Validation of a modified clinical risk score to predict cancer-specific survival for stage II colon cancer

Many patients with stage II colon cancer will die of their disease despite curative surgery. Therefore, identification of patients at high risk of poor outcome after surgery for stage II colon cancer is desirable. This study aims to validate a clinical risk score to predict cancer-specific survival in patients undergoing surgery for stage II colon cancer. Patients undergoing surgery for stage II colon cancer in 16 hospitals in the West of Scotland between 2001 and 2004 were identified from a prospectively maintained regional clinical audit database. Overall and cancer-specific survival rates up to 5 years were calculated. A total of 871 patients were included. At 5 years, cancer-specific survival was 81.9% and overall survival was 65.6%. On multivariate analysis, age ≥75 years (hazard ratio (HR) 2.11, 95% confidence intervals (CI) 1.57–2.85; P<0.001) and emergency presentation (HR 1.97, 95% CI 1.43–2.70; P<0.001) were independently associated with cancer-specific survival. Age and mode of presentation HRs were added to form a clinical risk score of 0–2. The cancer-specific survival at 5 years for patients with a cumulative score 0 was 88.7%, 1 was 78.2% and 2 was 65.9%. These results validate a modified simple clinical risk score for patients undergoing surgery for stage II colon cancer. The combination of these two universally documented clinical factors provides a solid foundation for the examination of the impact of additional clinicopathological and treatment factors on overall and cancer-specific survival

Measuring and modeling the (limited) consistency of free choice attitude questions

On average, respondents who give a positive answer to a binary free choice attitude question are NOT more likely, if surveyed again, to respond positively than to response negatively. However, stronger brands obtain more repeated positive answers. Our model shows why these two effects have to happen, even though all brands in a category benefit from the same reliability.survey reliability; attitude measurement; stochastic models; beta-binomial model; brand image; market research

Keck and VLT Observations of Super-damped Lyman-alpha Absorbers at z=2=2.5: Constraints on Chemical Compositions and Physical Conditions

We report Keck/ESI and VLT/UVES observations of three super-damped Lyman-alpha quasar absorbers with H I column densities log N(HI) >= 21.7 at redshifts z=2-2.5. All three absorbers show similar metallicities (-1.3 to -1.5 dex), and dust depletion of Fe, Ni, and Mn. Two of the absorbers show supersolar [S/Zn] and [Si/Zn]. We combine our results with those for other DLAs to examine trends between N(HI), metallicity, dust depletion. A larger fraction of the super-DLAs lie close to or above the line [X/H]=20.59-log N(HI) in the metallicity vs. N(HI) plot, compared to the less gas-rich DLAs, suggesting that super-DLAs are more likely to be rich in molecules. Unfortunately, our data for Q0230-0334 and Q0743+1421 do not cover H2 absorption lines. For Q1418+0718, some H2 lines are covered, but not detected. CO is not detected in any of our absorbers. For DLAs with log N(HI) < 21.7, we confirm strong correlation between metallicity and Fe depletion, and find a correlation between metallicity and Si depletion. For super-DLAs, these correlations are weaker or absent. The absorbers toward Q0230-0334 and Q1418+0718 show potential detections of weak Ly-alpha emission, implying star formation rates of about 1.6 and 0.7 solar masses per year, respectively (ignoring dust extinction). Upper limits on the electron densities from C II*/C II or Si II*/Si II are low, but are higher than the median values in less gas-rich DLAs. Finally, systems with log N(HI) > 21.7 may have somewhat narrower velocity dispersions delta v_90 than the less gas-rich DLAs, and may arise in cooler and/or less turbulent gas.Comment: 57 pages, 15 figures. Accepted for publication in Ap

Systemic inflammation predicts all-cause mortality: a Glasgow Inflammation Outcome Study

Introduction: Markers of the systemic inflammatory response, including C-reactive protein and albumin (combined to form the modified Glasgow Prognostic Score), as well as neutrophil, lymphocyte and platelet counts have been shown to be prognostic of survival in patients with cancer. The aim of the present study was to examine the prognostic relationship between these markers of the systemic inflammatory response and all-cause, cancer, cardiovascular and cerebrovascular mortality in a large incidentally sampled cohort.&lt;p&gt;&lt;/p&gt; Methods: Patients (n = 160 481) who had an incidental blood sample taken between 2000 and 2008 were studied for the prognostic value of C-reactive protein (&gt;10mg/l, albumin (&#62;35mg/l), neutrophil (&#62;7.5×109/l) lymphocyte and platelet counts. Also, patients (n = 52 091) sampled following the introduction of high sensitivity C-reactive protein (&#62;3mg/l) measurements were studied. A combination of these markers, to make cumulative inflammation-based scores, were investigated.&lt;p&gt;&lt;/p&gt; Results: In all patients (n = 160 481) C-reactive protein (&#62;10mg/l) (HR 2.71, p&#60;0.001), albumin (&#62;35mg/l) (HR 3.68, p&#60;0.001) and neutrophil counts (HR 2.18, p&#60;0.001) were independently predictive of all-cause mortality. These associations were also observed in cancer, cardiovascular and cerebrovascular mortality before and after the introduction of high sensitivity C-reactive protein measurements (&#62;3mg/l) (n = 52 091). A combination of high sensitivity C-reactive protein (&#62;3mg/l), albumin and neutrophil count predicted all-cause (HR 7.37, p&#60;0.001, AUC 0.723), cancer (HR 9.32, p&#60;0.001, AUC 0.731), cardiovascular (HR 4.03, p&#60;0.001, AUC 0.650) and cerebrovascular (HR 3.10, p&#60;0.001, AUC 0.623) mortality. Conclusion The results of the present study showed that an inflammation-based prognostic score, combining high sensitivity C-reactive protein, albumin and neutrophil count is prognostic of all-cause mortality

The Metallicity Distribution Functions of SEGUE G and K dwarfs: Constraints for Disk Chemical Evolution and Formation

We present the metallicity distribution function (MDF) for 24,270 G and 16,847 K dwarfs at distances from 0.2 to 2.3 kpc from the Galactic plane, based on spectroscopy from the Sloan Extension for Galactic Understanding and Exploration (SEGUE) survey. This stellar sample is significantly larger in both number and volume than previous spectroscopic analyses, which were limited to the solar vicinity, making it ideal for comparison with local volume-limited samples and Galactic models. For the first time, we have corrected the MDF for the various observational biases introduced by the SEGUE target selection strategy. The SEGUE sample is particularly notable for K dwarfs, which are too faint to examine spectroscopically far from the solar neighborhood. The MDF of both spectral types becomes more metal-poor with increasing |Z|, which reflects the transition from a sample with small [alpha/Fe] values at small heights to one with enhanced [alpha/Fe] above 1 kpc. Comparison of our SEGUE distributions to those of two different Milky Way models reveals that both are more metal-rich than our observed distributions at all heights above the plane. Our unbiased observations of G and K dwarfs provide valuable constraints over the |Z|-height range of the Milky Way disk for chemical and dynamical Galaxy evolution models, previously only calibrated to the solar neighborhood, with particular utility for thin- and thick-disk formation models.Comment: 70 pages, 25 figures, 7 tables. Accepted by The Astrophysical Journa

Galactic Globular and Open Clusters in the Sloan Digital Sky Survey. I. Crowded Field Photometry and Cluster Fiducial Sequences in ugriz

We present photometry for globular and open cluster stars observed with the Sloan Digital Sky Survey (SDSS). In order to exploit over 100 million stellar objects with r < 22.5 mag observed by SDSS, we need to understand the characteristics of stars in the SDSS ugriz filters. While star clusters provide important calibration samples for stellar colors, the regions close to globular clusters, where the fraction of field stars is smallest, are too crowded for the standard SDSS photometric pipeline to process. To complement the SDSS imaging survey, we reduce the SDSS imaging data for crowded cluster fields using the DAOPHOT/ALLFRAME suite of programs and present photometry for 17 globular clusters and 3 open clusters in a SDSS value-added catalog. Our photometry and cluster fiducial sequences are on the native SDSS 2.5-meter ugriz photometric system, and the fiducial sequences can be directly applied to the SDSS photometry without relying upon any transformations. Model photometry for red giant branch and main-sequence stars obtained by Girardi et al. cannot be matched simultaneously to fiducial sequences; their colors differ by ~0.02-0.05 mag. Good agreement (< ~0.02 mag in colors) is found with Clem et al. empirical fiducial sequences in u'g'r'i'z' when using the transformation equations in Tucker et al.Comment: 30 pages, 25 figures. Accepted for publication in ApJS. Version with high resolution figures available at http://www.astronomy.ohio-state.edu/~deokkeun/AnJohnson.pd

Group Averaging of massless scalar fields in 1+1 de Sitter

Perturbative gravity in global de Sitter space is subject to so-called linearization stability constraints: If they are to couple consistently to the gravitational field, quantum states must be invariant under the de Sitter isometries. While standard Fock spaces contain no de Sitter-invariant states apart from (possibly) the vacuum, a full Hilbert space of de Sitter-invariant quantum states can be constructed via group averaging techiniques. We re-examine the simple toy model of de Sitter group averaging given by the free 1+1 scalar field, expanding on an earlier analysis by Higuchi. Our purpose is twofold: to include the scalar zero-mode, and to explicitly count the number of de Sitter-invariant states as a function of an appropriately defined energy.Comment: 14 pages, accepted to Classical and Quantum Gravit

A systematic review on the effects of group singing on persistent pain in people with long‐term health conditions

Singing can have a range of health benefits; this paper reviews the evidence of the effects of group singing for chronic pain in people with long‐term health conditions. We searched for published peer‐reviewed singing studies reporting pain measures (intensity, interference and depression) using major electronic databases (last search date 31 July 2018). After screening 123 full texts, 13 studies met the inclusion criteria: five randomized controlled trials (RCTs), seven non‐RCTs and one qualitative study. Included studies were appraised using Downs and Black and the Critical Appraisals Skills Programme quality assessments. Included studies reported differences in the type of singing intervention, long‐term condition and pain measures. Due to the high heterogeneity, we conducted a narrative review. Singing interventions were found to reduce pain intensity in most studies, but there was more equivocal support for reducing pain interference and depression. Additionally, qualitative data synthesis identified three key linked and complementary themes: physical, psychological and social benefits. Group singing appears to have the potential to reduce pain intensity, pain interference and depression; however, we conclude that there is only partial support for singing on some pain outcomes based on the limited available evidence of varied quality. Given the positive findings of qualitative studies, this review recommends that practitioners are encouraged to continue this work. More studies of better quality are needed. Future studies should adopt more robust methodology and report their singing intervention in details. Group singing may be an effective and safe approach for reducing persistent pain and depression in people with long‐term health conditions.Health and Social Care Research Centr

Adjuvant radiotherapy and chemotherapy in breast cancer: 30 year follow-up of survival

BACKGROUND:The long term outcome (more than 15 years) of adjuvant treatment in patients with primary operable breast cancer has rarely been examined.METHODS:A randomised clinical trial of radiotherapy, chemotherapy (28 day cycles of cyclophosphamide, methotrexate and 5-fluorouracil) or both on women with primary operable breast cancer (n = 322) was followed-up for a median of 27 years.RESULTS:260 (81%) patients died, 204 (78%) from breast cancer. Cancer specific survival (SE) at 10 years, 20 years and 30 years was 41 (3)%, 34 (3)% and 33 (3)% respectively. Presence of more than 3 involved lymph nodes increased cancer-specific mortality (HR 1.88, 95% CI 1.34-2.63) after adjustment for age, socio-economic deprivation and adjuvant treatment. Both age (HR 1.63, 95% CI 1.19-2.22) and involved lymph nodes (HR 1.59, 95% CI 1.17-2.14) were significant predictors of all-cause mortality after adjustment for other factors. There was no significant difference in all-cause or cancer-specific survival between patients in each of the 3 treatment arms.CONCLUSIONS:The present study highlights the long term impact of node positive disease but does not indicate that any regimen was associated with significantly better long-term surviva