Circulating fibrinogen is a prognostic and predictive biomarker in malignant pleural mesothelioma.

Background:To investigate the clinical utility of pretreatment plasma fibrinogen levels in malignant pleural mesothelioma (MPM) patients.Methods:A retrospective multicenter study was performed in histologically proven MPM patients. All fibrinogen levels were measured at the time of diagnosis and clinical data were retrospectively collected after approval of the corresponding ethics committees.Results:In total, 176 MPM patients (mean age: 63.5 years+/-10.4 years, 38 females and 138 males) were analysed. Most patients (n=154, 87.5%) had elevated (>/=390 mg dl-1) plasma fibrinogen levels. When patients were grouped by median fibrinogen, patients with low level (</=627 mg dl-1) had significantly longer overall survival (OS) (19.1 months, confidence interval (CI) 14.5-23.7 months) when compared with those with high level (OS 8.5; CI 6.2-10.7 months). In multivariate survival analyses, fibrinogen was found to be an independent prognostic factor (hazard ratio 1.81, CI 1.23-2.65). Most interestingly, fibrinogen (cutoff 75th percentile per 750 mg dl-1) proved to be a predictive biomarker indicating treatment benefit achieved by surgery within multimodality therapy (interaction term: P=0.034). Accordingly, only patients below the 75th percentile benefit from surgery within multimodality therapy (31.3 vs 5.3 months OS).Conclusions:Fibrinogen is a novel independent prognostic biomarker in MPM. Most importantly, fibrinogen predicted treatment benefit achieved by surgery within multimodality therapy.British Journal of Cancer advance online publication, 16 January 2014; doi:10.1038/bjc.2013.815 www.bjcancer.com

Caching behaviour by red squirrels may contribute to food conditioning of grizzly bears

We describe an interspecific relationship wherein grizzly bears (Ursus arctos horribilis) appear to seek out and consume agricultural seeds concentrated in the middens of red squirrels (Tamiasciurus hudsonicus), which had collected and cached spilled grain from a railway. We studied this interaction by estimating squirrel density, midden density and contents, and bear activity along paired transects that were near (within 50 m) or far (200 m) from the railway. Relative to far ones, near transects had 2.4 times more squirrel sightings, but similar numbers of squirrel middens. Among 15 middens in which agricultural products were found, 14 were near the rail and 4 subsequently exhibited evidence of bear digging. Remote cameras confirmed the presence of squirrels on the rail and bears excavating middens. We speculate that obtaining grain from squirrel middens encourages bears to seek grain on the railway, potentially contributing to their rising risk of collisions with trains

Tracking Behavioral Health Indicators for Island Youth

The goal of this project was to develop a survey and interview subject matter experts to identify the mental health issues that are present within the middle and high school youth community on Nantucket. The online survey was designed to be modular and customizable to the user and contained a mixture of Likert scale and multiple-choice questions, and open-response questions. A slightly modified version of the survey was also distributed to Worcester Polytechnic Institute Undergraduates to gather data that could be compared with data from the Nantucket Youth Survey. Based on an analysis of the survey results, follow up recommendations included conducting focus groups with schoolteachers and counselors and interviews with youth-oriented professionals, adding specific questions to the survey to obtain data on future career interest and homelife, and investigating minority groups that do not have as much representation in their respective schools or communities as their peers

Acute effects of initiation and withdrawal of cardiac resynchronization therapy on papillary muscle dyssynchrony and mitral regurgitation

Objectives The purpose of this study was to evaluate the relationship between dyssynchrony involving the mitral valve apparatus and the acute improvement in mitral regurgitation (MR) after cardiac resynchronization therapy (CRT). The effect of interruption of CRT at 6 months' follow-up on dyssynchrony and MR was also evaluated. Background Mitral regurgitation may improve acutely after CRT, but the precise mechanism is not fully understood. Methods Out of 63 consecutive patients with baseline MR, 25 patients showed an acute reduction in MR severity immediately after CRT. This selected group of 25 patients (age 68 +/- 10 years, left ventricular ejection fraction 23 +/- 8%) was evaluated in the current study. Echocardiography including speckle tracking strain analysis was performed at baseline, after CRT initiation, and during interruption of CRT at 6 months' follow-up to study the relationship between clyssynchrony between the papillary muscles and severity of MR. Results According to the inclusion criteria, all patients showed an immediate improvement in MR after CRT (vena contracta width decreased from 0.54 +/- 0.15 cm to 0.39 +/- 0.13 cm; p < 0.001), accompanied by an improvement in mitral deformation indexes. Furthermore, dyssynchrony between the papillary muscles decreased from 169 69 ms to 25 +/- 26 ms (p < 0.001). Importantly, these beneficial effects were maintained at 6 months' followup, but acute loss of resynchronization (from 26 +/- 28 ms to 134 +/- 51 ms; p < 0.001) was observed after interruption of CRT, with an acute recurrence of MR and worsening in mitral deformation indexes. Conclusions Cardiac resynchronization therapy can acutely reduce MR in patients with clyssynchrony involving the papillary muscles; interruption of CRT at 6 months' follow-up, however, resulted in acute loss of resynchronization with recurrence of MR

Improved aortic enhancement in CT angiography using slope-based triggering with table speed optimization: a pilot study

To assess whether a scan triggering technique based on the slope of the time-attenuation curve combined with table speed optimization may improve arterial enhancement in aortic CT angiography compared to conventional threshold-based triggering techniques. Measurements of arterial enhancement were performed in a physiologic flow phantom over a range of simulated cardiac outputs (2.2-8.1 L/min) using contrast media boluses of 80 and 150 mL injected at 4 mL/s. These measurements were used to construct computer models of aortic attenuation in CT angiography, using cardiac output, aortic diameter, and CT table speed as input parameters. In-plane enhancement was calculated for normal and aneurysmal aortic diameters. Calculated arterial enhancement was poor (200 HU; 13/16 scenarios) to excellent-quality (>300 HU; 3/16 scenarios) enhancement in all cases. Slope-based triggering with table speed optimization may improve the technical quality of aortic CT angiography over conventional threshold-based techniques, and may reduce technical failures related to low cardiac output and slow flow through an aneurysmal aorta