Centre (ECMC) supported by funds from Cancer Research UK and the Department of Health (C37/A7283) and forms part of Imperial Cancer Research UK Centre (C42671/A12196). CP is recipient of a CRUK Clinician Scientist award. JW is The Flow Foundation Professor of Oncology at Imperial College London. MPC and GK were supported by donations from Tony and Rita Gallagher and Imperial College NHS Healthcare Trust Special Trustees (to JW and JS). MPC was funded by The Rosetrees Trust (Grant JS16/M59; to JW and JS). A-VF was funded by Fundação para a Ciência e Tecnologia fellowship (project supervisor: JS) and Imperial College NHS Healthcare Special Trustees (to JW and JS). MR-T was funded by the Association of International Cancer Research (Grant 08-0803 to JS)

Consensus guidelines for the use and interpretation of angiogenesis assays

The formation of new blood vessels, or angiogenesis, is a complex process that plays important roles in growth and development, tissue and organ regeneration, as well as numerous pathological conditions. Angiogenesis undergoes multiple discrete steps that can be individually evaluated and quantified by a large number of bioassays. These independent assessments hold advantages but also have limitations. This article describes in vivo, ex vivo, and in vitro bioassays that are available for the evaluation of angiogenesis and highlights critical aspects that are relevant for their execution and proper interpretation. As such, this collaborative work is the first edition of consensus guidelines on angiogenesis bioassays to serve for current and future reference

Painted Goby Larvae under high-CO2 fail to recognize reef sounds

Atmospheric CO2 levels have been increasing at an unprecedented rate due to anthropogenic activity. Consequently, ocean pCO2 is increasing and pH decreasing, affecting marine life, including fish. For many coastal marine fishes, selection of the adult habitat occurs at the end of the pelagic larval phase. Fish larvae use a range of sensory cues, including sound, for locating settlement habitat. This study tested the effect of elevated CO2 on the ability of settlement-stage temperate fish to use auditory cues from adult coastal reef habitats. Wild late larval stages of painted goby (Pomatoschistus pictus) were exposed to control pCO2 (532 μatm, pH 8.06) and high pCO2 (1503 μatm, pH 7.66) conditions, likely to occur in nearshore regions subjected to upwelling events by the end of the century, and tested in an auditory choice chamber for their preference or avoidance to nighttime reef recordings. Fish reared in control pCO2 conditions discriminated reef soundscapes and were attracted by reef recordings. This behaviour changed in fish reared in the high CO2 conditions, with settlement-stage larvae strongly avoiding reef recordings. This study provides evidence that ocean acidification might affect the auditory responses of larval stages of temperate reef fish species, with potentially significant impacts on their survival.Fundação para a Ciência e a Tecnologia (FCT)info:eu-repo/semantics/publishedVersio