Factors contributing to the time taken to consult with symptoms of lung cancer: a cross-sectional study

<b>Objectives</b>: To determine what factors are associated with the time people take to consult with symptoms of lung cancer, with a focus on those from rural and socially deprived areas. <b>Methods</b>: A cross-sectional quantitative interview survey was performed of 360 patients with newly diagnosed primary lung cancer in three Scottish hospitals (two in Glasgow, one in NE Scotland). Supplementary data were obtained from medical case notes. The main outcome measures were the number of days from (1) the date participant defined first symptom until date of presentation to a medical practitioner; and (2) the date of earliest symptom from a symptom checklist (derived from clinical guidelines) until date of presentation to a medical practitioner. <b>Results</b>: 179 participants (50%) had symptoms for more than 14 weeks before presenting to a medical practitioner (median 99 days; interquartile range 31–381). 270 participants (75%) had unrecognised symptoms of lung cancer. There were no significant differences in time taken to consult with symptoms of lung cancer between rural and/or deprived participants compared with urban and/or affluent participants. Factors independently associated with increased time before consulting about symptoms were living alone, a history of chronic obstructive pulmonary disease (COPD) and longer pack years of smoking. Haemoptysis, new onset of shortness of breath, cough and loss of appetite were significantly associated with earlier consulting, as were a history of chest infection and renal failure. <b>Conclusion</b>: For many people with lung cancer, regardless of location and socioeconomic status, the time between symptom onset and consultation was long enough to plausibly affect prognosis. Long-term smokers, those with COPD and/or those living alone are at particular risk of taking longer to consult with symptoms of lung cancer and practitioners should be alert to this

Experimental Analysis On Parameters Affecting The Material Removal Rate In Wire Electrical Discharge Turning Using The Taguchi Method

Wire electrical discharge turning (WEDT) allows success in the machining of advanced materials, particularly for the cylindrical shape components used in the metrology, medical and aerospace field. Using WEDT technology, the micro dimension of geometrical features can be machined without constraints on difficult-to-machine electrically conductive materials. The high precision with large aspect ratio machining capability make WEDT valuable. The correct machining parameter selection is the most important aspect to take into consideration when machining by WEDT. Therefore, the purpose of this study was to rank, determine and optimise the machining parameters that affect the material removal rate (MRR) in WEDT process. As WEDT has as much as eleven control parameters in this study, representing a large number of machining, the Taguchi L-12 orthogonal array was used to obtain the required data with a minimum number of experiments. By using similar experimental data, the regression equation was developed to represent as fitness function for optimisation by genetic algorithm (GA). It was found that by selecting the fast feed of workpiece to machining zone, the faster material was removed and moreover, it dominated other machining parameters. The optimised parameters yield 1.398 mm³/min as the maximum value predicted for MRR recommended by GA

The Effects Of Dry And Chilled Air On Tool Wear Behavior During Face Milling Of Inconel 718

Tool wear is one of the important criteria during the cutting process. It is mostly caused by the machining parameters, namely; cutting speed, feed rate, depth of cut, cooling condition, etc. This paper presents the behavior of cutting tool during dry and chilled air condition of face mill with the cutting speed of 20 to 40 m/min, the feed rate of 0.1 to 0.2 mm/tooth and axial depth of 0.1 mm. The analysis of variance (ANOVA) is applied to identify the significance of these factors effect on tool performance, later the mathematical model for the tool life prediction was developed. The investigation revealed that the cutting speed, feed rate dominating wear rate whilst the chilled air found to be marginally significant. Finally, the optimum condition for machining parameter for greater tool life can be obtained by the combination cutting speed of 20 m/min, the feed rate of 0.1 mm/tooth under chilled air condition. Implementation of chilled air contributed 7% improvement with 45 min compared to a dry condition. The study exhibited the round type insert of dry face milling is more prone to rapid flank wear than chilled air with no BUE appearance on the tool cutting edge

Observation of the Smectic C -- Smectic I Critical Point

We report the first observation of the smectic C--smectic I (C--I) critical point by Xray diffraction studies on a binary system. This is in confirmity with the theoretical idea of Nelson and Halperin that coupling to the molecular tilt should induce hexatic order even in the C phase and as such both C and I (a tilted hexatic phase) should have the same symmetry. The results provide evidence in support of the recent theory of Defontaines and Prost proposing a new universality class for critical points in layered systems.Comment: 9 pages Latex and 5 postscript figures available from [email protected] on request, Phys.Rev.Lett. (in press

Evidence of Color Coherence Effects in W+jets Events from ppbar Collisions at sqrt(s) = 1.8 TeV

We report the results of a study of color coherence effects in ppbar collisions based on data collected by the D0 detector during the 1994-1995 run of the Fermilab Tevatron Collider, at a center of mass energy sqrt(s) = 1.8 TeV. Initial-to-final state color interference effects are studied by examining particle distribution patterns in events with a W boson and at least one jet. The data are compared to Monte Carlo simulations with different color coherence implementations and to an analytic modified-leading-logarithm perturbative calculation based on the local parton-hadron duality hypothesis.Comment: 13 pages, 6 figures. Submitted to Physics Letters

A class-wide phylogenetic assessment of Dothideomycetes

We present a comprehensive phylogeny derived from 5 genes, nucSSU, nucLSU rDNA, TEF1, RPB1 and RPB2, for 356 isolates and 41 families (six newly described in this volume) in Dothideomycetes. All currently accepted orders in the class are represented for the first time in addition to numerous previously unplaced lineages. Subclass Pleosporomycetidae is expanded to include the aquatic order Jahnulales. An ancestral reconstruction of basic nutritional modes supports numerous transitions from saprobic life histories to plant associated and lichenised modes and a transition from terrestrial to aquatic habitats are confirmed. Finally, a genomic comparison of 6 dothideomycete genomes with other fungi finds a high level of unique protein associated with the class, supporting its delineation as a separate taxon

Ablation of lysophosphatidic acid receptor 1 attenuates hypertrophic cardiomyopathy in a mouse model.

Myocardial fibrosis is a key pathologic feature of hypertrophic cardiomyopathy (HCM). However, the fibrotic pathways activated by HCM-causing sarcomere protein gene mutations are poorly defined. Because lysophosphatidic acid is a mediator of fibrosis in multiple organs and diseases, we tested the role of the lysophosphatidic acid pathway in HCM. Lysphosphatidic acid receptor 1 (LPAR1), a cell surface receptor, is required for lysophosphatidic acid mediation of fibrosis. We bred HCM mice carrying a pathogenic myosin heavy-chain variant (403(+/-)) with Lpar1-ablated mice to create mice carrying both genetic changes (403(+/-) LPAR1(-/-)) and assessed development of cardiac hypertrophy and fibrosis. Compared with 403(+/-) LPAR1(WT), 403(+/-) LPAR1(-/-) mice developed significantly less hypertrophy and fibrosis. Single-nucleus RNA sequencing of left ventricular tissue demonstrated that Lpar1 was predominantly expressed by lymphatic endothelial cells (LECs) and cardiac fibroblasts. Lpar1 ablation reduced the population of LECs, confirmed by immunofluorescence staining of the LEC markers Lyve1 and Ccl21a and, by in situ hybridization, for Reln and Ccl21a. Lpar1 ablation also altered the distribution of fibroblast cell states. FB1 and FB2 fibroblasts decreased while FB0 and FB3 fibroblasts increased. Our findings indicate that Lpar1 is expressed predominantly by LECs and fibroblasts in the heart and is required for development of hypertrophy and fibrosis in an HCM mouse model. LPAR1 antagonism, including agents in clinical trials for other fibrotic diseases, may be beneficial for HCM

Evaluation of sesamum gum as an excipient in matrix tablets

In developing countries modern medicines are often beyond the affordability of the majority of the population. This is due to the reliance on expensive imported raw materials despite the abundance of natural resources which could provide an equivalent or even an improved function. The aim of this study was to investigate the potential of sesamum gum (SG) extracted from the leaves of Sesamum radiatum (readily cultivated in sub-Saharan Africa) as a matrix former. Directly compressed matrix tablets were prepared from the extract and compared with similar matrices of HPMC (K4M) using theophylline as a model water soluble drug. The compaction, swelling, erosion and drug release from the matrices were studied in deionized water, 0.1 N HCl (pH 1.2) and phosphate buffer (pH 6.8) using USP apparatus II. The data from the swelling, erosion and drug release studies were also fitted into the respective mathematical models. Results showed that the matrices underwent a combination of swelling and erosion, with the swelling action being controlled by the rate of hydration in the medium. SG also controlled the release of theophylline similar to the HPMC and therefore may have use as an alternative excipient in regions where Sesamum radiatum can be easily cultivated