Study of Sputum Collection and Evaluation in the Pittsburgh Lung Screening Study (PLuSS)

Lung cancer remains a significant public health problem in 2006, despite efforts aimed at educating individuals about the dangers of tobacco and the successes of smoking cessation programs. No screening methods aimed at high risk individuals are currently supported by the National Cancer Institute or other medical organizations. Since the risk for lung cancer persists even after smoking cessation, studies of methods to detect lung cancer in its early stages, when it is amenable to cure, are clearly needed. This study examined a novel method of sputum collection and processing to determine whether the adequacy of the samples collected was improved over conventional preparation methods. We also examined lung function as a possible predictor of cytologic abnormality in the sputum of individuals at high risk for lung cancer, and studied the potential of a molecular biomarker for the early detection of lung cancer. This study employed a cross-sectional design and utilized quantitative methods for exploring the relationships between the variables, particularly those of lung function, cytologic diagnosis and gene mutation status, with personal risk factors for developing lung cancer. This study demonstrated an association between lung function and cytologic diagnosis of moderate or worse atypia in the sputum collected from these participants and examined at the University of Colorado. We also demonstrated a higher rate of sputum specimen adequacy than has been previously reported from conventional clinical experience. We examined the feasibility of conducting somatic gene mutation analysis on the samples collected by this novel method. We achieved some success in studying K-ras mutations, but were unsuccessful in our analysis of DNA methylation. From these experiences we have gathered information upon which to base further studies.The importance of these findings from a public health perspective is that there is an opportunity for early detection of lung cancer via analysis of cellular and molecular changes in sputum. We have demonstrated that the Thin Prep® methodology, applied to sputum, produces material suitable for cytologic examination and, under certain circumstances, material suitable for molecular analysis. Patients at high risk for lung cancer will benefit from continued research into novel screening methods

Lincoln Heights, Chatham County : a community diagnosis including secondary data analysis and qualitative data collection

This document is a result of a community diagnosis of Lincoln Heights, a community in Siler City, North Carolina. The diagnosis was completed by four graduate students from the Department of Health Behavior and Health Education, School of Public Health, The University of North Carolina at Chapel Hill. Community diagnosis is a process to understand what it is like to live in a given community. The process involves examining the culture and functioning of a community, exploring its strengths and assets, and discovering issues of concern to the community members. To gain a better understanding of Lincoln Heights, the first part of the project involved gathering census data for the community, county, and state. Secondary data was collected on the neighborhood's economics, history, environment, housing, education, health concerns, and other social issues, and then compared to county and state figures. There were limitations to these methods of data collection. Wherever possible, data was collected on a community or town level. However, most of the health and community profile data was available only on a county-wide basis or by block group and may not be representative of the Lincoln Heights community, a very small neighborhood within the county. Data that is representative of Chatham County, and not necessarily Lincoln Heights, is so identified in the community profile and health sections of the document. Limitations to collecting secondary data included a lack of current information, especially with regard to immigration statistics and demographic characteristics. Another problem encountered was the lack of identification of statistics for Latinos within the specified census race categories, resulting in difficulty in distinguishing various racial indicators. To obtain a more accurate picture of the community, the second portion of the project focused on a qualitative assessment of community members' opinions on the quality of life in Lincoln Heights. Interviews contained personal background questions as well as questions about life in the Lincoln Heights community. Questions were asked about the strengths and weaknesses of the community to determine what issues could be addressed in the future. Service provider questions focused on the type of services provided as well as the provider’s perspective on the competence of the Lincoln Heights community. The interview process was approved by the University of North Carolina School of Public Health Institutional Review Board (IRB), which must approve all requests from School of Public Health students or faculty to conduct research on human subjects. Interviews began in November 1997 and concluded in January 1998. Members of the community diagnosis team interviewed 23 community members and eight service providers. In addition, 46 community members completed short surveys on two separate occasions, and two focus groups were held in the community. Interviews focused primarily on the strengths of the community, as well as issues of concern, including housing, recreation, substance abuse, and the growth of the Latino population in the neighborhood. The community diagnosis process concluded in February with a community forum. A comprehensive report on the Forum is included in Appendix E of this document. Limitations in the qualitative data collection process included time constraints imposed by the IRB process. The “snowball” sampling process of obtaining referrals yielded a homogeneous group, and difficulties in gaining entree to other, less accessible, community members. These two things were a barrier to gaining the perspective of a more representative sample. Finally, building the trust necessary to gain full disclosure about sensitive issues in a community is a long, ongoing process and takes more time than the community diagnosis process allows. This document was produced to present back to the community the comprehensive findings of the team about the Lincoln Heights community. The first half of the document includes sections representing our secondary data collection and analysis. Chapters include: Geography, History, Economic Outlook, Community Profile, and Health. The second half contains a review of qualitative data collected from interviews and is divided into chapters representing the salient issues facing the community, including: Community Assets and Resources, Education, Politics and Government, Immigration, Crime and Safety, Drugs, Housing, Recreation, and A Changing Climate. During the interview process, community members shared with us many of their views, experiences, and concerns about life in Lincoln Heights. Some of the strengths and challenges that were identified as most important to the community are: Commitment to Community: Members of the community are very active in the community and committed to Lincoln Heights. They also belong to, and take pride in, several strong local associations and organizations. Their affiliation with church and religious organizations is an important part of their lives. Family Ties: The Lincoln Heights neighborhood has an extensive history, with multiple generation families still living there. There are bonds and family ties that run deep in the community. Community Involvement: The strengths of commitment and roots in Lincoln Heights have led to several successful endeavors and achievements. Growth of Latino Population: Over the past several years, the size of the Latino population has grown significantly in Lincoln Heights. This growth has impacted community resources, schools, and community services, as well as introduced difficulties in communication due to a language barrier. Housing: The community continues to experience a shortage of affordable housing and expressed concerns about the condition of some of the homes and trailers in the neighborhood. Youth Recreation: Community members expressed concerns about a lack of recreation for the youth of the neighborhood. Crime and Drugs: Substance abuse was also indicated as a problem, both with the use and sale of illegal drugs occurring within the neighborhood. Future Directions and Conclusions Although numerous issues still exist in Lincoln Heights, much has changed since the last community diagnosis was completed there in 1994. Concerned citizens from the neighborhood have worked hard to build a healthier community and throughout this document we have tried to highlight their successes. Two organizations in particular have impacted the quality of life for residents, the Lincoln Heights Improvement Association and the Chatham Alumni Advancement Association. As was mentioned previously, the Lincoln Heights Improvement Association has played a vital role in the neighborhood by building Washington Park and also by demonstrating that a small group of concerned residents could affect change. The Chatham Alumni Advancement Association also showed that strength in numbers could work when they pressured the local government to give them part of the old Chatham Middle School for use as a cultural center. Both of these groups have proved themselves capable of taking on the issues that face the neighborhood, and winning. It is our hope that these groups will continue to thrive and that they will be able to use this document to steer their course of action in the future.Master of Public Healt

Born too soon: the global epidemiology of 15 million preterm births.

This second paper in the Born Too Soon supplement presents a review of the epidemiology of preterm birth, and its burden globally, including priorities for action to improve the data. Worldwide an estimated 11.1% of all livebirths in 2010 were born preterm (14.9 million babies born before 37 weeks of gestation), with preterm birth rates increasing in most countries with reliable trend data. Direct complications of preterm birth account for one million deaths each year, and preterm birth is a risk factor in over 50% of all neonatal deaths. In addition, preterm birth can result in a range of long-term complications in survivors, with the frequency and severity of adverse outcomes rising with decreasing gestational age and decreasing quality of care. The economic costs of preterm birth are large in terms of immediate neonatal intensive care, ongoing long-term complex health needs, as well as lost economic productivity. Preterm birth is a syndrome with a variety of causes and underlying factors usually divided into spontaneous and provider-initiated preterm births. Consistent recording of all pregnancy outcomes, including stillbirths, and standard application of preterm definitions is important in all settings to advance both the understanding and the monitoring of trends. Context specific innovative solutions to prevent preterm birth and hence reduce preterm birth rates all around the world are urgently needed. Strengthened data systems are required to adequately track trends in preterm birth rates and program effectiveness. These efforts must be coupled with action now to implement improved antenatal, obstetric and newborn care to increase survival and reduce disability amongst those born too soon

Forced Smoking Abstinence: Not Enough for Smoking Cessation

Importance: Millions of Americans are forced to quit smoking as they enter tobacco-free prisons and jails, but most return to smoking within days of release. Interventions are needed to sustain tobacco abstinence after release from incarceration. Objective: To evaluate the extent to which the WISE intervention (Working Inside for Smoking Elimination), based on motivational interviewing (MI) and cognitive behavioral therapy (CBT), decreases relapse to smoking after release from a smoke-free prison. Design: Participants were recruited approximately 8 weeks prior to their release from a smoke-free prison and randomized to 6 weekly sessions of either education videos (control) or the WISE intervention. Setting: A tobacco-free prison in the United States. Participants: A total of 262 inmates (35% female). Main Outcome Measure: Continued smoking abstinence was defined as 7-days point-prevelance abstinence validated by urine cotinine measurement. Results: At the 3-week follow-up, 25% of the participants in the WISE intervention (31 of 122) and 7% of the control participants (9 of 125) continued to be tobacco-abstinent (odds ration [OR], 4.4; 95% CI, 2.0-9.7). In addition to the intervention, Hispanic ethnicity, a plan to remain abstinent, and being incarcerated for more than 6 months were all associated with increased likelihood of remaining abstinent. In the logistical regression analysis, participants randomized to the WISE intervention were 6.6 times more likely to remain tobacco abstinent at the 3-week follow up than those randomized to the control condition (95% CI, 2.5-17.0). Nonsmokers at the 3-week follow-up had an additional follow-up 3 months after release, and overall 12% of the participants in the WISER intervention (14 of 122) and 2% of the control participants (3 of 125) were tobacco free at 3 months, as confirmed by urine cotinine measurement (OR, 5.3; 95% CI, 1.4-23.8). Conclusions and Relevance: Forced tobacco abstinence alone during incarceration has little impact on postrelease smoking status. A behavioral intervention provided prior to release greatly improves cotinine-confirmed smoking cessation in the community. Trial Registration: clinicaltrials.gov Identifier: NCT0112258

Multiplicativity of completely bounded p-norms implies a new additivity result

We prove additivity of the minimal conditional entropy associated with a quantum channel Phi, represented by a completely positive (CP), trace-preserving map, when the infimum of S(gamma_{12}) - S(gamma_1) is restricted to states of the form gamma_{12} = (I \ot Phi)(| psi >< psi |). We show that this follows from multiplicativity of the completely bounded norm of Phi considered as a map from L_1 -> L_p for L_p spaces defined by the Schatten p-norm on matrices; we also give an independent proof based on entropy inequalities. Several related multiplicativity results are discussed and proved. In particular, we show that both the usual L_1 -> L_p norm of a CP map and the corresponding completely bounded norm are achieved for positive semi-definite matrices. Physical interpretations are considered, and a new proof of strong subadditivity is presented.Comment: Final version for Commun. Math. Physics. Section 5.2 of previous version deleted in view of the results in quant-ph/0601071 Other changes mino

The Maunakea Spectroscopic Explorer Book 2018

(Abridged) This is the Maunakea Spectroscopic Explorer 2018 book. It is intended as a concise reference guide to all aspects of the scientific and technical design of MSE, for the international astronomy and engineering communities, and related agencies. The current version is a status report of MSE's science goals and their practical implementation, following the System Conceptual Design Review, held in January 2018. MSE is a planned 10-m class, wide-field, optical and near-infrared facility, designed to enable transformative science, while filling a critical missing gap in the emerging international network of large-scale astronomical facilities. MSE is completely dedicated to multi-object spectroscopy of samples of between thousands and millions of astrophysical objects. It will lead the world in this arena, due to its unique design capabilities: it will boast a large (11.25 m) aperture and wide (1.52 sq. degree) field of view; it will have the capabilities to observe at a wide range of spectral resolutions, from R2500 to R40,000, with massive multiplexing (4332 spectra per exposure, with all spectral resolutions available at all times), and an on-target observing efficiency of more than 80%. MSE will unveil the composition and dynamics of the faint Universe and is designed to excel at precision studies of faint astrophysical phenomena. It will also provide critical follow-up for multi-wavelength imaging surveys, such as those of the Large Synoptic Survey Telescope, Gaia, Euclid, the Wide Field Infrared Survey Telescope, the Square Kilometre Array, and the Next Generation Very Large Array.Comment: 5 chapters, 160 pages, 107 figure

BRCA2 polymorphic stop codon K3326X and the risk of breast, prostate, and ovarian cancers

Background: The K3326X variant in BRCA2 (BRCA2*c.9976A&gt;T; p.Lys3326*; rs11571833) has been found to be associated with small increased risks of breast cancer. However, it is not clear to what extent linkage disequilibrium with fully pathogenic mutations might account for this association. There is scant information about the effect of K3326X in other hormone-related cancers. Methods: Using weighted logistic regression, we analyzed data from the large iCOGS study including 76 637 cancer case patients and 83 796 control patients to estimate odds ratios (ORw) and 95% confidence intervals (CIs) for K3326X variant carriers in relation to breast, ovarian, and prostate cancer risks, with weights defined as probability of not having a pathogenic BRCA2 variant. Using Cox proportional hazards modeling, we also examined the associations of K3326X with breast and ovarian cancer risks among 7183 BRCA1 variant carriers. All statistical tests were two-sided. Results: The K3326X variant was associated with breast (ORw = 1.28, 95% CI = 1.17 to 1.40, P = 5.9x10- 6) and invasive ovarian cancer (ORw = 1.26, 95% CI = 1.10 to 1.43, P = 3.8x10-3). These associations were stronger for serous ovarian cancer and for estrogen receptor–negative breast cancer (ORw = 1.46, 95% CI = 1.2 to 1.70, P = 3.4x10-5 and ORw = 1.50, 95% CI = 1.28 to 1.76, P = 4.1x10-5, respectively). For BRCA1 mutation carriers, there was a statistically significant inverse association of the K3326X variant with risk of ovarian cancer (HR = 0.43, 95% CI = 0.22 to 0.84, P = .013) but no association with breast cancer. No association with prostate cancer was observed. Conclusions: Our study provides evidence that the K3326X variant is associated with risk of developing breast and ovarian cancers independent of other pathogenic variants in BRCA2. Further studies are needed to determine the biological mechanism of action responsible for these associations

OSIRIS-REx Encounters Bennu: Initial Assessment from the Approach Phase

The OSIRIS-REx spacecraft launched on September 8, 2016, on a seven-year journey to return samples from asteroid (101955) Bennu. This presentation summarizes the scientific results from the Approach and Preliminary Survey phases. Bennu observations are set to begin on August 17, 2018,when the asteroid is bright enough for detection by the PolyCam. PolyCam and MapCam collect data to survey the asteroid environment for any hazards and characterize the asteroid point-source photometric properties. Resolved images acquired during final approach, starting in late October 2018, allow the creation of a shape model using stereophotoclinometry (SPC), needed by both the navigation team and science planners. The OVIRS and OTES spectrometers characterize the point- source spectral properties over a full rotation period, providing a first look at any features and thermophysical properties. TAGSAM is released from the launch container and deployed into the sampling configuration then returned to the stow position.Preliminary Survey follows the Approach Phase in early December 2018. This phase consists of a series of hyperbolic trajectories that cross over the North and South poles and the equator of Bennu at a close-approach distance of 7 km. Images from these Preliminary Survey passes provide data to complete the 75-cm resolution SPC global shape model and solve for the rotation state. Once the shape model is complete, the asteroid coordinate system is defined for co-registration of all data products. These higher-resolution images also constrain the photometric properties and allow for an initial assessment of the geology. In Preliminary Survey the team also obtains the first OLA data, providing a measure of the surface topography. OVIRS and OTES collect data as "ride-along" instruments, with the spacecraft pointing driven by imaging constraints. These data provide a first look at the spectral variation across the surface of Bennu. Radio science measurements, combined with altimetry and imagery, determine Bennu's mass, a prerequisite to placing the spacecraft into orbit in late December 2018. Together, data from the Approach and Preliminary Survey phases set the stage for the extensive mapping planned for 2019. These dates are the baseline plan. Any contingency or unexpected discovery may change this mission profile