Validation of the Malaysian Chinese-version of the EORTC QLQ-CR29 among Colorectal cancer patients in Malaysia

Patient reported outcome research are becoming a very important way of understanding patient’s satisfaction and tolerance with the treatment they receive. This study examined the validity and reliability of the Malaysian Chinese version of the European Organization for Research and Treatment of Cancer (EORTC) colorectal cancer-specific quality of life questionnaire (QLQ-CR29). Patients were recruited at the outpatient clinics of the University of Malaya and Universiti Kebangsaan Medical Centre, Malaysia. The QLQ-CR29 and Karnofsky Performance Scales (KPS) were used. Multi-traits scaling analysis such as Cronbach’s alpha, inter-class correlation (ICC) and known-groups comparisons (Wilcoxon-rank sum test) were performed. Significant level was pre-set at ≤ 0.05. Patients mean age (standard deviation, SD) was 64 (10) years, and 60% were male. Colon cancer was 50%. While 60% had advanced stage (Dukes’ C/D) cancers and about 30% of patients had a stoma. The mean KPS was 80% (SD 10). The internal consistency coefficient (ICC) was 0.89, 0.84, 0.46, and 0.73 for body image, urinary frequency, blood & mucus in stool and stool frequency scales respectively. The correlation coefficients for convergent validity were moderate to large (r ranged from 0.72 to 0.93) across all scales. For the discriminant validity measurements, small to moderate correlations were observed across the scales. The psychometric properties of the Malaysian Chinese version of the QLQ-CR29 were comparable to the original English version. This work provides a translated, culturally adapted, reliable and valid measure of HRQOL for use among Malaysian Chinese patients with colorectal cancer

TIM3+FOXP3+ regulatory T cells are tissue-specific promoters of T-cell dysfunction in cancer

T-cell immunoglobulin mucin 3 (TIM3) is an inhibitory molecule that has emerged as a key regulator of dysfunctional or exhausted CD8+ T cells arising in chronic diseases such as cancer. In addition to exhausted CD8+ T cells, highly suppressive regulatory T cells (Tregs) represent a significant barrier against the induction of antitumor immunity. We have found that the majority of intratumoral FOXP3+ Tregs express TIM3. TIM3+ Tregs co-express PD-1, are highly suppressive and comprise a specialized subset of tissue Tregs that are rarely observed in the peripheral tissues or blood of tumor-bearing mice. The co-blockade of the TIM3 and PD-1 signaling pathways in vivo results in the downregulation of molecules associated with TIM3+ Treg suppressor functions. This suggests that the potent clinical efficacy of co-blocking TIM3 and PD-1 signal transduction cascades likely stems from the reversal of T-cell exhaustion combined with the inhibition of regulatory T-cell function in tumor tissues. Interestingly, we find that TIM3+ Tregs accumulate in the tumor tissue prior to the appearance of exhausted CD8+ T cells, and that the depletion of Tregs at this stage interferes with the development of the exhausted phenotype by CD8+ T cells. Collectively, our data indicate that TIM3 marks highly suppressive tissue-resident Tregs that play an important role in shaping the antitumor immune response in situ, increasing the value of TIM3-targeting therapeutic strategies against cancer

Average Entropy of a Subsystem from its Average Tsallis Entropy

In the nonextensive Tsallis scenario, Page's conjecture for the average entropy of a subsystem[Phys. Rev. Lett. {\bf 71}, 1291(1993)] as well as its demonstration are generalized, i.e., when a pure quantum system, whose Hilbert space dimension is $mn$, is considered, the average Tsallis entropy of an $m$-dimensional subsystem is obtained. This demonstration is expected to be useful to study systems where the usual entropy does not give satisfactory results.Comment: Revtex, 6 pages, 2 figures. To appear in Phys. Rev.

The clinical utility of lung clearance index in early cystic fibrosis lung disease is not impacted by the number of multiple-breath washout trials

© ERS 2018. The lung clearance index (LCI) from the multiple-breath washout (MBW) test is a promising surveillance tool for pre-school children with cystic fibrosis (CF). Current guidelines for MBW testing recommend that three acceptable trials are required. However, success rates to achieve these criteria are low in children aged < 7 years and feasibility may improve with modified pre-school criteria that accepts tests with two acceptable trials. This study aimed to determine if relationships between LCI and clinical outcomes of CF lung disease differ when only two acceptable MBW trials are assessed. Healthy children and children with CF aged 3–6 years were recruited for MBW testing. Children with CF also underwent bronchoalveolar lavage fluid collection and a chest computed tomography scan. MBW feasibility increased from 46% to 75% when tests with two trials were deemed acceptable compared with tests where three acceptable trials were required. Relationships between MBW outcomes and markers of pulmonary inflammation, infection and structural lung disease were not different between tests with three acceptable trials compared with tests with two acceptable trials. This study indicates that pre-school MBW data from two acceptable trials may provide sufficient information on ventilation distribution if three acceptable trials are not possible

The Quantized O(1,2)/O(2)×Z2O(1,2)/O(2)\times Z_2 Sigma Model Has No Continuum Limit in Four Dimensions. II. Lattice Simulation

A lattice formulation of the $O(1,2)/O(2)\times Z_2$ sigma model is developed, based on the continuum theory presented in the preceding paper. Special attention is given to choosing a lattice action (the ``geodesic'' action) that is appropriate for fields having noncompact curved configuration spaces. A consistent continuum limit of the model exists only if the renormalized scale constant $\beta_R$ vanishes for some value of the bare scale constant~$\beta$. The geodesic action has a special form that allows direct access to the small-$\beta$ limit. In this limit half of the degrees of freedom can be integrated out exactly. The remaining degrees of freedom are those of a compact model having a $\beta$-independent action which is noteworthy in being unbounded from below yet yielding integrable averages. Both the exact action and the $\beta$-independent action are used to obtain $\beta_R$ from Monte Carlo computations of field-field averages (2-point functions) and current-current averages. Many consistency cross-checks are performed. It is found that there is no value of $\beta$ for which $\beta_R$ vanishes. This means that as the lattice cutoff is removed the theory becomes that of a pair of massless free fields. Because these fields have neither the geometry nor the symmetries of the original model we conclude that the $O(1,2)/O(2)\times Z_2$ model has no continuum limit.Comment: 32 pages, 7 postscript figures, UTREL 92-0

Are people who participate in cultural activities more satisfied with life?

The influence of various aspects of life on wellbeing has been extensively researched. However, despite little empirical evidence, participation in leisure activities has been assumed to increase subjective wellbeing. Leisure is important because it is more under personal control than other sources of life satisfaction. This study asked whether people who participate in cultural leisure activities have higher life satisfaction than people who do not, if different types of leisure have the same influence on life satisfaction and if satisfaction is dependent on the frequency of participation or the number of activities undertaken. It used data from UKHLS Survey to establish associations between type, number and frequency of participation in leisure activities and life satisfaction. Results showed an independent and positive association of participation in sport, heritage and active-creative leisure activities and life satisfaction but not for participation in popular entertainment, theatre hobbies and museum/galleries. The association of reading hobbies and sedentary-creative activities and life satisfaction was negative. High life satisfaction was associated with engaging in a number of different activities rather than the frequency of participation in each of them. The results have implications for policy makers and leisure services providers, in particular those associated with heritage recreation. Subjective wellbeing measures, such as life satisfaction, and not economic measures alone should be considered in the evaluation of services. The promotion of leisure activities which are active and promote social interaction should be considered in programmes aimed at improving the quality of life

Nutrient Intake in the First Two Weeks of Life and Brain Growth in Preterm Neonates.

BACKGROUND: Optimizing early nutritional intake in preterm neonates may promote brain health and neurodevelopment through enhanced brain maturation. Our objectives were (1) to determine the association of energy and macronutrient intake in the first 2 weeks of life with regional and total brain growth and white matter (WM) maturation, assessed by 3 serial MRI scans in preterm neonates; (2) to examine how critical illness modifies this association; and (3) to investigate the relationship with neurodevelopmental outcomes. METHODS: Forty-nine preterm neonates (21 boys, median [interquartile range] gestational age: 27.6 [2.3] weeks) were scanned serially at the following median postmenstrual weeks: 29.4, 31.7, and 41. The total brain, basal nuclei, and cerebellum were semiautomatically segmented. Fractional anisotropy was extracted from diffusion tensor imaging data. Nutritional intake from day of life 1 to 14 was monitored and clinical factors were collected. RESULTS: Greater energy and lipid intake predicted increased total brain and basal nuclei volumes over the course of neonatal care to term-equivalent age. Similarly, energy and lipid intake were significantly associated with fractional anisotropy values in selected WM tracts. The association of ventilation duration with smaller brain volumes was attenuated by higher energy intake. Brain growth predicted psychomotor outcome at 18 months\u27 corrected age. CONCLUSIONS: In preterm neonates, greater energy and enteral feeding during the first 2 weeks of life predicted more robust brain growth and accelerated WM maturation. The long-lasting effect of early nutrition on neurodevelopment may be mediated by enhanced brain growth. Optimizing nutrition in preterm neonates may represent a potential avenue to mitigate the adverse brain health consequences of critical illness

Statistical distribution of quantum entanglement for a random bipartite state

We compute analytically the statistics of the Renyi and von Neumann entropies (standard measures of entanglement), for a random pure state in a large bipartite quantum system. The full probability distribution is computed by first mapping the problem to a random matrix model and then using a Coulomb gas method. We identify three different regimes in the entropy distribution, which correspond to two phase transitions in the associated Coulomb gas. The two critical points correspond to sudden changes in the shape of the Coulomb charge density: the appearance of an integrable singularity at the origin for the first critical point, and the detachement of the rightmost charge (largest eigenvalue) from the sea of the other charges at the second critical point. Analytical results are verified by Monte Carlo numerical simulations. A short account of some of these results appeared recently in Phys. Rev. Lett. {\bf 104}, 110501 (2010).Comment: 7 figure

Power plant maintenance scheduling using ant colony optimization: an improved formulation

Abstract It is common practice in the hydropower industry to either shorten the maintenance duration or to postpone maintenance tasks in a hydropower system when there is expected unserved energy based on current water storage levels and forecast storage inflows. It is therefore essential that a maintenance scheduling optimizer can incorporate the options of shortening the maintenance duration and/or deferring maintenance tasks in the search for practical maintenance schedules. In this article, an improved ant colony optimization-power plant maintenance scheduling optimization (ACO-PPMSO) formulation that considers such options in the optimization process is introduced. As a result, both the optimum commencement time and the optimum outage duration are determined for each of the maintenance tasks that need to be scheduled. In addition, a local search strategy is presented in this article to boost the robustness of the algorithm. When tested on a five-station hydropower system problem, the improved formulation is shown to be capable of allowing shortening of maintenance duration in the event of expected demand shortfalls. In addition, the new local search strategy is also shown to have significantly improved the optimization ability of the ACO-PPMSO algorithm

Impairments in hearing and vision impact on mortality in older people: the AGES-Reykjavik Study.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.to examine the relationships between impairments in hearing and vision and mortality from all-causes and cardiovascular disease (CVD) among older people.population-based cohort study.the study population included 4,926 Icelandic individuals, aged ≥67 years, 43.4% male, who completed vision and hearing examinations between 2002 and 2006 in the Age, Gene/Environment Susceptibility-Reykjavik Study (AGES-RS) and were followed prospectively for mortality through 2009.participants were classified as having 'moderate or greater' degree of impairment for vision only (VI), hearing only (HI), and both vision and hearing (dual sensory impairment, DSI). Cox proportional hazard regression, with age as the time scale, was used to calculate hazard ratios (HR) associated with impairment and mortality due to all-causes and specifically CVD after a median follow-up of 5.3 years.the prevalence of HI, VI and DSI were 25.4, 9.2 and 7.0%, respectively. After adjusting for age, significantly (P < 0.01) increased mortality from all causes, and CVD was observed for HI and DSI, especially among men. After further adjustment for established mortality risk factors, people with HI remained at higher risk for CVD mortality [HR: 1.70 (1.27-2.27)], whereas people with DSI remained at higher risk of all-cause mortality [HR: 1.43 (1.11-1.85)] and CVD mortality [HR: 1.78 (1.18-2.69)]. Mortality rates were significantly higher in men with HI and DSI and were elevated, although not significantly, among women with HI.older men with HI or DSI had a greater risk of dying from any cause and particularly cardiovascular causes within a median 5-year follow-up. Women with hearing impairment had a non-significantly elevated risk. Vision impairment alone was not associated with increased mortality.National Institutes of Health, National Institute on Aging (NIA) N01-AG-12100 NIA Z01-AG007380 National Eye Institute (NEI) ZIAEY000401 National Institute on Deafness and Other Communication Disorders (NIDCD) Division of Scientific Programs/IAA Y2-DC-1004-02 Hjartavernd (Icelandic Heart Association) Althingi (Icelandic Parliament