Cancer detection in primary care: Insights from general practitioners

© 2015 Cancer Research UK. Background: General practitioners (GPs) have a key role in cancer detection as the usual first point of contact for patients with potential cancer symptoms. Nevertheless, there is limited work that investigates their perceptions of their role in the early detection of cancer. To address this gap, we aimed to gain an in-depth understanding of cancer diagnosis from the perspective of GPs. Methods: Individual face-to-face semi-structured interviews were conducted with 55 GPs from the North and North East of England and Greater London. All interviews were recorded and professionally transcribed verbatim. Repeated reading and co-coding engendered systematic thematic analysis across the interview material. Results: Three main themes emerged from the analysis of our data. First, we identified the burden of early cancer detection in general practice, both related to the anxiety and symptoms patients bring to GPs and the need for GPs to recognise patterns of cancer symptoms and refer appropriately; second, this burden is intensified by a perceived fragmentation of services within the National Health Service (NHS); and third, it is made more complex by the interface between general practice and public health. Conclusions: GPs occupy a challenging but pivotal role in cancer detection. It is crucial that this role be supported by policy and research

The biostratigraphy and paleogeography of Maastrichtian inoceramids

The global distribution of Maastrichtian inoceramids is now known in enough detail that the patterns of disappearance can be used to place first-order constraints on paleoceanographic changes that may have occurred during that age. The Inoceramidae is an excellent group to focus on in a study of Maastrichtian events for the following reasons: (1) they were globally distributed in the early Maastrichtian; (2) they did not survive the age (i.e., they undergo change during the interval); and (3) they have left a rich microfossil and macrofossil record. Some inoceramids grew to be very large; however, even the largest often passively disaggregated and are preserved as hundreds of millions of characteristic, columnar, polygonal prisms of calcite approximately 100 microns across. This taphonomic process has greatly increased the inoceramid fossil record and provides a means of objectively estimating changes in their standing population. In addition, because these prisms commonly occur in Deep Sea Drilling Project (DSDP) and Ocean Drilling Program (ODP) cores, it is relatively easy to generate a truly global database. The existing macrofossil record of inoceramids has less temporal and spacial resolution but greater taxonomic resolution than the microfossil record. In concert the microfossil and macrofossil records of inoceramids demonstrate that important changes occurred during the Maastrichtian. These changes are distinct from the KT boundary catastrophe but are part of the larger KT transition

Late Cretaceous Paleoceanographic Evolution and the Onset of Cooling in the Santonian at Southern High Latitudes (IODP Site U1513, SE Indian Ocean)

The latest Cenomanian to Santonian sedimentary record recovered at IODP Expedition 369 Site U1513 in the Mentelle Basin (SE Indian Ocean, paleolatitude 60°S at 85 Ma) is studied to interpret the paleoceanographic evolution in the Southern Hemisphere. The planktonic foraminiferal assemblage changes, the depth ecology preferences of different species, and the surface and seafloor temperature inferred from the stable isotopic values measured on foraminiferal tests provide meaningful information to the understanding of the Late Cretaceous climate. The hothouse climate during the Turonian-Santonian, characterized by weak latitudinal temperature gradients and high atmospheric CO2 concentrations, is followed by a progressive cooling during the Campanian. At Site U1513 the beginning of this climatic transition is nicely recorded within the Santonian, as indicated by an ∼1‰ increase in δ18O values of planktonic foraminifera suggesting a decline in surface water paleotemperatures of 4°C. The onset of cooling is mirrored by changes in the planktonic foraminiferal assemblages including extinctions among surface and deep dwellers, appearances and diversification of newly evolving taxa, and changes from predominantly epifaunal oxic to infaunal dysoxic/ suboxic taxa among co-occurring benthic foraminifera. Overall, the data presented here document an interval in the Santonian during which the rate of southern high latitude cooling increased. Both surface and bottom waters were affected, although the cooling signal is more evident in the data for surface waters. This pattern of cooling ascribes the deterioration of the Late Cretaceous climate to decreased CO2 in the atmosphere and changes in the oceanic circulation correlated with enhanced meridional circulation

Adaptive light-sheet fluorescence microscopy with a deformable mirror for video-rate volumetric imaging

Light-sheet fluorescence microscopy (LSFM) achieves optically sectioned imaging with the relatively low photobleaching and phototoxic effect. To achieve high-speed volumetric LSFM imaging without perturbing the sample, it is necessary to use some form of remote refocusing in the detection beam path. Previous work used electrically tunable lenses, tunable acoustic gradient index of refraction lenses, or the remote-refocusing approach of Botcherby et al. [Opt. Lett. 32(14), 2007 (2007)] to achieve remote refocusing. However, these approaches generally only provide low-order defocus correction, which is not compatible with higher-NA objectives that require higher order defocus corrections or reduce the optical throughput. In order to simultaneously achieve high-speed remote refocusing and correct system aberrations, we employ a deformable mirror in the detection path that is capable of providing higher orders of defocus and aberration correction in an optical system with an NA of 0.72–0.75. We demonstrate high-speed volumetric imaging at 26.3 volumes per second and 35 frames per volume for a defocus range of −50 to 50 μm

Hadronic interactions, precocious unification, and cosmic ray showers at Auger energies

At Auger energies only model predictions enable us to extract primary cosmic ray features. The simulation of the shower evolution depends sensitively on the first few interactions, necessarily related to the quality of our understanding of high energy hadronic collisions. Distortions of the standard ``soft semi-hard'' scenario include novel large compact dimensions and a string or quantum gravity scale not far above the electroweak scale. Na\"{\i}vely, the additional degrees of freedom yield unification of all forces in the TeV range. In this article we study the influence of such precocious unification during atmospheric cascade developments by analyzing the most relevant observables in proton induced showers.Comment: 16 pages latex. 4 eps figure

Cost-benefit analysis for commissioning decisions in GEO600

Gravitational wave interferometers are complex instruments, requiring years of commissioning to achieve the required sensitivities for the detection of gravitational waves, of order 10^-21 in dimensionless detector strain, in the tens of Hz to several kHz frequency band. Investigations carried out by the GEO600 detector characterisation group have shown that detector characterisation techniques are useful when planning for commissioning work. At the time of writing, GEO600 is the only large scale laser interferometer currently in operation running with a high duty factor, 70%, limited chiefly by the time spent commissioning the detector. The number of observable gravitational wave sources scales as the product of the volume of space to which the detector is sensitive and the observation time, so the goal of commissioning is to improve the detector sensitivity with the least possible detector down time. We demonstrate a method for increasing the number of sources observable by such a detector, by assessing the severity of non-astrophysical noise contaminations to efficiently guide commissioning. This method will be particularly useful in the early stages and during the initial science runs of the aLIGO and adVirgo detectors, as they are brought up to design performance.Comment: 17 pages, 17 figures, 2 table

Dogs’ health and demographics in wildlife-populated and tsetse-infested villages of Mambwe district, eastern Zambia.

Good dog-keeping practices and access to veterinary care are essential for the well-being of dogs. As the main causes of morbidity and mortality in the rural canine population in Zambia are poorly understood, we followed a cohort of 162 indigenous dogs for six months in wildlife-populated and tsetse-infested villages of Mambwe district, eastern Zambia to gain deeper insights. Dogs lacked basic home and veterinary care, they were often starved and burdened with ticks, and some passed live adult worms in their stool. The frequent exposure of dogs to tsetse bites and consumption of fresh raw game meat and bones puts them at greater risk of acquiring African trypanosomiasis. Nearly 20% of dogs were lost to follow-up, with the main causes being poor health (58.1%), predation by wild carnivores (29%), and owner culling or euthanasia (12.9%). We observed that indigenous dogs' general well-being and survival were largely influenced by their environment, infectious diseases, injuries sustained during interaction with conspecifics and wildlife, and community attitudes and practices associated with dog ownership

Systematic review and meta-analysis of temozolomide in animal models of glioma:was clinical efficacy predicted?

Background:Malignant glioma is an aggressive tumour commonly associated with a dismal outcome despite optimal surgical and radio-chemotherapy. Since 2005 temozolomide has been established as first-line chemotherapy. We investigate the role of in vivo glioma models in predicting clinical efficacy.Methods:We searched three online databases to systematically identify publications testing temozolomide in animal models of glioma. Median survival and number of animals treated were extracted and quality was assessed using a 12-point scale; random effects meta-analysis was used to estimate efficacy. We analysed the impact of study design and quality and looked for evidence of publication bias.Results:We identified 60 publications using temozolomide in models of glioma, comprising 2443 animals. Temozolomide prolonged survival by a factor of 1.88 (95% CI 1.74-2.03) and reduced tumour volume by 50.4% (41.8-58.9) compared with untreated controls. Study design characteristics accounted for a significant proportion of between-study heterogeneity, and there was evidence of a significant publication bias.Conclusion:These data reflect those from clinical trials in that temozolomide improves survival and reduces tumour volume, even after accounting for publication bias. Experimental in vivo glioma studies of temozolomide differ from those of other glioma therapies in their consistent efficacy and successful translation into clinical medicine

Homogeneous bubble nucleation limit of mercury under the normal working conditions of the planned European Spallation Source

In spallation neutron sources, liquid mercury is the subject of big thermal and pressure shocks, upon adsorbing the proton beam. These changes can cause unstable bubbles in the liquid, which can damage the structural material. While there are methods to deal with the pressure shock, the local temperature shock cannot be avoided. In our paper we calculated the work of the critical cluster formation (i.e. for mercury micro-bubbles) together with the rate of their formation (nucleation rate). It is shown that the homogeneous nucleation rates are very low even after adsorbing several proton pulses, therefore the probability of temperature induced homogeneous bubble nucleation is negligible.Comment: 22 Pages, 11 figures, one of them is colour, we plan to publish it in Eur. Phys. J.