Establishing the added benefit of measuring MMP9 in FOB positive patients as a part of the Wolverhampton colorectal cancer screening programme

<p>Abstract</p> <p>Background</p> <p>Bowel cancer is common and a major cause of death. The NHS is currently rolling out a national bowel cancer screening programme that aims to cover the entire population by 2010. The programme will be based on the Faecal Occult Blood test (FOBt) that reduces mortality from colon cancer by 16%. However, FOB testing has a relatively low positive predictive value, with associated unnecessary cost, risk and anxiety from subsequent investigation, and is unacceptable to a proportion of the target population. Increased levels of an enzyme called matrix metalloproteinase 9 (MMP9) have been found to be associated with colorectal cancer, and this can be measured from a blood sample. MMP9 has potential for detecting those at risk of having colorectal cancer. The aim of this study is to assess whether MMP9 estimation enhances the predictive value of a positive FOBt.</p> <p>Methods and design</p> <p>FOBt positive people aged 60–69 years attending the Wolverhampton NHS Bowel Cancer Screening Unit and providing consent for colonoscopy will be recruited. Participants will provide a blood sample prior to colonoscopy and permission for collection of the clinical outcome from screening unit records. Multivariate logistic regression analyses will determine the independent factors (patient and disease related, MMP9) associated with the prediction of neoplasia.</p> <p>Discussion</p> <p>Colorectal cancer is a major cause of morbidity and mortality. Pilot studies have confirmed the feasibility of the national cancer screening programme that is based on FOBt. However, the test has high false positive rates. MMP9 has significant potential as a marker for both adenomas and cancers. This study is to examine whether using MMP9 as an adjunct to FOBt improves the accuracy of screening and reduces the number of false positive tests that cause anxiety and require invasive and potentially harmful investigation.</p

The kinematics of the large western knot in the halo of the young planetary nebula NGC 6543

A detailed analysis is presented of the dominant ionised knot in the halo of the planetary nebula NGC 6543. Observations were made at high spectral and spatial resolution of the [OIII] 5007 line using the Manchester echelle spectrometer combined with the 2.1-m San Pedro Martir Telescope. A 20-element multislit was stepped across the field to give almost complete spatial coverage of the knot and surrounding halo. The spectra reveal, for the first time, gas flows around the kinematically inert knot. The gas flows are found to have velocities comparable to the sound speed as gas is photo-evaporated off an ionised surface. No evidence is found of fast wind interaction with the knot and we find it likely that the fast wind is still contained in a pressure-driven bubble in the core of the nebula. This rules out the possibility of the knot having its origin in instabilities at the interface of the fast and AGB winds. We suggest that the knot is embedded in the slowly expanding Red Giant wind and that its surfaces are being continually photoionised by the central star.Comment: 13 pages, 11 figures (all eps format). To be published in MNRAS, accepted on 6/7/0

Hybridization in parasites: consequences for adaptive evolution, pathogenesis and public health in a changing world

[No abstract available

Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial.

BACKGROUND: Remote ischaemic conditioning with transient ischaemia and reperfusion applied to the arm has been shown to reduce myocardial infarct size in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). We investigated whether remote ischaemic conditioning could reduce the incidence of cardiac death and hospitalisation for heart failure at 12 months. METHODS: We did an international investigator-initiated, prospective, single-blind, randomised controlled trial (CONDI-2/ERIC-PPCI) at 33 centres across the UK, Denmark, Spain, and Serbia. Patients (age >18 years) with suspected STEMI and who were eligible for PPCI were randomly allocated (1:1, stratified by centre with a permuted block method) to receive standard treatment (including a sham simulated remote ischaemic conditioning intervention at UK sites only) or remote ischaemic conditioning treatment (intermittent ischaemia and reperfusion applied to the arm through four cycles of 5-min inflation and 5-min deflation of an automated cuff device) before PPCI. Investigators responsible for data collection and outcome assessment were masked to treatment allocation. The primary combined endpoint was cardiac death or hospitalisation for heart failure at 12 months in the intention-to-treat population. This trial is registered with ClinicalTrials.gov (NCT02342522) and is completed. FINDINGS: Between Nov 6, 2013, and March 31, 2018, 5401 patients were randomly allocated to either the control group (n=2701) or the remote ischaemic conditioning group (n=2700). After exclusion of patients upon hospital arrival or loss to follow-up, 2569 patients in the control group and 2546 in the intervention group were included in the intention-to-treat analysis. At 12 months post-PPCI, the Kaplan-Meier-estimated frequencies of cardiac death or hospitalisation for heart failure (the primary endpoint) were 220 (8·6%) patients in the control group and 239 (9·4%) in the remote ischaemic conditioning group (hazard ratio 1·10 [95% CI 0·91-1·32], p=0·32 for intervention versus control). No important unexpected adverse events or side effects of remote ischaemic conditioning were observed. INTERPRETATION: Remote ischaemic conditioning does not improve clinical outcomes (cardiac death or hospitalisation for heart failure) at 12 months in patients with STEMI undergoing PPCI. FUNDING: British Heart Foundation, University College London Hospitals/University College London Biomedical Research Centre, Danish Innovation Foundation, Novo Nordisk Foundation, TrygFonden

La teoría de la ciencia de Karl Popper y la econometría

En este ensayo mostraré que la teoría de la falsación ejerció su principalimpacto en los primeros desarrollos de la macroeconomía, quein fortunadamente su impacto a largo plazo no ha sido productivo y que el seguimiento de este desarrollo ayuda a explicar muchos de los actuales escándalos en la econometría y la macroeconomía. Dado que la literatura ha difundido muchos mitos sobre la teoría de la ciencia de Popper, primero revisaré sus teorías de las ciencias naturales y sociales y explicaré por qué la falsación fracasa en ambas ramas antes de exponer la conexión con la econometría

La teoría de la ciencia de Karl Popper y la econometría

En este ensayo mostrare que la teoría de la falsación ejerció su principal impacto en los primeros desarrollos de la macroeconomía, que infortunadamente en los primeros desarrollos de la macroeconomía, que infortunadamente su impacto a largo plazo no ha sido productivo y que el seguimiento de este desarrollo ayuda a explicar muchos de los actuales escándalos en la econometría y la macroeconomía. Dado que la literatura ha difundido muchos mitos sobre la teoría de la ciencia de Popper, primero revisaré sus teorías de las ciencias naturales y sociales y explicaré por qué la falsación fracasa en ambas ramas antes de exponer la conexión con la econometría.Cuadernos de Economía, 14(23), Bogotá, 1995

Economics and the philosophy of science

Redman DA. Economics and the philosophy of science. New York: Oxford Univ. Pr.; 1991

La teoría de la ciencia de Karl Popper y la econometría

En este ensayo mostraré que la teoría de la falsación ejerció su principalimpacto en los primeros desarrollos de la macroeconomía, quein fortunadamente su impacto a largo plazo no ha sido productivo y que el seguimiento de este desarrollo ayuda a explicar muchos de los actuales escándalos en la econometría y la macroeconomía. Dado que la literatura ha difundido muchos mitos sobre la teoría de la ciencia de Popper, primero revisaré sus teorías de las ciencias naturales y sociales y explicaré por qué la falsación fracasa en ambas ramas antes de exponer la conexión con la econometría