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

Oxidation state of a polyurethane membrane after plasma etching

Low moduli cell culture substrates can be used to apply dynamic mechanical strain to cells, by surface deformation. Understanding the surface interaction with cells is critical to improving cell adhesion and normal growth. A medical grade polyurethane (PU), Chronoflex AL 80A, was modified by oxygen plasma etching and characterised by X-ray photoelectron spectroscopy. Etching resulted in increased cross-linking at the isocyanate bond and formation of new oxygen moieties. The model, derived from patent data and XPS data of the unetched PU, indicated that the additional oxygen was likely to be hydroxyl and carbonyl groups. Etched membranes enhanced protein adhesion, resulting in full surface coverage compared to unetched PU. The etched PU supported cell adhesion and spreading, while the unetched PU was not conducive to monolayer formation

Blood parameter changes during stopover in a long-distance migratory shorebird, the bar-tailed godwit Limosa lapponica taymyrensis

Bar-tailed godwits migrate from West African wintering sites to breeding areas in northern Russia with only one stopover. We compared hematocrit (Hct), blood hemoglobin concentration (Hb), and mean cell hemoglobin concentration (MCHb; a measure of the relative proportion of Hb in the cellular blood fraction) between arriving godwits lured to land 60 km short of the stopover site and godwits during subsequent refueling. The Hct and Hb of arriving godwits was low when compared to that of refueling birds. On the stopover site, Hct and Hb correlated positively with size-corrected body mass. In addition, Hb and MCHb reached peak levels in the last days of stopover. We explored the possibility of regenerative anemia in arriving godwits by comparing the fraction of reticulocytes (young red blood cells) between arriving and refueling birds. No differences were found. Therefore, we suggest that the increase in Hct, Hb, and MCHb during refueling is not in response to a severe anemic state at arrival. Rather, we suggest that the increase in blood parameters may anticipate the increased aerobic requirements of impending migratory flight and possibly satisfy heightened oxygen demands of the larger body mass of fattened birds. The Hct increase on the stopover site may also serve to buffer the red blood cell population against possible red blood cell breakdown during long-distance flight.

Surface acoustic wave-induced electroluminescence intensity oscillation in planar light-emitting devices

Electroluminescence emission from surface acoustic wave-driven light-emitting diodes (SAWLEDs) is studied by means of time-resolved techniques. We show that the intensity of the SAW-induced electroluminescence is modulated at the SAW frequency (~1 GHz), demonstrating electron injection into the p-type region synchronous with the SAW wavefronts.Comment: 4 pages, 3 figure

Asymmetric Silver to Oxide Adhesion in Multilayers Deposited on Glass by Sputtering

We have developed a wedge-loaded double-cantilever beam adhesion measurement set-up for thin films deposited on glass by sputtering. The test is described in details. Results on the Glass/sublayer/Ag/ZnO multilayer provide evidence that \SnOd or \TiOd perform better than ZnO as a sublayer. Then however, rupture within the multilayer shifts to the upper Ag/ZnO interface. The latter is shown to be tougher than the lower ZnO/Ag interface, an asymmetry due to non-equilibrium interfacial structures

Physiological parameter response to variation of mental workload

Previous studies have examined how individual physiological measures respond to changes in mental demand and subjective reports of mental workload. This study explores the response of multiple physiological parameters, measured simultaneously and quantifies the added value of each of the measures when estimating the level of demand. The study presented was conducted in laboratory conditions and required participants to perform a custom-designed visual-motor task that imposed varying levels of demand. The data collected consisted of: physiological measurements (heart inter-beat intervals, breathing rate, pupil diameter, facial thermography); subjective ratings of workload from the participants (ISA and NASA-TLX); and the performance measured within the task. Facial thermography and pupil diameter were demonstrated to be good candidates for non-invasive mental workload measurements; for 7 out of 10 participants, pupil diameter showed a strong correlation (with R values between 0.61 and 0.79 at a significance value of 0.01) with mean ISA normalized values. Facial thermography measures added on average 47.7% to the amount of variability in task performance explained by a regression model. As with the ISA ratings, the relationship between the physiological measures and performance showed strong inter-participant differences, with some individuals demonstrating a much stronger relationship between workload and performance measures than others. The results presented in this paper demonstrate that physiological monitoring can be used for non-invasive real-time measurement of workload, assuming models have been appropriately trained on previously recorded data from the user population. Facial thermography combined with measurement of pupil diameter are strong candidates for real-time monitoring of workload due to the availability and non-intrusive nature of current technology. The study also demonstrates the importance of identifying whether an individual is one who demonstrates a strong relationship between physiological measures and experienced workload measures before physiological measures are applied uniformly. This is a feasible proposition in a setting such as aircraft cockpits, where pilots are drawn from a relatively small, targeted and managed population

Rural and urban differences in stage at diagnosis of colorectal and lung cancers

There is evidence that patients living in outlying areas have poorer survival from cancer. This study set out to investigate whether they have more advanced disease at diagnosis. Case notes of 1323 patients in north and northeast Scotland who were diagnosed with lung or colorectal cancer in 1995 or 1996 were reviewed. Of patients with lung cancer, 42% (69/164) living 58 km or more from a cancer centre had disseminated disease at diagnosis compared to 33% (71/215) living within 5 km. For colorectal cancer the respective figures were 24% (38/161) and 16% (31/193). For both cancers combined, the adjusted odds ratio for disseminated disease at diagnosis in furthest group compared to the closest group was 1.59 (P = 0.037). Of 198 patients with non-small-cell lung cancer in the closest group, 56 (28%) had limited disease (stage I or II) at diagnosis compared to 23 of 165 (14%) of the furthest group (P = 0.002). The respective figures for Dukes A and B colorectal cancer were 101 of 196 (52%) and 67 of 172 (39%) (P = 0.025). These findings suggest that patients who live remote from cities and the associated cancer centres have poorer chances of survival from lung or colorectal cancer because of more advanced disease at diagnosis. This needs to be taken into account when planning investigation and treatment services. © 2001 Cancer Research Campaign http://www.bjcancer.co

The use of decellularised animal tissue to study disseminating cancer cells

Since the establishment of cell culture, common practice has been to grow adherent cells in 2D monolayers. Although cells behave completely differently when grown under these artificial conditions, the ease of 2D culturing has meant that this practice still prevails, and adopting conditions that more closely reflect the natural microenvironment has been met with substantial inertia. The alternative, animal models that mimic natural human physiology, are less accessible, strictly regulated and require licences and expensive facilities. Although transition from 2D to 3D cell culturing is gathering momentum, there is a clear need for alternative culturing methods that more closely resemble in vivo conditions. Here, we show that decellularised organs gleaned from discarded animal carcasses are ideal biomimetic scaffolds to support secondary tumour initiation in vitro. Further, we describe how to decellularise tissue and perform basic histochemistry and immunofluorescence procedures for cell and matrix detection. Cancer cell behaviour on this matrix is followed by way of an example. Because integration into the traditional work flow is easy and inexpensive, we hope this article will encourage other researchers to adopt this approach