Incidence and Mortality in Upper Gastrointestinal Cancer After Negative Endoscopy for Gastroesophageal Reflux Disease

BACKGROUND AND AIMS: Gastroesophageal reflux disease (GERD) is associated with an increased risk of cancer of the upper gastrointestinal tract. This study aimed to assess whether and to what extent a negative upper endoscopy in patients with GERD is associated with decreased incidence and mortality in upper gastrointestinal cancer (ie, esophageal, gastric, or duodenal cancer). METHODS: We conducted a population-based cohort study of all patients with newly diagnosed GERD between July 1, 1979 and December 31, 2018 in Denmark, Finland, Norway, and Sweden. The exposure, negative upper endoscopy, was examined as a time-varying exposure, where participants contributed unexposed person-time from GERD diagnosis until screened and exposed person-time from the negative upper endoscopy. The incidence and mortality in upper gastrointestinal cancer were assessed using parametric flexible models, providing adjusted hazard ratios (HRs) with 95% confidence intervals (CIs). RESULTS: Among 1,062,740 patients with GERD (median age 58 years; 52% were women) followed for a mean of 7.0 person-years, 5324 (0.5%) developed upper gastrointestinal cancer and 4465 (0.4%) died from such cancer. Patients who had a negative upper endoscopy had a 55% decreased risk of upper gastrointestinal cancer compared with those who did not undergo endoscopy (HR, 0.45; 95% CI, 0.43-0.48), a decrease that was more pronounced during more recent years (HR, 0.34; 95% CI, 0.30-0.38 from 2008 onward), and was otherwise stable across sex and age groups. The corresponding reduction in upper gastrointestinal mortality among patients with upper endoscopy was 61% (adjusted HR, 0.39; 95% CI, 0.37-0.42). The risk reduction after a negative upper endoscopy in incidence and mortality lasted for 5 and at least 10 years, respectively. CONCLUSIONS: Negative upper endoscopy is associated with strong and long-lasting decreases in incidence and mortality in upper gastrointestinal cancer in patients with GERD.Peer reviewe

Towards the integration of functions, relations and types in an AI programming language

This paper describes the design and implementation of the programming language PC-Life. This language integrates the functional and the Logic-oriented programming style and feature types supporting inheritance. This combination yields a language particularly suited to knowledge representation, especially for application in computational linguistics

Mechanism of Deep-focus Earthquakes Anomalous Statistics

Analyzing the NEIC-data we have shown that the spatial deep-focus earthquake distribution in the Earth interior over the 1993-2006 is characterized by the clearly defined periodical fine discrete structure with period L=50 km, which is solely generated by earthquakes with magnitude M 3.9 to 5.3 and only on the convergent boundary of plates. To describe the formation of this structure we used the model of complex systems by A. Volynskii and S. Bazhenov. The key property of this model consists in the presence of a rigid coating on a soft substratum. It is shown that in subduction processes the role of a rigid coating plays the slab substance (lithosphere) and the upper mantle acts as a soft substratum. Within the framework of this model we have obtained the estimation of average values of stress in the upper mantle and Young's modulus for the oceanic slab (lithosphere) and upper mantle.Comment: 9 pages, 7 figure

Looking for magnetic monopoles at LHC with diphoton events

Magnetic monopoles have been a subject of interest since Dirac established the relation between the existence of monopoles and charge quantization. The intense experimental search carried thus far has not met with success. The Large Hadron Collider is reaching energies never achieved before allowing the search for exotic particles in the TeV mass range. In a continuing effort to discover these rare particles we propose here other ways to detect them. We study the observability of monopoles and monopolium, a monopole-antimonopole bound state, at the Large Hadron Collider in the $\gamma \gamma$ channel for monopole masses in the range 500-1000 GeV. We conclude that LHC is an ideal machine to discover monopoles with masses below 1 TeV at present running energies and with 5 fb$^{-1}$ of integrated luminosity.Comment: This manuscript contains information appeared in Looking for magnetic monopoles at LHC, arXiv:1104.0218 [hep-ph] and Monopolium detection at the LHC.,arXiv:1107.3684 [hep-ph] by the same authors, rewritten for joint publication in The European Physica Journal Plus. 26 pages, 22 figure

Modelling pulmonary microthrombosis coupled to metastasis: distinct effects of thrombogenesis on tumorigenesis

Thrombosis can cause localized ischemia and tissue hypoxia, and both of these are linked to cancer metastasis. Vascular micro-occlusion can occur as a result of arrest of circulating tumour cells in small capillaries, giving rise to microthrombotic events that affect flow, creating localized hypoxic regions. To better understand the association between metastasis and thrombotic events, we generated an experimental strategy whereby we modelled the effect of microvascular occlusion in metastatic efficiency by using inert microbeads to obstruct lung microvasculature before, during and after intravenous tumour cell injection. We found that controlled induction of a specific number of these microthrombotic insults in the lungs caused an increase in expression of the hypoxia-inducible transcription factors (HIFs), a pro-angiogenic and pro-tumorigenic environment, as well as an increase in myeloid cell infiltration. Induction of pulmonary microthrombosis prior to introduction of tumour cells to the lungs had no effect on tumorigenic success, but thrombosis at the time of tumour cell seeding increased number and size of tumours in the lung, and this effect was strikingly more pronounced when the micro-occlusion occurred on the day following introduction of tumour cells. The tumorigenic effect of microbead treatment was seen even when thrombosis was induced five days after tumour cell injection. We also found positive correlations between thrombotic factors and expression of HIF2$\alpha$ in human tumours. The model system described here demonstrates the importance of thrombotic insult in metastatic success and can be used to improve understanding of thrombosis-associated tumorigenesis and its treatment.Research was supported through a Wellcome Trust Principal Research Fellowship to R.S.J. (RG59596). C.B. is supported through a Scientific Fellowship from Breast Cancer Now (2014MaySF275). C.E.E. received a Pump-Priming Grant from the University of Cambridge British Heart Foundation Centre of Research Excellence (RG68639)

Resolved Photon Processes

We review the present level of knowledge of the hadronic structure of the photon, as revealed in interactions involving quarks and gluons ``in" the photon. The concept of photon structure functions is introduced in the description of deep--inelastic $e \gamma$ scattering, and existing parametrizations of the parton densities in the photon are reviewed. We then turn to hard \gamp\ and \gaga\ collisions, where we treat the production of jets, heavy quarks, hard (direct) photons, \jpsi\ mesons, and lepton pairs. We also comment on issues that go beyond perturbation theory, including recent attempts at a comprehensive description of both hard and soft \gamp\ and \gaga\ interactions. We conclude with a list of open problems.Comment: LaTeX with equation.sty, 85 pages, 29 figures (not included). A complete PS file of the paper, including figures, can be obtained via anonymous ftp from ftp://phenom.physics.wisc.edu/pub/preprints/1995/madph-95-898.ps.

A Synaptic Mechanism for Temporal Filtering of Visual Signals

The visual system transmits information about fast and slow changes in light intensity through separate neural pathways. We used in vivo imaging to investigate how bipolar cells transmit these signals to the inner retina. We found that the volume of the synaptic terminal is an intrinsic property that contributes to different temporal filters. Individual cells transmit through multiple terminals varying in size, but smaller terminals generate faster and larger calcium transients to trigger vesicle release with higher initial gain, followed by more profound adaptation. Smaller terminals transmitted higher stimulus frequencies more effectively. Modeling global calcium dynamics triggering vesicle release indicated that variations in the volume of presynaptic compartments contribute directly to all these differences in response dynamics. These results indicate how one neuron can transmit different temporal components in the visual signal through synaptic terminals of varying geometries with different adaptational properties