Colorectal Cancer Screening After Sequential Outreach Components in a Demographically Diverse Cohort.

Organized screening outreach can reduce differences in colorectal cancer (CRC) incidence and mortality between demographic subgroups. Outcomes associated with additional outreach, beyond universal outreach, are not well known. To compare CRC screening completion by race and ethnicity, age, and sex after universal automated outreach and additional personalized outreach. This observational cohort study included screening-eligible individuals aged 50 to 75 years assessed during 2019 in a community-based organized CRC screening program within the Kaiser Permanente Northern California (KPNC) integrated health care delivery setting. For KPNC members who are not up to date with screening by colonoscopy, each year the program first uses automated outreach (mailed prescreening notification postcards and fecal immunochemical test [FIT] kits, automated telephone calls, and postcard reminders), followed by personalized components for nonresponders (telephone calls, electronic messaging, and screening offers during office visits). Data analyses were performed between November 2021 and February 2023 and completed on February 5, 2023. Completed CRC screening via colonoscopy, sigmoidoscopy, or FIT. The primary outcome was the proportion of participants completing an FIT or colonoscopy after each component of the screening process. Differences across subgroups were assessed using the χ2 test. This study included 1 046 745 KPNC members. Their mean (SD) age was 61.1 (6.9) years, and more than half (53.2%) were women. A total of 0.4% of members were American Indian or Alaska Native, 18.5% were Asian, 7.2% were Black, 16.2% were Hispanic, 0.8% were Native Hawaiian or Other Pacific Islander, and 56.5% were White. Automated outreach significantly increased screening participation by 31.1%, 38.1%, 29.5%, 31.9%, 31.8%, and 34.5% among these groups, respectively; follow-up personalized outreach further significantly increased participation by absolute additional increases of 12.5%, 12.4%, 13.3%, 14.4%, 14.7%, and 11.2%, respectively (all differences P < .05 compared with White members). Overall screening coverage at the end of the yearly program differed significantly among members who were American Indian or Alaska Native (74.1%), Asian (83.5%), Black (77.7%), Hispanic (76.4%), or Native Hawaiian or Other Pacific Islander (74.4%) compared with White members (82.2%) (all differences P < .05 compared with White members). Screening completion was similar by sex; older members were substantially more likely to be up to date with CRC screening both before and at the end of the screening process. In this cohort study of a CRC screening program, sequential automated and personalized strategies each contributed to substantial increases in screening completion in all demographic groups. These findings suggest that such programs may potentially reduce differences in CRC screening completion across demographic groups

Analysis of common attacks in LDPCC-based public-key cryptosystems

We analyze the security and reliability of a recently proposed class of public-key cryptosystems against attacks by unauthorized parties who have acquired partial knowledge of one or more of the private key components and/or of the plaintext. Phase diagrams are presented, showing critical partial knowledge levels required for unauthorized decryptionComment: 14 pages, 6 figure

Resonant tunneling through ultrasmall quantum dots: zero-bias anomalies, magnetic field dependence, and boson-assisted transport

We study resonant tunneling through a single-level quantum dot in the presence of strong Coulomb repulsion beyond the perturbative regime. The level is either spin-degenerate or can be split by a magnetic field. We, furthermore, discuss the influence of a bosonic environment. Using a real-time diagrammatic formulation we calculate transition rates, the spectral density and the nonlinear $I-V$ characteristic. The spectral density shows a multiplet of Kondo peaks split by the transport voltage and the boson frequencies, and shifted by the magnetic field. This leads to zero-bias anomalies in the differential conductance, which agree well with recent experimental results for the electron transport through single-charge traps. Furthermore, we predict that the sign of the zero-bias anomaly depends on the level position relative to the Fermi level of the leads.Comment: 27 pages, latex, 21 figures, submitted to Phys. Rev.

Magnetotransport in Two-Dimensional Electron Systems with Spin-Orbit Interaction

We present magnetotransport calculations for homogeneous two-dimensional electron systems including the Rashba spin-orbit interaction, which mixes the spin-eigenstates and leads to a modified fan-chart with crossing Landau levels. The quantum mechanical Kubo formula is evaluated by taking into account spin-conserving scatterers in an extension of the self-consistent Born approximation that considers the spin degree of freedom. The calculated conductivity exhibits besides the well-known beating in the Shubnikov-de Haas (SdH) oscillations a modulation which is due to a suppression of scattering away from the crossing points of Landau levels and does not show up in the density of states. This modulation, surviving even at elevated temperatures when the SdH oscillations are damped out, could serve to identify spin-orbit coupling in magnetotransport experiments. Our magnetotransport calculations are extended also to lateral superlattices and predictions are made with respect to 1/B periodic oscillations in dependence on carrier density and strength of the spin-orbit coupling.Comment: 8 pages including 8 figures; submitted to PR

Slow oscillations of magnetoresistance in quasi-two-dimensional metals

Slow oscillations of the interlayer magnetoresistance observed in the layered organic metal $\beta$-(BEDT-TTF)$_2$IBr$_2$ are shown to originate from the slight warping of its Fermi surface rather than from independent small cyclotron orbits. Unlike the usual Shubnikov-de Haas effect, these oscillations are not affected by the temperature smearing of the Fermi distribution and can therefore become dominant at high enough temperatures. We suggest that the slow oscillations are a general feature of clean quasi-two-dimensional metals and discuss possible applications of the phenomenon.Comment: 11 pages, 3 figure

Randomized phase III trial of consolidation therapy with bortezomib–lenalidomide–Dexamethasone (VRd) vs bortezomib–dexamethasone (Vd) for patients with multiple myeloma who have completed a dexamethasone based induction regimen

Long-awaited results from the the Southwest Oncology Group (SWOG) trial comparing bortezomib–lenalidomide-dexamethasone (VRd) versus lenalidomide-dexamethasone (Rd) as induction treatment for previously untreated multiple myeloma (MM) patients were recently presented (S0777).1 Results justified the early adoption of VRd in the frontline setting over 5 years ago by the NCCN based on Level 2A evidence according to their guidelines.2 The randomized study E1A05 also sought to evaluate VRd superiority over a doublet (Vd), but in the consolidation setting. The trial was closed to enrollment prematurely due to slow accrual. Results reported here include 48 enrolled patients.This study was coordinated by the ECOG-ACRIN Cancer Research Group (Robert L Comis, MD, and Mitchell D Schnall, MD, PhD, Group Co-Chairs) and supported by the National Cancer Institute of the National Institutes of Health under award numbers: CA180820, CA180794, CA21115, CA23318, CA66636, CA180790, CA13650, CA189956, CA35412, CA15488, CA180799 and CA21076.http://www.sherpa.ac.uk/romeo/issn/2044-5385/am2016Medical Oncolog

No Association Between Screening for Hepatocellular Carcinoma and Reduced Cancer-Related Mortality in Patients With Cirrhosis

Background & Aims: Screening patients with cirrhosis for hepatocellular carcinoma (HCC) has been recommended. We conducted a matched case–control study within the US Veterans Affairs (VA) health care system to determine whether screening by abdominal ultrasonography (USS) and/or by measuring serum level of α-fetoprotein (AFP) was associated with decreased cancer-related mortality in patients with cirrhosis. Methods: We defined cases (n = 238) as patients with cirrhosis who died of HCC from January 1, 2013 through August 31, 2015 and had been in VA care with a diagnosis of cirrhosis for at least 4 years before the diagnosis of HCC. We matched each case to 1 control (n = 238), defined as a patient with cirrhosis who did not die of HCC and had been in VA care for at least 4 years before the date of the matched case's HCC diagnosis. Controls were matched to cases by year of cirrhosis diagnosis, race and ethnicity, age, sex, etiology of cirrhosis, Model for End-Stage Liver Disease score, and VA medical center. We identified all USS and serum AFP tests performed within 4 years before the date of HCC diagnosis in cases or the equivalent index date in controls and determined by chart extraction (blinded to case or control status) whether these tests were performed for screening. Results: There were no significant differences between cases and controls in the proportions of patients who underwent screening USS (52.9% vs 54.2%), screening measurement of serum AFP (74.8% vs 73.5%), screening USS or measurement of serum AFP (81.1% vs 79.4%), or screening USS and measurement of serum AFP (46.6% vs 48.3%) within 4 years before the index date, with or without adjusting for potential confounders. There also was no difference in receipt of these screening tests within 1, 2, or 3 years before the index date. Conclusions: In a matched case–control study of the VA health care system, we found that screening patients with cirrhosis for HCC by USS, measurement of serum AFP, either test, or both tests was not associated with decreased HCC-related mortality. We encourage additional case–control studies to evaluate the efficacy of screening for HCC in other health care systems, in which available records are sufficiently detailed to enable identification of the indication for USS and AFP tests

Reply

Reply. We are grateful for the interest others have shown in our paper, which allowed us to clarify critical aspects of the case-control study design and the nature of our study population

The Effect of Valproic Acid on Mesenchymal Pluripotent Cell Proliferation and Differentiation in Extracellular Matrices

Valproic acid (2-n-propylpentanoic acid, VPA) is a widely used antiepileptic and anticonvulsant drug. Previous studies have reported that VPA effects osteogenesis in vivo and in vitro, yet it remains unclear whether VPA promotes cell differentiation of osteoblasts derived from mesenchymal cells. The purpose of this study was to clarify the effect of VPA on undifferentiated pluripotent mesenchymal cell proliferation and differentiation into osteoblasts while analyzing the impact of the absence or presence of extracellular matrices (ECMs). Mouse mesenchymal cells were cultured on non-coated plastic, type I collagen-coated, and fibronectin-coated plates in the absence or presence of VPA. A cell proliferation assay was performed in which modified formazan dye content was analyzed and proliferation nuclear antigen (PCNA)-positive cells were counted at various concentrations of VPA. A high concentration of VPA did not clearly alter cell morphology, but large numbers of stress fibers were observed in these cells and the cell proliferation ratio was decreased with positive PCNA counts. In the presence of matrices, the cell proliferation ratio decreased at low VPA concentrations compared with the ratio obtained in the absence of these ECMs. On the other hand, VPA promoted osteoblastic differentiation in the presence of type I collagen. These findings indicate that for undifferentiated mesenchymal cells, VPA promotes a decrease in the cell proliferation rate in the presence of ECMs and promotes osteoblastic differentiation, both of which could provide insight into additional mechanisms of osteoblastic cell differentiation caused by VPA