Science.gov

Sample records for adjusted cancer rates

  1. Bias From Using Occupational Smoking Prevalence to Adjust Occupational Incidence Cohort Lung Cancer Mortality Rates

    PubMed Central

    Roth, H. Daniel

    2015-01-01

    Objective: To describe how smoking correction factors based on comparing worker smoking prevalence with population smoking prevalence are biased if applied to an occupational incidence cohort. Methods: Relative rates of smoking for shorter-tenure workers derived from occupational cohort lung cancer studies were applied to incidence and prevalence population tenure distributions to calculate relative smoking estimates. Results: High smoking rates in short-tenure workers have little effect on prevalent worker rates (relative smoking estimates, 1.04 and 1.02) and much larger effect in occupational incidence populations (relative smoking estimates, 1.58 and 1.21), which have a much higher proportion of short tenure-workers. Conclusions: Smoking correction estimates derived from surveys of smoking habits in prevalent workers may introduce bias when applied to incidence workers because of very different proportions of short-tenure workers (length-time biased sampling). PMID:25427172

  2. 78 FR 62712 - Rate Adjustment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-22

    ... Rate Adjustment AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recent Postal Service filing seeking postal rate adjustments based on exigent circumstances... On September 26, 2013, the Postal Service filed an exigent rate request with the Commission...

  3. Coping - Adjusting to Cancer

    Cancer.gov

    Information that helps you and your family face life’s changes from cancer. Includes talking with your doctors, talking to children, changes for the family, and information on cancer support groups.

  4. Choosing a standard for adjusted mortality rates.

    PubMed

    Seltzer, F

    1996-01-01

    For over half a century, the standard for age-adjustment in mortality studies has been based on the total population according to the 1940 census. The question periodically arises, however, whether a more recent census population might now be more appropriate. Thus, a study using the six censuses from 1940 to 1990 was conducted to see the effect each of these populations would have on the age-adjusted (standardized) death rates. While the size of the age-adjusted rates was affected by the censal standard populations from 1940 to 1990, these populations hardly changed the proportional mortality by age, sex, cause-of-death and geographic area. It appears that a shift from the 1940 standard will not be necessary, although if more detailed comparisons are needed, age-specific death rates can always be used. The 1940 standard also has the advantage of being consistent with many earlier studies. PMID:8744891

  5. Speaking rate adjustment across changes in talker

    NASA Astrophysics Data System (ADS)

    Newman, Rochelle S.; Sawusch, James R.

    2002-05-01

    Individuals vary their speaking rate, and listeners use the speaking rate of precursor sentences to adjust for these changes [Kidd (1989)]. Recent work has suggested that speaking rate adjustment may not always be limited to speech from a single talker (Sawusch and Newman, 2000). When a talker change occurs in the midst of a vowel, the durations of both portions of the vowel influence perception of the rate-based contrast. In the present experiments, we examined the effect of talker change on rate normalization for precursor phrases. A male talker produced the sentence, I heard him say the word-at one of three different speaking rates. A female talker then produced a nonword containing a duration-based contrast. We examined whether the male talker's speaking rate would influence perception of the female talker's speech. The results were somewhat surprising. The speaking rate of the first talker did influence perception of the contrast in the second talker. However, the effect was a U-shaped function of speaking rate, rather than the linear function typically demonstrated in the single-voice condition. Several follow-up studies replicated this basic pattern. Implications of this finding for studies of rate normalization will be discussed.

  6. Risk adjustment for a children's capitation rate.

    PubMed

    Newhouse, J P; Sloss, E M; Manning, W G; Keeler, E B

    1993-01-01

    Few capitation arrangements vary premiums by a child's health characteristics, yielding an incentive to discriminate against children with predictably high expenditures from chronic diseases. In this article, we explore risk adjusters for the 35 percent of the variance in annual out-patient expenditure we find to be potentially predictable. Demographic factors such as age and gender only explain 5 percent of such variance; health status measures explain 25 percent, prior use and health status measures together explain 65 to 70 percent. The profit from risk selection falls less than proportionately with improved ability to adjust for risk. Partial capitation rates may be necessary to mitigate skimming and dumping. PMID:10133708

  7. Oncogene activation and tumor suppressor gene inactivation find their sites of expression in the changes in time and space of the age-adjusted cancer incidence rate.

    PubMed

    Kodama, M; Kodama, T; Murakami, M

    2000-01-01

    The purpose of the present investigation is to elucidate the relation between the distribution pattern of the age-adjusted incidence rate (AAIR) changes in time and space of 15 tumors of bothe sexes and the locations of centers of centripetal-(oncogene type) and centrifugal-(tumoe suppressor gene type) forces. The fitness of the observed log AAIR data sets to the oncogene type- and the tumor suppressor gene type-equilibrium models and the locations of 2 force centers were calculated by applying the least square method of Gauss to log AAIR pair data series with and without topological data manipulations, which are so designed as to let log AAIR pair data series fit to 2 variant (x, y) frameworks, the Rect-coordinates and the Para-coordinates. The 2 variant (x, y) coordinates are defined each as an (x, y) framework with its X axis crossed at a right angle to the regression line of the original log AAIR data (the Rect-coordinates) and as another framework with its X axis run in parallel with the regression line of the original log AAIR pair data series (the Para-coordinates). The fitness test of log AAIR data series to either the oncogene activation type equilibrium model (r = -1.000) or the tumor suppressor gene inactivation type (r = 1.000) was conducted for each of the male-female type pair data and the female-male type data, for each of log AAIR changes in space and log AAIR changes in time, and for each of the 3 (x, y) frameworks in a given neoplasia of both sexes. The results obtained are given as follows: 1) The positivity rates of the fitness test to the oncogene type equilibrium model and the tumor suppressor gene type model were each 63.3% and 56.7% with the log AAIR changes in space, and 73.3% and 73.3% with log AAIR changes in time, as tested in 15 human neoplasias of both sexes. 2) Evidence was presented to indicate that the clearance of oncogene activation and tumor suppressor gene inactivation is the sine qua non premise of carciniogenesis. 3) The r

  8. Adjustable flow rate controller for polymer solutions

    DOEpatents

    Jackson, Kenneth M.

    1981-01-01

    An adjustable device for controlling the flow rate of polymer solutions which results in only little shearing of the polymer molecules, said device comprising an inlet manifold, an outlet manifold, a plurality of tubes capable of providing communication between said inlet and outlet manifolds, said tubes each having an internal diameter that is smaller than that of the inlet manifold and large enough to insure that viscosity of the polymer solution passing through each said tube will not be reduced more than about 25 percent, and a valve associated with each tube, said valve being capable of opening or closing communication in that tube between the inlet and outlet manifolds, each said valve when fully open having a diameter that is substantially at least as great as that of the tube with which it is associated.

  9. Adjustment process in Iranian women with breast cancer.

    PubMed

    Taleghani, Fariba; Yekta, Zohreh Parsa; Nasrabadi, Alireza Nikbakht; Käppeli, Silvia

    2008-01-01

    Breast cancer is a devastating event for a woman. Physical changes and psychological problems, treatment to improve the patient's condition, and increased survival rates compared with other cancers manifest the importance of quality of life in these patients. This quality of life is affected by how the patients adjust to their situation. Hence, to understand adjustment to breast cancer, this research aimed to investigate the experience from the patients' perspective and how they interact with others and interpret their experiences in adjusting to the disease. A qualitative research approach based on grounded theory was used. The data were the result of 45 interviews with patients in different phases of their illness trajectory during 1 year, 6 interviews with families, and 10 observation sessions. The main categories that emerged were perceived threat to live, religious aspects, supportive dimensions, will to recover, increase in endurance, barriers to efforts leading to health, living with the disease with tolerance, and inhibitors and facilitators of tolerance. These main categories were understood as passages to reach evolutionary peaceful coexistence. Adjustment to breast cancer has positive evolutional process, and its direction is toward better adjustment. By positive mental reconstruction, the patients feel that they can live with their disease. PMID:18453870

  10. 5 CFR 9901.322 - Setting and adjusting rate ranges.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Setting and adjusting rate ranges. 9901... Increases § 9901.322 Setting and adjusting rate ranges. (a) Subject to § 9901.105, the Secretary may set and... factors. (b) The Secretary may determine the effective date of newly set or adjusted band rate...

  11. 10 CFR 903.11 - Advance announcement of rate adjustment.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Power and Transmission Rate Adjustments and Extensions for the Alaska, Southeastern, Southwestern, and Western Area Power Administrations § 903.11 Advance announcement of rate adjustment. The Administrator may... 10 Energy 4 2010-01-01 2010-01-01 false Advance announcement of rate adjustment. 903.11...

  12. 10 CFR 436.22 - Adjusted internal rate of return.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 3 2011-01-01 2011-01-01 false Adjusted internal rate of return. 436.22 Section 436.22 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methodology and Procedures for Life Cycle Cost Analyses § 436.22 Adjusted internal rate of return. The adjusted internal rate of return is the overall...

  13. 10 CFR 436.22 - Adjusted internal rate of return.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 3 2014-01-01 2014-01-01 false Adjusted internal rate of return. 436.22 Section 436.22 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methodology and Procedures for Life Cycle Cost Analyses § 436.22 Adjusted internal rate of return. The adjusted internal rate of return is the overall...

  14. Rate adjusters for Medicare under capitation

    PubMed Central

    Newhouse, Joseph P.

    1986-01-01

    This article addresses three issues related to capitation. First, the average adjusted per capita cost (AAPCC) fluctuates with the mix of risks in the fee-for-service system. More sensitive adjusters in the AAPCC are needed. Second, the AAPCC, as now estimated, exhibits large geographic variance; so-called shrinkage estimators may help. Third, the AAPCC requires new adjusters to yield more homogeneous risk classes. Otherwise, the portion of the Medicare population under capitation may experience access problems at alternative delivery systems: Until such adjusters are developed, it seems better to rely upon a blend of capitation and fee-for-service than the present AAPCC. PMID:10311926

  15. Breast Cancer Rates by State

    MedlinePlus

    ... Associated Lung Ovarian Prostate Skin Uterine Cancer Home Breast Cancer Rates by State Language: English Español (Spanish) Recommend ... from breast cancer each year. Rates of Getting Breast Cancer by State The number of people who get ...

  16. 5 CFR 536.305 - Adjusting an employee's retained rate when a pay schedule is adjusted.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Adjusting an employee's retained rate when a pay schedule is adjusted. 536.305 Section 536.305 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS GRADE AND PAY RETENTION Pay Retention § 536.305 Adjusting an employee's retained rate when a pay schedule...

  17. 7 CFR 1421.102 - Adjustment of basic loan rates.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... be adjusted or not adjusted as follows: (1) For farm-stored commodities, except for peanuts, that... shall be discounted to 30 percent of the county loan rate. (4) With respect to farm-stored wheat, the basic county loan rate shall not be adjusted to reflect the protein content. (5) With respect...

  18. 7 CFR 4287.112 - Interest rate adjustments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... variable rates to reduce the borrower's interest rate only when the variable rate has a ceiling which is less than or equal to the original fixed rate. (2) Variable rates can be changed to a fixed rate which is at or below the current variable rate. (3) The interest rates, after adjustments, must comply...

  19. 7 CFR 4287.112 - Interest rate adjustments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... variable rates to reduce the borrower's interest rate only when the variable rate has a ceiling which is less than or equal to the original fixed rate. (2) Variable rates can be changed to a fixed rate which is at or below the current variable rate. (3) The interest rates, after adjustments, must comply...

  20. 10 CFR 436.22 - Adjusted internal rate of return.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Methodology and Procedures for Life Cycle Cost Analyses § 436.22 Adjusted internal rate of return. The adjusted internal rate of return is the overall rate of return on an energy or water conservation measure... yearly net savings in energy or water and non-fuel or non-water operation and maintenance...

  1. 10 CFR 436.22 - Adjusted internal rate of return.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Methodology and Procedures for Life Cycle Cost Analyses § 436.22 Adjusted internal rate of return. The adjusted internal rate of return is the overall rate of return on an energy or water conservation measure... yearly net savings in energy or water and non-fuel or non-water operation and maintenance...

  2. 10 CFR 436.22 - Adjusted internal rate of return.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Methodology and Procedures for Life Cycle Cost Analyses § 436.22 Adjusted internal rate of return. The adjusted internal rate of return is the overall rate of return on an energy or water conservation measure... yearly net savings in energy or water and non-fuel or non-water operation and maintenance...

  3. Lung Cancer Rates by State

    MedlinePlus

    ... HPV-Associated Ovarian Prostate Skin Uterine Cancer Home Lung Cancer Rates by State Language: English Español (Spanish) ... incidence data are currently available. Rates of Getting Lung Cancer by State The number of people who ...

  4. 5 CFR 9701.322 - Setting and adjusting rate ranges.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 3 2012-01-01 2012-01-01 false Setting and adjusting rate ranges. 9701.322 Section 9701.322 Administrative Personnel DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES... SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Setting and Adjusting Rate...

  5. 5 CFR 9701.322 - Setting and adjusting rate ranges.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Setting and Adjusting Rate Ranges... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Setting and adjusting rate ranges. 9701.322 Section 9701.322 Administrative Personnel DEPARTMENT OF HOMELAND SECURITY HUMAN...

  6. 5 CFR 9701.322 - Setting and adjusting rate ranges.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Setting and Adjusting Rate Ranges... 5 Administrative Personnel 3 2013-01-01 2013-01-01 false Setting and adjusting rate ranges. 9701.322 Section 9701.322 Administrative Personnel DEPARTMENT OF HOMELAND SECURITY HUMAN...

  7. 5 CFR 9701.322 - Setting and adjusting rate ranges.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Setting and Adjusting Rate Ranges... 5 Administrative Personnel 3 2014-01-01 2014-01-01 false Setting and adjusting rate ranges. 9701.322 Section 9701.322 Administrative Personnel DEPARTMENT OF HOMELAND SECURITY HUMAN...

  8. 77 FR 10767 - Rate Adjustments for Indian Irrigation Projects

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-23

    ... Federal Register on September 20, 2011 (76 FR 58293) to propose adjustments to the irrigation assessment... (76 FR 26759). In addition, a Construction Water Rate Schedule for the San Carlos Irrigation Project... Bureau of Indian Affairs Rate Adjustments for Indian Irrigation Projects AGENCY: Bureau of Indian...

  9. Survival Rates for Thymus Cancer

    MedlinePlus

    ... staged? Next Topic How is thymus cancer treated? Survival rates for thymus cancer Survival rates are often ... into account. Stage of thymoma 5-year observed survival rate I 74% II 73% III 64% IV ...

  10. 76 FR 53160 - Postal Service Rate Adjustment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-25

    ... Service and Koninklijke TNT Post BV and TNT Post Pakketservice Benelux BV (TNT Agreement), and the China... the agreement is functionally equivalent to the previously filed TNT and CPG Agreements, and contains...'' and the TNT Agreement does not include rates for a service described as ``Global Confirmation Over...

  11. Men's Adjustment to Their Partners' Breast Cancer: A Dyadic Coping Perspective

    ERIC Educational Resources Information Center

    Feldman, Barry N.; Broussard, Anne C.

    2006-01-01

    The continuing increase in cancer rates among women in the United States is forcing more men to experience the impact of breast cancer on their relationships. Using 71 male partners of newly diagnosed breast cancer patients, this study assessed how dyadic coping strategies affected men's adjustment to their partners' illness. While their partners…

  12. 5 CFR 9701.322 - Setting and adjusting rate ranges.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ....322 Section 9701.322 Administrative Personnel DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM (DEPARTMENT OF HOMELAND SECURITY-OFFICE OF PERSONNEL MANAGEMENT) DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Setting and Adjusting Rate...

  13. 5 CFR 531.609 - Adjusting or terminating locality rates.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... area, the employee's entitlement to the locality rate for the new locality pay area begins on the effective date of the change in official worksite. (b) A locality rate must be adjusted as of the effective... rate associated with a particular locality pay area under this subpart terminates on the date— (1)...

  14. 75 FR 29577 - Rate Adjustments for Indian Irrigation Projects

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-26

    ... rates for the 2011 season for the San Carlos Irrigation Project (74 FR 40227).) Final Project name Rate... published in the Federal Register on October 23, 2009 (74 FR 54846) to propose adjustments to the irrigation... rates for the 2011 season in the Federal Register on October 23, 2009 (74 FR 54848), and we will...

  15. 5 CFR 531.244 - Adjusting a GM employee's rate at the time of an annual pay adjustment.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Adjusting a GM employee's rate at the... Rules for Gm Employees § 531.244 Adjusting a GM employee's rate at the time of an annual pay adjustment... agency must set the new GS rate for a GM employee as follows: (1) For a GM employee whose GS rate...

  16. Adjustment to Cancer: A Psychosocial and Rehabilitative Perspective

    ERIC Educational Resources Information Center

    McCollum, Paul S.

    1978-01-01

    Initial reaction to cancer is typically shock and denial followed by various coping strategies. A surgical or chemotherapeutic period is entered with concomitant adjustment reactions. The third adjustment period comes after treatment and may evolve into a prolonged death crisis which brings difficult changes and pressures to the patient and his or…

  17. Adjustment of lifetime risks of space radiation-induced cancer by the healthy worker effect and cancer misclassification.

    PubMed

    Peterson, Leif E; Kovyrshina, Tatiana

    2015-12-01

    Background. The healthy worker effect (HWE) is a source of bias in occupational studies of mortality among workers caused by use of comparative disease rates based on public data, which include mortality of unhealthy members of the public who are screened out of the workplace. For the US astronaut corp, the HWE is assumed to be strong due to the rigorous medical selection and surveillance. This investigation focused on the effect of correcting for HWE on projected lifetime risk estimates for radiation-induced cancer mortality and incidence. Methods. We performed radiation-induced cancer risk assessment using Poisson regression of cancer mortality and incidence rates among Hiroshima and Nagasaki atomic bomb survivors. Regression coefficients were used for generating risk coefficients for the excess absolute, transfer, and excess relative models. Excess lifetime risks (ELR) for radiation exposure and baseline lifetime risks (BLR) were adjusted for the HWE using standardized mortality ratios (SMR) for aviators and nuclear workers who were occupationally exposed to ionizing radiation. We also adjusted lifetime risks by cancer mortality misclassification among atomic bomb survivors. Results. For all cancers combined ("Nonleukemia"), the effect of adjusting the all-cause hazard rate by the simulated quantiles of the all-cause SMR resulted in a mean difference (not percent difference) in ELR of 0.65% and mean difference of 4% for mortality BLR, and mean change of 6.2% in BLR for incidence. The effect of adjusting the excess (radiation-induced) cancer rate or baseline cancer hazard rate by simulated quantiles of cancer-specific SMRs resulted in a mean difference of [Formula: see text] in the all-cancer mortality ELR and mean difference of [Formula: see text] in the mortality BLR. Whereas for incidence, the effect of adjusting by cancer-specific SMRs resulted in a mean change of [Formula: see text] for the all-cancer BLR. Only cancer mortality risks were adjusted by

  18. 7 CFR 4287.112 - Interest rate adjustments.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 15 2013-01-01 2013-01-01 false Interest rate adjustments. 4287.112 Section 4287.112 Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE SERVICING Servicing Business and Industry...

  19. 7 CFR 4287.112 - Interest rate adjustments.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 15 2014-01-01 2014-01-01 false Interest rate adjustments. 4287.112 Section 4287.112 Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE SERVICING Servicing Business and Industry...

  20. 7 CFR 4287.112 - Interest rate adjustments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 15 2012-01-01 2012-01-01 false Interest rate adjustments. 4287.112 Section 4287.112 Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE SERVICING Servicing Business and Industry...

  1. 24 CFR 203.49 - Eligibility of adjustable rate mortgages.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... change in either direction of more than two percentage points from the interest rate in effect for the... insured pursuant to this section and 24 CFR part 234 in any fiscal year may not exceed 30 percent of the... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Eligibility of adjustable...

  2. 24 CFR 203.49 - Eligibility of adjustable rate mortgages.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... change in either direction of more than two percentage points from the interest rate in effect for the... insured pursuant to this section and 24 CFR part 234 in any fiscal year may not exceed 30 percent of the... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Eligibility of adjustable...

  3. 18 CFR 154.403 - Periodic rate adjustments.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Periodic rate adjustments. 154.403 Section 154.403 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... recovery or return, the past period must be defined and the mechanism for the recovery or return must...

  4. A gigawatt level repetitive rate adjustable magnetic pulse compressor

    NASA Astrophysics Data System (ADS)

    Li, Song; Gao, Jing-Ming; Yang, Han-Wu; Qian, Bao-Liang; Li, Ze-Xin

    2015-08-01

    In this paper, a gigawatt level repetitive rate adjustable magnetic pulse compressor is investigated both numerically and experimentally. The device has advantages of high power level, high repetitive rate achievability, and long lifetime reliability. Importantly, dominate parameters including the saturation time, the peak voltage, and even the compression ratio can be potentially adjusted continuously and reliably, which significantly expands the applicable area of the device and generators based on it. Specifically, a two-stage adjustable magnetic pulse compressor, utilized for charging the pulse forming network of a high power pulse generator, is designed with different compression ratios of 25 and 18 through an optimized design process. Equivalent circuit analysis shows that the modification of compression ratio can be achieved by just changing the turn number of the winding. At the same time, increasing inductance of the grounded inductor will decrease the peak voltage and delay the charging process. Based on these analyses, an adjustable compressor was built and studied experimentally in both the single shot mode and repetitive rate mode. Pulses with peak voltage of 60 kV and energy per pulse of 360 J were obtained in the experiment. The rise times of the pulses were compressed from 25 μs to 1 μs and from 18 μs to 1 μs, respectively, at repetitive rate of 20 Hz with good repeatability. Experimental results show reasonable agreement with analyses.

  5. A gigawatt level repetitive rate adjustable magnetic pulse compressor.

    PubMed

    Li, Song; Gao, Jing-Ming; Yang, Han-Wu; Qian, Bao-Liang; Li, Ze-Xin

    2015-08-01

    In this paper, a gigawatt level repetitive rate adjustable magnetic pulse compressor is investigated both numerically and experimentally. The device has advantages of high power level, high repetitive rate achievability, and long lifetime reliability. Importantly, dominate parameters including the saturation time, the peak voltage, and even the compression ratio can be potentially adjusted continuously and reliably, which significantly expands the applicable area of the device and generators based on it. Specifically, a two-stage adjustable magnetic pulse compressor, utilized for charging the pulse forming network of a high power pulse generator, is designed with different compression ratios of 25 and 18 through an optimized design process. Equivalent circuit analysis shows that the modification of compression ratio can be achieved by just changing the turn number of the winding. At the same time, increasing inductance of the grounded inductor will decrease the peak voltage and delay the charging process. Based on these analyses, an adjustable compressor was built and studied experimentally in both the single shot mode and repetitive rate mode. Pulses with peak voltage of 60 kV and energy per pulse of 360 J were obtained in the experiment. The rise times of the pulses were compressed from 25 μs to 1 μs and from 18 μs to 1 μs, respectively, at repetitive rate of 20 Hz with good repeatability. Experimental results show reasonable agreement with analyses. PMID:26329219

  6. 7 CFR 1421.102 - Adjustment of basic loan rates.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 10 2012-01-01 2012-01-01 false Adjustment of basic loan rates. 1421.102 Section 1421.102 Agriculture Regulations of the Department of Agriculture (Continued) COMMODITY CREDIT CORPORATION...-MARKETING ASSISTANCE LOANS AND LOAN DEFICIENCY PAYMENTS FOR 2008 THROUGH 2012 Marketing Assistance...

  7. The Impact of Financial Sophistication on Adjustable Rate Mortgage Ownership

    ERIC Educational Resources Information Center

    Smith, Hyrum; Finke, Michael S.; Huston, Sandra J.

    2011-01-01

    The influence of a financial sophistication scale on adjustable-rate mortgage (ARM) borrowing is explored. Descriptive statistics and regression analysis using recent data from the Survey of Consumer Finances reveal that ARM borrowing is driven by both the least and most financially sophisticated households but for different reasons. Less…

  8. Age-adjusted Labor Force Participation Rates, 1960-2045.

    ERIC Educational Resources Information Center

    Szafran, Robert F.

    2002-01-01

    A proposed new age-adjusted measure for calculating labor force participation rate eliminates the effect of changes in the age distribution. According to the new criterion, increases in women's labor force participation from 1960-2000 would have been even greater of shifts in the age distribution had not occurred. (Contains 12 references.) (JOW)

  9. HPV-Associated Oropharyngeal Cancer Rates by Race and Ethnicity

    MedlinePlus

    ... Ethnicity, and Sex, United States, 2008–2012 The graph above shows age-adjusted incidence rates for HPV- ... were diagnosed with HPV-associated oropharyngeal cancer. This graph was adapted from Viens LJ, Henley SJ, Watson ...

  10. Judging hospitals by severity-adjusted mortality rates: the influence of the severity-adjustment method.

    PubMed Central

    Iezzoni, L I; Ash, A S; Shwartz, M; Daley, J; Hughes, J S; Mackiernan, Y D

    1996-01-01

    OBJECTIVES: This research examined whether judgments about a hospital's risk-adjusted mortality performance are affected by the severity-adjustment method. METHODS: Data came from 100 acute care hospitals nationwide and 11880 adults admitted in 1991 for acute myocardial infarction. Ten severity measures were used in separate multivariable logistic models predicting in-hospital death. Observed-to-expected death rates and z scores were calculated with each severity measure for each hospital. RESULTS: Unadjusted mortality rates for the 100 hospitals ranged from 4.8% to 26.4%. For 32 hospitals, observed mortality rates differed significantly from expected rates for 1 or more, but not for all 10, severity measures. Agreement between pairs of severity measures on whether hospitals were flagged as statistical mortality outliers ranged from fair to good. Severity measures based on medical records frequently disagreed with measures based on discharge abstracts. CONCLUSIONS: Although the 10 severity measures agreed about relative hospital performance more often than would be expected by chance, assessments of individual hospital mortality rates varied by different severity-adjustment methods. PMID:8876505

  11. 5 CFR 531.244 - Adjusting a GM employee's rate at the time of an annual pay adjustment.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Adjusting a GM employee's rate at the time of an annual pay adjustment. 531.244 Section 531.244 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY UNDER THE GENERAL SCHEDULE Determining Rate of Basic Pay Special Rules for Gm Employees § 531.244 Adjusting...

  12. Prostate cancer incidence rates in Africa.

    PubMed

    Chu, Lisa W; Ritchey, Jamie; Devesa, Susan S; Quraishi, Sabah M; Zhang, Hongmei; Hsing, Ann W

    2011-01-01

    African American men have among the highest prostate cancer incidence rates in the world yet rates among their African counterparts are unclear. In this paper, we compared reported rates among black men of Sub-Saharan African descent using data from the International Agency for Research on Cancer (IARC) and the National Cancer Institute Surveillance, Epidemiology, and End Results Program for 1973-2007. Although population-based data in Africa are quite limited, the available data from IARC showed that rates among blacks were highest in the East (10.7-38.1 per 100,000 man-years, age-adjusted world standard) and lowest in the West (4.7-19.8). These rates were considerably lower than those of 80.0-195.3 observed among African Americans. Rates in Africa increased over time (1987-2002) and have been comparable to those for distant stage in African Americans. These patterns are likely due to differences between African and African American men in medical care access, screening, registry quality, genetic diversity, and Westernization. Incidence rates in Africa will likely continue to rise with improving economies and increasing Westernization, warranting the need for more high-quality population-based registration to monitor cancer incidence in Africa. PMID:22111004

  13. 25 CFR 175.12 - Procedures for adjusting electric power rates except for adjustments due to changes in the cost...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... adjustments due to changes in the cost of purchased power or energy. 175.12 Section 175.12 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN ELECTRIC POWER UTILITIES Service Fees... adjustments due to changes in the cost of purchased power or energy. Except for adjustments to rates due...

  14. 25 CFR 175.12 - Procedures for adjusting electric power rates except for adjustments due to changes in the cost...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... adjustments due to changes in the cost of purchased power or energy. 175.12 Section 175.12 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN ELECTRIC POWER UTILITIES Service Fees... adjustments due to changes in the cost of purchased power or energy. Except for adjustments to rates due...

  15. 25 CFR 175.12 - Procedures for adjusting electric power rates except for adjustments due to changes in the cost...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... adjustments due to changes in the cost of purchased power or energy. 175.12 Section 175.12 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN ELECTRIC POWER UTILITIES Service Fees... adjustments due to changes in the cost of purchased power or energy. Except for adjustments to rates due...

  16. Early Parental Adjustment and Bereavement after Childhood Cancer Death

    ERIC Educational Resources Information Center

    Barrera, Maru; O'connor, Kathleen; D'Agostino, Norma Mammone; Spencer, Lynlee; Nicholas, David; Jovcevska, Vesna; Tallet, Susan; Schneiderman, Gerald

    2009-01-01

    This study comprehensively explored parental bereavement and adjustment at 6 months post-loss due to childhood cancer. Interviews were conducted with 18 mothers and 13 fathers. Interviews were transcribed verbatim and analyzed based on qualitative methodology. A model describing early parental bereavement and adaptation emerged with 3 domains:…

  17. U.S. congressional district cancer death rates

    PubMed Central

    Hao, Yongping; Ward, Elizabeth M; Jemal, Ahmedin; Pickle, Linda W; Thun, Michael J

    2006-01-01

    Background Geographic patterns of cancer death rates in the U.S. have customarily been presented by county or aggregated into state economic or health service areas. Herein, we present the geographic patterns of cancer death rates in the U.S. by congressional district. Many congressional districts do not follow state or county boundaries. However, counties are the smallest geographical units for which death rates are available. Thus, a method based on the hierarchical relationship of census geographic units was developed to estimate age-adjusted death rates for congressional districts using data obtained at county level. These rates may be useful in communicating to legislators and policy makers about the cancer burden and potential impact of cancer control in their jurisdictions. Results Mortality data were obtained from the National Center for Health Statistics (NCHS) for 1990–2001 for 50 states, the District of Columbia, and all counties. We computed annual average age-adjusted death rates for all cancer sites combined, the four major cancers (lung and bronchus, prostate, female breast, and colorectal cancer) and cervical cancer. Cancer death rates varied widely across congressional districts for all cancer sites combined, for the four major cancers, and for cervical cancer. When examined at the national level, broad patterns of mortality by sex, race and region were generally similar with those previously observed based on county and state economic area. Conclusion We developed a method to generate cancer death rates by congressional district using county-level mortality data. Characterizing the cancer burden by congressional district may be useful in promoting cancer control and prevention programs, and persuading legislators to enact new cancer control programs and/or strengthening existing ones. The method can be applied to state legislative districts and other analyses that involve data aggregation from different geographic units. PMID:16796732

  18. Psychosocial adjustment among pediatric cancer patients and their parents.

    PubMed

    Chao, Chia-Chen; Chen, Sue-Huei; Wang, Chia-Yu; Wu, Yin-Chang; Yeh, Chao-Hsing

    2003-02-01

    Children with cancer face both physical and psychosocial challenges. However, there is not enough empirical evidence in Taiwan regarding how they and their families cope with their illness. The purpose of the present study was to explore the psychosocial impact of cancer on target children and their families as well as the degree of depression experienced by these children. Twenty-four pediatric cancer patients, aged 8 through 17 years, completed the Chinese version of Children Depression Inventory (CDI). Both these patients and 18 parents completed questionnaires about their psychosocial adjustment since the diagnosis of cancer. The results showed: (i) patients did not perceive significant changes in their psychosocial adjustment, whereas parents indicated significantly lower mood of patients and a slight decrease in the number of friends; (ii) both parents and siblings showed positive adjustment; and (iii) there was neither significant difference on the CDI scores between the pediatric cancer patients and a normative group, nor significant relationships between patients' CDI scores and demographic characteristics of both patients and their parents, parenting attitudes, as well as variables related to the illness. Lastly, the results are discussed in terms of issues of methodology and instruments. Possible direction for further investigations is suggested. PMID:12519458

  19. RATE-ADJUSTMENT ALGORITHM FOR AGGREGATE TCP CONGESTION CONTROL

    SciTech Connect

    P. TINNAKORNSRISUPHAP, ET AL

    2000-09-01

    The TCP congestion-control mechanism is an algorithm designed to probe the available bandwidth of the network path that TCP packets traverse. However, it is well-known that the TCP congestion-control mechanism does not perform well on networks with a large bandwidth-delay product due to the slow dynamics in adapting its congestion window, especially for short-lived flows. One promising solution to the problem is to aggregate and share the path information among TCP connections that traverse the same bottleneck path, i.e., Aggregate TCP. However, this paper shows via a queueing analysis of a generalized processor-sharing (GPS) queue with regularly-varying service time that a simple aggregation of local TCP connections together into a single aggregate TCP connection can result in a severe performance degradation. To prevent such a degradation, we introduce a rate-adjustment algorithm. Our simulation confirms that by utilizing our rate-adjustment algorithm on aggregate TCP, connections which would normally receive poor service achieve significant performance improvements without penalizing connections which already receive good service.

  20. Adjustment to Cancer: Anxiety and Distress (PDQ®)—Health Professional Version

    Cancer.gov

    Expert-reviewed information summary about the difficult emotional responses many cancer patients experience. This summary focuses on normal adjustment issues, psychosocial distress, and adjustment disorders.

  1. Adjustment to Cancer: Anxiety and Distress (PDQ®)—Patient Version

    Cancer.gov

    Expert-reviewed information summary about the difficult emotional responses many cancer patients experience. This summary focuses on normal adjustment issues, psychosocial distress, and adjustment disorders.

  2. Estimation of adjusted rate differences using additive negative binomial regression.

    PubMed

    Donoghoe, Mark W; Marschner, Ian C

    2016-08-15

    Rate differences are an important effect measure in biostatistics and provide an alternative perspective to rate ratios. When the data are event counts observed during an exposure period, adjusted rate differences may be estimated using an identity-link Poisson generalised linear model, also known as additive Poisson regression. A problem with this approach is that the assumption of equality of mean and variance rarely holds in real data, which often show overdispersion. An additive negative binomial model is the natural alternative to account for this; however, standard model-fitting methods are often unable to cope with the constrained parameter space arising from the non-negativity restrictions of the additive model. In this paper, we propose a novel solution to this problem using a variant of the expectation-conditional maximisation-either algorithm. Our method provides a reliable way to fit an additive negative binomial regression model and also permits flexible generalisations using semi-parametric regression functions. We illustrate the method using a placebo-controlled clinical trial of fenofibrate treatment in patients with type II diabetes, where the outcome is the number of laser therapy courses administered to treat diabetic retinopathy. An R package is available that implements the proposed method. Copyright © 2016 John Wiley & Sons, Ltd. PMID:27073156

  3. Peer- and Self-Rated Correlates of a Teacher-Rated Typology of Child Adjustment

    ERIC Educational Resources Information Center

    Lindstrom, William A., Jr.; Lease, A. Michele; Kamphaus, Randy W.

    2007-01-01

    External correlates of a teacher-rated typology of child adjustment developed using the Behavior Assessment System for Children were examined. Participants included 377 elementary school children recruited from 26 classrooms in the southeastern United States. Multivariate analyses of variance and planned comparisons were used to determine whether…

  4. 78 FR 54934 - Order Making Fiscal Year 2014 Annual Adjustments to Registration Fee Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-06

    ... COMMISSION Order Making Fiscal Year 2014 Annual Adjustments to Registration Fee Rates I. Background The...\\ Public Law 111-203, 124 Stat.1376 (2010). II. Fiscal Year 2014 Annual Adjustment to the Fee Rate Section...(b) for fiscal year 2014. Specifically, the Commission must adjust the fee rate under Section 6(b)...

  5. 39 CFR 3010.2 - Types of rate adjustments for market dominant products.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Types of rate adjustments for market dominant... FOR MARKET DOMINANT PRODUCTS General Provisions § 3010.2 Types of rate adjustments for market dominant products. (a) There are four types of rate adjustments for market dominant products. A Type 1-A...

  6. Why have ovarian cancer mortality rates declined? Part I. Incidence.

    PubMed

    Sopik, Victoria; Iqbal, Javaid; Rosen, Barry; Narod, Steven A

    2015-09-01

    The age-adjusted mortality rate from ovarian cancer in the United States has declined over the past several decades. The decline in mortality might be the consequence of a reduced number of cases (incidence) or a reduction in the proportion of patients who die from their cancer (case-fatality). In part I of this three-part series, we examine rates of ovarian cancer incidence and mortality from the Surveillance Epidemiology and End Results (SEER) registry database and we explore to what extent the observed decline in mortality can be explained by a downward shift in the stage distribution of ovarian cancer (i.e. due to early detection) or by fewer cases of ovarian cancer (i.e. due to a change in risk factors). The proportion of localized ovarian cancers did not increase, suggesting that a stage-shift did not contribute to the decline in mortality. The observed decline in mortality paralleled a decline in incidence. The trends in ovarian cancer incidence coincided with temporal changes in the exposure of women from different birth cohorts to various reproductive risk factors, in particular, to changes in the use of the oral contraceptive pill and to declining parity. Based on recent changes in risk factor propensity, we predict that the trend of the declining age-adjusted incidence rate of ovarian cancer in the United States will reverse and rates will increase in coming years. PMID:26080287

  7. Adjusting capitation rates using objective health measures and prior utilization

    PubMed Central

    Newhouse, Joseph P.; Manning, Willard G.; Keeler, Emmett B.; Sloss, Elizabeth M.

    1989-01-01

    Several analysts have proposed adding adjusters based on health status and prior utilization to the adjusted average per capita cost formula. The authors estimate how well such adjusters predict annual medical expenditures among non-elderly adults. Both measures substantially improve on the variables currently used. If only health measures are added, 20-30 percent of the predictable variance is explained; if only prior use is added, more than 40 percent is explained; if both are added, about 60 percent is explained. The results support including some measure of use in the formula until better health measures are developed. PMID:10313096

  8. 43 CFR 38.3 - Administration of adjusted rates of pay.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 1 2014-10-01 2014-10-01 false Administration of adjusted rates of pay. 38.3 Section 38.3 Public Lands: Interior Office of the Secretary of the Interior PAY OF U.S. PARK POLICE-INTERIM GEOGRAPHIC ADJUSTMENTS § 38.3 Administration of adjusted rates of pay. (a) An employee...

  9. 43 CFR 38.3 - Administration of adjusted rates of pay.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 1 2013-10-01 2013-10-01 false Administration of adjusted rates of pay. 38.3 Section 38.3 Public Lands: Interior Office of the Secretary of the Interior PAY OF U.S. PARK POLICE-INTERIM GEOGRAPHIC ADJUSTMENTS § 38.3 Administration of adjusted rates of pay. (a) An employee...

  10. 43 CFR 38.3 - Administration of adjusted rates of pay.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Administration of adjusted rates of pay. 38.3 Section 38.3 Public Lands: Interior Office of the Secretary of the Interior PAY OF U.S. PARK POLICE-INTERIM GEOGRAPHIC ADJUSTMENTS § 38.3 Administration of adjusted rates of pay. (a) An employee...

  11. 43 CFR 38.3 - Administration of adjusted rates of pay.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 1 2012-10-01 2011-10-01 true Administration of adjusted rates of pay. 38.3 Section 38.3 Public Lands: Interior Office of the Secretary of the Interior PAY OF U.S. PARK POLICE-INTERIM GEOGRAPHIC ADJUSTMENTS § 38.3 Administration of adjusted rates of pay. (a) An employee...

  12. 43 CFR 38.3 - Administration of adjusted rates of pay.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false Administration of adjusted rates of pay. 38.3 Section 38.3 Public Lands: Interior Office of the Secretary of the Interior PAY OF U.S. PARK POLICE-INTERIM GEOGRAPHIC ADJUSTMENTS § 38.3 Administration of adjusted rates of pay. (a) An employee...

  13. 5 CFR 535.105 - Setting and adjusting rates of basic pay.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Setting and adjusting rates of basic pay... REGULATIONS CRITICAL POSITION PAY AUTHORITY § 535.105 Setting and adjusting rates of basic pay. (a) The rate... head of an agency may set pay initially at any amount up to the rate of pay for level II or level I...

  14. 42 CFR 417.594 - Computation of adjusted community rate (ACR).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Computation of adjusted community rate (ACR). 417... adjusted community rate (ACR). (a) Basic rule. Each HMO or CMP must compute its basic rate as follows: (1... community rating system as defined in § 417.104(b); or (ii) A system, approved by CMS, under which the...

  15. 42 CFR 417.594 - Computation of adjusted community rate (ACR).

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Computation of adjusted community rate (ACR). 417... adjusted community rate (ACR). (a) Basic rule. Each HMO or CMP must compute its basic rate as follows: (1... community rating system as defined in § 417.104(b); or (ii) A system, approved by CMS, under which the...

  16. 42 CFR 417.594 - Computation of adjusted community rate (ACR).

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Computation of adjusted community rate (ACR). 417... adjusted community rate (ACR). (a) Basic rule. Each HMO or CMP must compute its basic rate as follows: (1... community rating system as defined in § 417.104(b); or (ii) A system, approved by CMS, under which the...

  17. 39 CFR 3010.44 - Proceedings for Type 2 rate adjustments

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Proceedings for Type 2 rate adjustments 3010.44 Section 3010.44 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL REGULATION OF RATES FOR MARKET DOMINANT PRODUCTS Rules for Rate Adjustments for Negotiated Service Agreements (Type 2 Rate...

  18. Prevalence, correlates, and costs of patients with poor adjustment to mixed cancers.

    PubMed

    Butler, Lorna; Downe-Wamboldt, Barbara; Melanson, Patricia; Coulter, Lynn; Keefe, Janice; Singleton, Jerome; Bell, David

    2006-01-01

    Approximately 2% to 3% of the Canadian society has experienced cancer. Literature indicates that there is poor adjustment to chronic illness. Individuals with poor adjustment to chronic illness have been found to disproportionately use more health services. The purpose of this study was to determine the prevalence, correlates, and costs associated with poor adjustment to mixed cancer. A consecutive sample (n = 171) of breast, lung, and prostate cancer patients at the Nova Scotia Regional Cancer Center were surveyed. Twenty-eight percent of the cancer group showed fair to poor adjustment to illness using the Psychological Adjustment to Illness Self-report Scale Psychological Adjustment to Illness Self-Report Scale raw score. Poor adjustment was moderately correlated with depression (r = 0.50, P < .0001) and evasive coping (r = 0.38, P < .0001) and unrelated to demographic variables. Depression explained 25% of the variance in poor adjustment to illness in regression analysis. Cancer patients with fair to poor adjustment to illness had statistically significantly higher annual healthcare expenditures (P < .002) than those with good adjustment to illness. Expenditure findings agree with previous literature on chronic illnesses. The prevalence of fair to poor adjustment in this cancer population using the Psychological Adjustment to Illness Self-Report Scale measure is similar to that reported for chronic illness to date, suggesting that only those with better adjustment consented to this study. PMID:16557115

  19. Heart Rate and Risk of Cancer Death in Healthy Men

    PubMed Central

    Jouven, Xavier; Escolano, Sylvie; Celermajer, David; Empana, Jean-Philippe; Bingham, Annie; Hermine, Olivier; Desnos, Michel; Perier, Marie-Cécile; Marijon, Eloi; Ducimetière, Pierre

    2011-01-01

    Background Data from several previous studies examining heart-rate and cardiovascular risk have hinted at a possible relationship between heart-rate and non-cardiac mortality. We thus systematically examined the predictive value of heart-rate variables on the subsequent risk of death from cancer. Methods In the Paris Prospective Study I, 6101 asymptomatic French working men aged 42 to 53 years, free of clinically detectable cardiovascular disease and cancer, underwent a standardized graded exercise test between 1967 and 1972. Resting heart-rate, heart-rate increase during exercise, and decrease during recovery were measured. Change in resting heart-rate over 5 years was also available in 5139 men. Mortality including 758 cancer deaths was assessed over the 25 years of follow-up. Findings There were strong, graded and significant relationships between all heart-rate parameters and subsequent cancer deaths. After adjustment for age and tobacco consumption and, compared with the lowest quartile, those with the highest quartile for resting heart-rate had a relative risk of 2.4 for cancer deaths (95% confidence interval: 1.9–2.9, p<0.0001) This was similar after adjustment for traditional cardiovascular risk factors and was observed for the commonest malignancies (respiratory and gastrointestinal). Similarly, significant relationships with cancer death were observed between poor heart rate increase during exercise, poor decrease during recovery and greater heart-rate increase over time (p<0.0001 for all). Interpretation Resting and exercise heart rate had consistent, graded and highly significant associations with subsequent cancer mortality in men. PMID:21826196

  20. Demonization of Divorce: Prevalence Rates and Links to Postdivorce Adjustment

    ERIC Educational Resources Information Center

    Krumrei, Elizabeth J.; Mahoney, Annette; Pargament, Kenneth I.

    2011-01-01

    The meaning-making process can be crucial to individuals as they adjust to their divorce. Demonization is a negative coping response (also known as spiritual struggle) that involves appraising someone or something as related to demonic forces. Individuals may cognitively frame a divorce as the work of Satan in order to understand suffering while…

  1. 76 FR 26759 - Rate Adjustments for Indian Irrigation Projects

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-09

    ... Federal Register on November 1, 2010 (75 FR 67095) to propose adjustments to the irrigation assessment... Street, Billings, Montana 59101, Telephone: (406) 247-7943 Project Name Agency/Project Contacts Blackfeet..., PH: (406) 653-1752 602 6th Avenue North Wolf Point, MT 59201 Wind River Ed Lone Fight,...

  2. 37 CFR 255.3 - Adjustment of royalty rate.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... fraction thereof, whichever amount is larger, subject to further adjustment pursuant to paragraphs (b....85 cent per minute of playing time or fraction thereof, whichever amount is larger, subject to... embodied in the phonorecord shall be either 5.0 cents, or 0.95 cent per minute of playing time or...

  3. Ovarian Cancer Rates by State

    MedlinePlus

    ... Controls Search The CDC Cancel Submit Search The CDC Gynecologic Cancers Note: Javascript is disabled or is not supported ... about this message, please visit this page: About CDC.gov . Gynecologic Cancers Basic Information What Is Gynecologic Cancer? What Are ...

  4. [Burden of cancer in China: data on disability-adjusted life years].

    PubMed

    Shi, Jufang; Zhang, Yue; Qu, Chunfeng; Zhang, Kai; Guo, Lanwei; Dai, Min; He, Jie

    2015-04-01

    Disability-adjusted life years (DALYs) has been increasingly used to estimate burden of disease worldwide. By giving a particular attention to DALYs, the objectives of the study were to review various data sources and to conduct an extended estimation on the burden of cancer in China. Based on the publications released by the GLOBOCAN 2008 program and the Global Burden of Disease 2010 (GBD 2010) program, we reviewed the methodological information and gathered DALY data associated with burden of cancer in China, and then we extracted and summarized the data and conducted an extended analysis. From a methodological perspective, both of the programs applied the utility weights mainly from populations other than China. The data from GLOBOCAN 2008 suggests that liver cancer has replaced lung cancer and became the leading cancer in males in China when using DALY rather than mortality rate as the indicator (6.3 million and 5.4 million DALYs, respectively); although the ranking is different, data from the GBD 2010 project shows DALYs caused by liver cancer is comparable to that associated with lung cancer (7.9 million and 8.0 million, respectively). The years lived with disability (YLDs) comprised 26% and 12% of the total DALYs associated with breast cancer and colorectal cancer in China. Both projects suggest that liver cancer might have become or is becoming the leading contributor to males' DALYs in China. There are indications that, along with economic development, YLD will play a more important role in estimation of burden of cancer in China; it suggests that China should consider introducing DALY into the estimation system as early as possible. It also suggests that research on quality of life and utility associated with the major cancers in China need to be systematically conducted to facilitate more accurate DALY estimation. PMID:26081549

  5. 10 CFR 903.17 - Informal public meetings for minor rate adjustments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Participation in Power and Transmission Rate Adjustments and Extensions for the Alaska, Southeastern, Southwestern, and Western Area Power Administrations § 903.17 Informal public meetings for minor rate... 10 Energy 4 2010-01-01 2010-01-01 false Informal public meetings for minor rate adjustments....

  6. 12 CFR 747.1001 - Adjustment of civil money penalties by the rate of inflation.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Adjustment of civil money penalties by the rate... civil money penalties by the rate of inflation. (a) NCUA is required by the Federal Civil Penalties... adjust the maximum amount of each civil money penalty within its jurisdiction by the rate of...

  7. 78 FR 52781 - 30-Day Notice of Proposed Information Collection: Disclosure of Adjustable Rate Mortgages (ARMs...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-26

    ... URBAN DEVELOPMENT 30-Day Notice of Proposed Information Collection: Disclosure of Adjustable Rate... or speech impairments may access this number through TTY by calling the toll-free Federal Relay... Collection: Disclosure of Adjustable Rate Mortgages (ARMs) Rates. OMB Approval Number: 2502-0322. Type...

  8. 42 CFR 422.308 - Adjustments to capitation rates, benchmarks, bids, and payments.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Payments to Medicare Advantage Organizations § 422.308 Adjustments to capitation rates, benchmarks, bids, and...

  9. 7 CFR 1421.102 - Adjustment of basic loan rates.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... rate. (3) With respect to commodities harvested, excluding silage or hay, as other than grain and... shall be discounted to 30 percent of the county loan rate. (4) With respect to farm-stored wheat,...

  10. 7 CFR 1421.102 - Adjustment of basic loan rates.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... rate. (3) With respect to commodities harvested, excluding silage or hay, as other than grain and... shall be discounted to 30 percent of the county loan rate. (4) With respect to farm-stored wheat,...

  11. Intertumor linkage of age-adjusted incidence rate in 15 human neoplasias of both sexes.

    PubMed

    Kodama, M; Kodama, T; Murakami, M; Yokochi, T

    2000-01-01

    We report here that the application of the least square method of Gauss to the log-transformed age-adjusted incidence rate changes in time and space, as tested with either the male-female or the female-male tumor pairs for each of 15 tumor entities, has revealed the presence of intertumor linkage that was conditioning the changes of two cancer risk parameters to let them fit to the equilibrium model with close resemblance to the chemical equilibrium model. The dissimilarity of the cancer risk equilibrium model to the chemical equilibrium model--topological dissociation between the equilibrium model of centripetal force (r = -1.000) and that of centrifugal force (r = +1.000)--was discussed in the light of the concept of the oncogene activation-tumor suppressor gene inactivation. The proposed network hypothesis of human neoplasia found supporting evidence in the corresponding changes of the statistical features of human neoplasias with and without sex discrimination of cancer risk. PMID:10836207

  12. Distress and adjustment among adolescents and young adults with cancer: an empirical and conceptual review

    PubMed Central

    Wakefield, Claire E.

    2013-01-01

    Adolescents and young adults (AYAs) with cancer must simultaneously navigate the challenges associated with their cancer experience, whilst striving to achieve a number of important developmental milestones at the cusp of adulthood. The disruption caused by their cancer experience at this critical life-stage is assumed to be responsible for significant distress among AYAs living with cancer. The quality and severity of psychological outcomes among AYAs remain poorly documented, however. This review examined the existing literature on psychological outcomes among AYAs living with cancer. All psychological outcomes (both distress and positive adjustment) were included, and AYAs were included across the cancer trajectory, ranging from newly-diagnosed patients, to long-term cancer survivors. Four key research questions were addressed. Section 1 answered the question, “What is the nature and prevalence of distress (and other psychological outcomes) among AYAs living with cancer?” and documented rates of clinical distress, as well as evidence for the trajectory of this distress over time. Section 2 examined the individual, cancer/treatment-related and socio-demographic factors that have been identified as predictors of these outcomes in this existing literature. Section 3 examined current theoretical models relevant to explaining psychological outcomes among AYAs, including developmental models, socio-cognitive and family-systems models, stress-coping frameworks, and cognitive appraisal models (including trauma and meaning making models). The mechanisms implicated in each model were discussed, as was the existing evidence for each model. Converging evidence implicating the potential role of autobiographical memory and future thinking systems in how AYAs process and integrate their cancer experience into their current sense of self and future goals are highlighted. Finally, Section 4 addressed the future of psycho-oncology in understanding and conceptualizing

  13. Distress and adjustment among adolescents and young adults with cancer: an empirical and conceptual review.

    PubMed

    Sansom-Daly, Ursula M; Wakefield, Claire E

    2013-10-01

    Adolescents and young adults (AYAs) with cancer must simultaneously navigate the challenges associated with their cancer experience, whilst striving to achieve a number of important developmental milestones at the cusp of adulthood. The disruption caused by their cancer experience at this critical life-stage is assumed to be responsible for significant distress among AYAs living with cancer. The quality and severity of psychological outcomes among AYAs remain poorly documented, however. This review examined the existing literature on psychological outcomes among AYAs living with cancer. All psychological outcomes (both distress and positive adjustment) were included, and AYAs were included across the cancer trajectory, ranging from newly-diagnosed patients, to long-term cancer survivors. Four key research questions were addressed. Section 1 answered the question, "What is the nature and prevalence of distress (and other psychological outcomes) among AYAs living with cancer?" and documented rates of clinical distress, as well as evidence for the trajectory of this distress over time. Section 2 examined the individual, cancer/treatment-related and socio-demographic factors that have been identified as predictors of these outcomes in this existing literature. Section 3 examined current theoretical models relevant to explaining psychological outcomes among AYAs, including developmental models, socio-cognitive and family-systems models, stress-coping frameworks, and cognitive appraisal models (including trauma and meaning making models). The mechanisms implicated in each model were discussed, as was the existing evidence for each model. Converging evidence implicating the potential role of autobiographical memory and future thinking systems in how AYAs process and integrate their cancer experience into their current sense of self and future goals are highlighted. Finally, Section 4 addressed the future of psycho-oncology in understanding and conceptualizing

  14. 78 FR 649 - Adjustments of Certain Rates of Pay

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-03

    ... ] TD03JA13.085 ] TD03JA13.086 ] TD03JA13.087 ] TD03JA13.088 [FR Doc. 2013-00002 Filed 1-2-13; 11:15 a.m... National Institutes of Health NOTICES Meetings: Center for Scientific Review, 312-313 National Cancer... implement an alternative level of comparability payments under section 5304a of title 5, United States...

  15. 75 FR 81817 - Adjustments of Certain Rates of Pay

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-29

    ... Extensions Act, 2011 (H.R. 3082), which I signed into law today (the ``Continuing Appropriations Act''), the...; section 301(a) of Public Law 102-40) at Schedule 3. Sec. 2. Senior Executive Service. The ranges of rates... section 140 of Public Law 97-92) at Schedule 7. Sec. 4. Uniformed Services. The rates of monthly basic...

  16. 18 CFR 154.403 - Periodic rate adjustments.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... revenue enters into the determination of pre-tax book income. Any balance upon which the natural gas... added to each rate schedule with workpapers showing all mathematical calculations. (ii) If the...

  17. 42 CFR 417.594 - Computation of adjusted community rate (ACR).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Computation of adjusted community rate (ACR). 417... community rate (ACR). (a) Basic rule. Each HMO or CMP must compute its basic rate as follows: (1) Compute an... must compute its initial rate using either of the following systems: (i) A community rating system...

  18. 42 CFR 417.594 - Computation of adjusted community rate (ACR).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Computation of adjusted community rate (ACR). 417... community rate (ACR). (a) Basic rule. Each HMO or CMP must compute its basic rate as follows: (1) Compute an... must compute its initial rate using either of the following systems: (i) A community rating system...

  19. 78 FR 80451 - Adjustments of Certain Rates of Pay

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-31

    ... ] TD31DE13.201 ] TD31DE13.202 ] TD31DE13.203 ] TD31DE13.204 [FR Doc. 2013-31445 Filed 12-30-13; 11:15 a.m... Administration of the Department of Veterans Affairs (38 U.S.C. 7306, 7404; section 301(a) of Public Law 102-40... under 37 U.S.C. 1009, and the rate of monthly cadet or midshipman pay (37 U.S.C. 203(c)) are set...

  20. A 5-trial adjusting delay discounting task: accurate discount rates in less than one minute.

    PubMed

    Koffarnus, Mikhail N; Bickel, Warren K

    2014-06-01

    Individuals who discount delayed rewards at a high rate are more likely to engage in substance abuse, overeating, or problem gambling. Such findings suggest the value of methods to obtain an accurate and fast measurement of discount rate that can be easily deployed in variety of settings. In the present study, we developed and evaluated the 5-trial adjusting delay task, a novel method of obtaining a discount rate in less than 1 min. We hypothesized that discount rates from the 5-trial adjusting delay task would be similar and would correlate with discount rates from a lengthier task we have used previously, and that 4 known effects relating to delay discounting would be replicable with this novel task. To test these hypotheses, the 5-trial adjusting delay task was administered to 111 college students 6 times to obtain discount rates for 6 different commodities, along with a lengthier adjusting amount discounting task. We found that discount rates were similar and correlated between the 5-trial adjusting delay task and the adjusting amount task. Each of the 4 known effects relating to delay discounting was replicated with the 5-trial adjusting delay task to varying degrees. First, discount rates were inversely correlated with amount. Second, discount rates between past and future outcomes were correlated. Third, discount rates were greater for consumable rewards than with money, although we did not control for amount in this comparison. Fourth, discount rates were lower when $0 amounts opposing the chosen time point were explicitly described. Results indicate that the 5-trial adjusting delay task is a viable, rapid method to assess discount rate. PMID:24708144

  1. Cancer death rates in US congressional districts.

    PubMed

    Siegel, Rebecca L; Sahar, Liora; Portier, Kenneth M; Ward, Elizabeth M; Jemal, Ahmedin

    2015-01-01

    Knowledge of the cancer burden is important for informing and advocating cancer prevention and control. Mortality data are readily available for states and counties, but not for congressional districts, from which representatives are elected and which may be more influential in compelling legislation and policy. The authors calculated average annual cancer death rates during 2002 to 2011 for each of the 435 congressional districts using mortality data from the National Center for Health Statistics and population estimates from the US Census Bureau. Age-standardized death rates were mapped for all sites combined and separately for cancers of the lung and bronchus, colorectum, breast, and prostate by race/ethnicity and sex. Overall cancer death rates vary by almost 2-fold and are generally lowest in Mountain states and highest in Appalachia and areas of the South. The distribution is similar for lung and colorectal cancers, with the lowest rates consistently noted in districts in Utah. However, for breast and prostate cancers, while the highest rates are again scattered throughout the South, the geographic pattern is less clear and the lowest rates are in Hawaii and southern Texas and Florida. Within-state heterogeneity is limited, particularly for men, with the exceptions of Texas, Georgia, and Florida. Patterns also vary by race/ethnicity. For example, the highest prostate cancer death rates are in the West and north central United States among non-Hispanic whites, but in the deep South among African Americans. Hispanics have the lowest rates except for colorectal cancer in Wyoming, eastern Colorado, and northern New Mexico. These data can facilitate cancer control and stimulate conversation about the relationship between cancer and policies that influence access to health care and the prevalence of behavioral and environmental risk factors. PMID:26208318

  2. Liver cancer mortality rate model in Thailand

    NASA Astrophysics Data System (ADS)

    Sriwattanapongse, Wattanavadee; Prasitwattanaseree, Sukon

    2013-09-01

    Liver Cancer has been a leading cause of death in Thailand. The purpose of this study was to model and forecast liver cancer mortality rate in Thailand using death certificate reports. A retrospective analysis of the liver cancer mortality rate was conducted. Numbering of 123,280 liver cancer causes of death cases were obtained from the national vital registration database for the 10-year period from 2000 to 2009, provided by the Ministry of Interior and coded as cause-of-death using ICD-10 by the Ministry of Public Health. Multivariate regression model was used for modeling and forecasting age-specific liver cancer mortality rates in Thailand. Liver cancer mortality increased with increasing age for each sex and was also higher in the North East provinces. The trends of liver cancer mortality remained stable in most age groups with increases during ten-year period (2000 to 2009) in the Northern and Southern. Liver cancer mortality was higher in males and increase with increasing age. There is need of liver cancer control measures to remain on a sustained and long-term basis for the high liver cancer burden rate of Thailand.

  3. The Impact of Statistically Adjusting for Rater Effects on Conditional Standard Errors of Performance Ratings

    ERIC Educational Resources Information Center

    Raymond, Mark R.; Harik, Polina; Clauser, Brian E.

    2011-01-01

    Prior research indicates that the overall reliability of performance ratings can be improved by using ordinary least squares (OLS) regression to adjust for rater effects. The present investigation extends previous work by evaluating the impact of OLS adjustment on standard errors of measurement ("SEM") at specific score levels. In addition, a…

  4. 12 CFR 747.1001 - Adjustment of civil money penalties by the rate of inflation.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... of inflation. 747.1001 Section 747.1001 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION... PROCEDURE, AND INVESTIGATIONS Inflation Adjustment of Civil Monetary Penalties § 747.1001 Adjustment of civil money penalties by the rate of inflation. (a) NCUA is required by the Federal Civil...

  5. 12 CFR 747.1001 - Adjustment of civil money penalties by the rate of inflation.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... of inflation. 747.1001 Section 747.1001 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION... PROCEDURE, AND INVESTIGATIONS Inflation Adjustment of Civil Monetary Penalties § 747.1001 Adjustment of civil money penalties by the rate of inflation. (a) NCUA is required by the Federal Civil...

  6. 12 CFR 747.1001 - Adjustment of civil money penalties by the rate of inflation.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... of inflation. 747.1001 Section 747.1001 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION... PROCEDURE, AND INVESTIGATIONS Inflation Adjustment of Civil Monetary Penalties § 747.1001 Adjustment of civil money penalties by the rate of inflation. (a) NCUA is required by the Federal Civil...

  7. 12 CFR 747.1001 - Adjustment of civil money penalties by the rate of inflation.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... of inflation. 747.1001 Section 747.1001 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION... PROCEDURE, AND INVESTIGATIONS Inflation Adjustment of Civil Monetary Penalties § 747.1001 Adjustment of civil money penalties by the rate of inflation. (a) NCUA is required by the Federal Civil...

  8. 75 FR 75624 - Cost of Living Adjustment to Satellite Carrier Compulsory License Royalty Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-06

    ... FR 53198 (August 31, 2010). Section 119(c)(2) requires the Judges annually to adjust these rates ``to... Copyright Royalty Board 37 CFR Part 386 Cost of Living Adjustment to Satellite Carrier Compulsory License... by satellite carriers under the satellite carrier compulsory license of the Copyright Act. The...

  9. 43 CFR 38.2 - Computation of hourly, daily, weekly, and biweekly adjusted rates of pay.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Computation of hourly, daily, weekly, and biweekly adjusted rates of pay. 38.2 Section 38.2 Public Lands: Interior Office of the Secretary of the Interior PAY OF U.S. PARK POLICE-INTERIM GEOGRAPHIC ADJUSTMENTS § 38.2 Computation of hourly, daily,...

  10. 43 CFR 38.2 - Computation of hourly, daily, weekly, and biweekly adjusted rates of pay.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 1 2014-10-01 2014-10-01 false Computation of hourly, daily, weekly, and biweekly adjusted rates of pay. 38.2 Section 38.2 Public Lands: Interior Office of the Secretary of the Interior PAY OF U.S. PARK POLICE-INTERIM GEOGRAPHIC ADJUSTMENTS § 38.2 Computation of hourly, daily,...

  11. 43 CFR 38.2 - Computation of hourly, daily, weekly, and biweekly adjusted rates of pay.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 1 2013-10-01 2013-10-01 false Computation of hourly, daily, weekly, and biweekly adjusted rates of pay. 38.2 Section 38.2 Public Lands: Interior Office of the Secretary of the Interior PAY OF U.S. PARK POLICE-INTERIM GEOGRAPHIC ADJUSTMENTS § 38.2 Computation of hourly, daily,...

  12. 43 CFR 38.2 - Computation of hourly, daily, weekly, and biweekly adjusted rates of pay.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false Computation of hourly, daily, weekly, and biweekly adjusted rates of pay. 38.2 Section 38.2 Public Lands: Interior Office of the Secretary of the Interior PAY OF U.S. PARK POLICE-INTERIM GEOGRAPHIC ADJUSTMENTS § 38.2 Computation of hourly, daily,...

  13. 43 CFR 38.2 - Computation of hourly, daily, weekly, and biweekly adjusted rates of pay.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 1 2012-10-01 2011-10-01 true Computation of hourly, daily, weekly, and biweekly adjusted rates of pay. 38.2 Section 38.2 Public Lands: Interior Office of the Secretary of the Interior PAY OF U.S. PARK POLICE-INTERIM GEOGRAPHIC ADJUSTMENTS § 38.2 Computation of hourly, daily,...

  14. Adjusted hospital death rates: a potential screen for quality of medical care.

    PubMed Central

    Dubois, R W; Brook, R H; Rogers, W H

    1987-01-01

    Increased economic pressure on hospitals has accelerated the need to develop a screening tool for identifying hospitals that potentially provide poor quality care. Based upon data from 93 hospitals and 205,000 admissions, we used a multiple regression model to adjust the hospitals crude death rate. The adjustment process used age, origin of patient from the emergency department or nursing home, and a hospital case mix index based on DRGs (diagnostic related groups). Before adjustment, hospital death rates ranged from 0.3 to 5.8 per 100 admissions. After adjustment, hospital death ratios ranged from 0.36 to 1.36 per 100 (actual death rate divided by predicted death rate). Eleven hospitals (12 per cent) were identified where the actual death rate exceeded the predicted death rate by more than two standard deviations. In nine hospitals (10 per cent), the predicted death rate exceeded the actual death rate by a similar statistical margin. The 11 hospitals with higher than predicted death rates may provide inadequate quality of care or have uniquely ill patient populations. The adjusted death rate model needs to be validated and generalized before it can be used routinely to screen hospitals. However, the remaining large differences in observed versus predicted death rates lead us to believe that important differences in hospital performance may exist. PMID:3113272

  15. 77 FR 13594 - Proposed Rate Adjustment, Public Forum, and Opportunities for Public Review and Comment for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-07

    ... Southeastern Power Administration Proposed Rate Adjustment, Public Forum, and Opportunities for Public Review... present rates and the proposed rates and supporting studies, to participate in a public forum and to... comments are due on or before June 5, 2012. A public information and comment forum will be held in...

  16. 75 FR 12740 - Proposed Rate Adjustment, Public Forum, and Opportunities for Public Review and Comment for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-17

    ... Southeastern Power Administration Proposed Rate Adjustment, Public Forum, and Opportunities for Public Review... present rates and the proposed rates and supporting studies, to participate in a public forum, and to... comments are due on or before June 15, 2010. A public information and comment forum will be held in...

  17. Breast Cancer Death Rates Down 34% Since 1990

    MedlinePlus

    ... News » Filed under: Breast Cancer Report: Breast Cancer Death Rates Down 34% Since 1990 Article date: October ... report from the American Cancer Society finds that death rates from breast cancer in the United States ...

  18. How to improve colon cancer screening rates

    PubMed Central

    Alberti, Luiz Ronaldo; Garcia, Diego Paim Carvalho; Coelho, Debora Lucciola; De Lima, David Correa Alves; Petroianu, Andy

    2015-01-01

    Colorectal carcinoma is a common cause of death throughout the world and may be prevented by routine control, which can detect precancerous neoplasms and early cancers before they undergo malignant transformation or metastasis. Three strategies may improve colon cancer screening rates: convince the population about the importance of undergoing a screening test; achieve higher efficacy in standard screening tests and make them more available to the community and develop new more sensitive and efficacious screening methods and make them available as routine tests. In this light, the present study seeks to review these three means through which to increase colon cancer screening rates. PMID:26688708

  19. Goal adjustment strategies operationalised and empirically examined in adolescents with cancer.

    PubMed

    Janse, Moniek; Sulkers, Esther; Tissing, Wim Je; Sanderman, Robbert; Sprangers, Mirjam Ag; Ranchor, Adelita V; Fleer, Joke

    2016-08-01

    Adolescents facing cancer may need to adjust their personal life goals. Theories identified several goal adjustment strategies, but their use has not been tested. Therefore, this study operationalises goal adjustment strategies and examines their use. Adolescent cancer patients listed their goals 3 and 12 months post-diagnosis. Goals received scores on five goal characteristics: life domain, level of abstraction, importance, attainability and effort. Results showed that adolescents with cancer (N = 30, mean age: 14.2 years, 60% female) used four of five strategies described in theory, while one additional strategy was found. These findings suggest that adolescents with cancer use goal adjustment strategies as measured by goal characteristics over time. PMID:25476574

  20. Linguistic Indicators of Patient, Couple, and Family Adjustment following Breast Cancer

    PubMed Central

    Robbins, Megan L.; Mehl, Matthias R.; Smith, Hillary L.; Weihs, Karen L.

    2012-01-01

    Introduction This study examined how language reflective of emotional and social processes during a cancer-related discussion relates to patient, couple, and family adjustment after breast cancer. It investigated whether emotional expression or relational focus, manifested in language use, indicates healthy family coping following breast cancer. Methods Family members each completed measures of adjustment (Family Environment Scale, Dyadic Adjustment Scale, and patient Profile of Mood States), and engaged in a 15-minute family discussion about how they have coped with breast cancer. Transcripts from the discussion were submitted to a text-analysis software program to obtain frequency of positive and negative emotion words, and personal pronouns spoken by each family member. The relationship between self-reports of adjustment and frequency of language use during the family discussion was analyzed with regression models. Results Partners’ positive emotion words were indicative of better family adjustment, patients’ negative emotion words indicated greater family conflict, and sons’ and daughters’ anger words indicated poorer adjustment, whereas their anxiety words indicated better family adjustment. Partner we-talk was related to better dyadic adjustment, and couples’ “you” was somewhat related to worse adjustment at all levels. Conclusions/Implications Important information about how a family copes with breast cancer can be obtained by attending to families’ emotional and relational language. This study suggests that clinicians and members of families’ support networks can gauge how well a family has adapted after the breast cancer experience by attending to the type of words that each family member uses to describe how they coped with breast cancer. PMID:22887054

  1. 75 FR 32228 - Rate Adjustment for the Satellite Carrier Compulsory License

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-07

    ... adjusted the rates in 1997. 62 FR 55742 (October 28, 1997). In the Satellite Home Viewer Improvement Act of... the former Copyright Royalty Tribunal. 57 FR 129052 (May 1, 1992). When the license was reauthorized... carriers; and the Librarian adopted the respective rates. See 70 FR 17320 (April 6, 2005) and 70 FR...

  2. 75 FR 39891 - Rate Adjustment for the Satellite Carrier Compulsory License

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-13

    ... carrier statutory license, 17 U.S.C. 119. 75 FR 32228 (June 7, 2010). The law further provides that... Copyright Royalty Board 37 CFR Part 386 Rate Adjustment for the Satellite Carrier Compulsory License AGENCY... are publishing for comment negotiated royalty rates for the satellite carrier statutory license of...

  3. 75 FR 14150 - Proposed Rate Adjustment, Public Forum, and Opportunities for Public Review and Comment for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-24

    ... rate for the sale of power from the Georgia-Alabama-South Carolina System of Projects (75 FR 12740... Southeastern Power Administration Proposed Rate Adjustment, Public Forum, and Opportunities for Public Review... Administration, DOE. ACTION: Notice to change date and location of the Public Information and Comment...

  4. Family Adjustment to Childhood Cancer: A Systematic Review

    ERIC Educational Resources Information Center

    Long, Kristin A.; Marsland, Anna L.

    2011-01-01

    This systematic review integrates qualitative and quantitative research findings regarding family changes in the context of childhood cancer. Twenty-eight quantitative, 42 qualitative, and one mixed-method studies were reviewed. Included studies focused on family functioning, marital quality, and/or parenting in the context of pediatric cancer,…

  5. Lung cancer death rates fall, helping drive decrease in overall cancer death rates

    Cancer.gov

    The Annual Report to the Nation on the Status of Cancer, covering the period 1975–2010, showed death rates for lung cancer, which accounts for more than one in four cancer deaths, dropping at a faster pace than in previous years.

  6. Self-reports and spouse ratings of neuroticism: perspectives on emotional adjustment in couples.

    PubMed

    Smith, Timothy W; Williams, Paula G

    2015-04-01

    Evidence of reciprocal associations between individual emotional adjustment and the quality of intimate relationships has led to the growing use of interventions that combine a focus on couple issues with a focus on individual emotional functioning. In these approaches, spouse ratings of emotional functioning can provide an important second method of assessment, beyond the much more commonly used self-reports. Although an extensive literature demonstrates substantial convergent correlations between self-reported and spouse-rated emotional adjustment, levels of adjustment evident across these 2 assessment methods are much less commonly compared, especially among couples reporting higher levels of marital distress. Well-documented limitations of both self-reports and spouse ratings suggest that differences--which would not necessarily be evident in correlations between methods--might be common and substantial, perhaps raising complications in couple assessments and intervention. The present study compared self-reports and spouse ratings of neuroticism and its specific components using the NEO Personality Inventory-Revised in a sample of 301 middle-aged and older couples. For overall neuroticism and the specific facets of anxiety, angry hostility, and vulnerability, self-reported levels of negative emotionality were consistently lower than the parallel ratings by spouses, most notably among couples reporting low levels of marital adjustment. Hence, substantial underestimates of negative emotionality obtained through self-reports as compared to ratings by spouses (or overestimates as obtained through spouse ratings) may be common and could complicate couple assessment and intervention. PMID:25844498

  7. 12 CFR 622.61 - Adjustment of civil money penalties by the rate of inflation under the Federal Civil Penalties...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... of inflation under the Federal Civil Penalties Inflation Adjustment Act of 1990, as amended. 622.61... civil money penalties by the rate of inflation under the Federal Civil Penalties Inflation Adjustment... is adjusted in accordance with the Federal Civil Penalties Inflation Adjustment Act of 1990,...

  8. 12 CFR 622.61 - Adjustment of civil money penalties by the rate of inflation under the Federal Civil Penalties...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... of inflation under the Federal Civil Penalties Inflation Adjustment Act of 1990, as amended. 622.61... civil money penalties by the rate of inflation under the Federal Civil Penalties Inflation Adjustment... is adjusted in accordance with the Federal Civil Penalties Inflation Adjustment Act of 1990,...

  9. 12 CFR 622.61 - Adjustment of civil money penalties by the rate of inflation under the Federal Civil Penalties...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... of inflation under the Federal Civil Penalties Inflation Adjustment Act of 1990, as amended. 622.61... civil money penalties by the rate of inflation under the Federal Civil Penalties Inflation Adjustment... is adjusted in accordance with the Federal Civil Penalties Inflation Adjustment Act of 1990,...

  10. 12 CFR 622.61 - Adjustment of civil money penalties by the rate of inflation under the Federal Civil Penalties...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... of inflation under the Federal Civil Penalties Inflation Adjustment Act of 1990, as amended. 622.61... civil money penalties by the rate of inflation under the Federal Civil Penalties Inflation Adjustment... is adjusted in accordance with the Federal Civil Penalties Inflation Adjustment Act of 1990,...

  11. 12 CFR 622.61 - Adjustment of civil money penalties by the rate of inflation under the Federal Civil Penalties...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... of inflation under the Federal Civil Penalties Inflation Adjustment Act of 1990, as amended. 622.61... civil money penalties by the rate of inflation under the Federal Civil Penalties Inflation Adjustment... is adjusted in accordance with the Federal Civil Penalties Inflation Adjustment Act of 1990,...

  12. SOCIAL-COGNITIVE CORRELATES OF ADJUSTMENT TO PROSTATE CANCER

    PubMed Central

    ROBERTS, KATHERINE J.; LEPORE, STEPHEN J.; HELGESON, VICKI

    2008-01-01

    SUMMARY This study examined whether social support might enhance health-related quality of life in men (n = 89) treated for localized prostate cancer by improving their ability to cognitively process their cancer experience. Data were collected using two, structured in-person interviews and abstracting medical records. The baseline interview was within several months (T1) after treatment for cancer, and follow-up was 3 months later (T2). Most men (61.8%) were treated by radical prostatectomy. Results showed that T1 social support was positively related to T2 mental functioning, and this relation appeared to be mediated by T1 indicators of cognitively processing, intrusive thoughts and searching for meaning. These findings suggest that supportive social relations may improve mental functioning by helping men cognitively process their prostate cancer experience. PMID:15929030

  13. Psychosocial Adjustment in School-age Girls With a Family History of Breast Cancer

    PubMed Central

    Bradbury, Angela R.; Patrick-Miller, Linda; Schwartz, Lisa; Egleston, Brian; Sands, Colleen Burke; Chung, Wendy K.; Glendon, Gord; McDonald, Jasmine A.; Moore, Cynthia; Rauch, Paula; Tuchman, Lisa; Andrulis, Irene L.; Buys, Saundra S.; Frost, Caren J.; Keegan, Theresa H.M.; Knight, Julia A.; Terry, Mary Beth; John, Esther M.; Daly, Mary B.

    2016-01-01

    OBJECTIVE Understanding how young girls respond to growing up with breast cancer family histories is critical given expansion of genetic testing and breast cancer messaging. We examined the impact of breast cancer family history on psychosocial adjustment and health behaviors among >800 girls in the multicenter LEGACY Girls Study. METHODS Girls aged 6 to 13 years with a family history of breast cancer or familial BRCA1/2 mutation (BCFH+), peers without a family history (BCFH−), and their biological mothers completed assessments of psychosocial adjustment (maternal report for 6- to 13-year-olds, self-report for 10- to 13-year-olds), breast cancer–specific distress, perceived risk of breast cancer, and health behaviors (10- to 13-year-olds). RESULTS BCFH+ girls had better general psychosocial adjustment than BCFH− peers by maternal report. Psychosocial adjustment and health behaviors did not differ significantly by self-report among 10- to 13-year-old girls. BCFH+ girls reported higher breast cancer–specific distress (P = .001) and were more likely to report themselves at increased breast cancer risk than BCFH− peers (38.4% vs 13.7%, P < .001), although many girls were unsure of their risk. In multivariable analyses, higher daughter anxiety was associated with higher maternal anxiety and poorer family communication. Higher daughter breast cancer–specific distress was associated with higher maternal breast cancer-specific distress. CONCLUSIONS Although growing up in a family at risk for breast cancer does not negatively affect general psychosocial adjustment among preadolescent girls, those from breast cancer risk families experience greater breast cancer–specific distress. Interventions to address daughter and mother breast cancer concerns and responses to genetic or familial risk might improve psychosocial outcomes of teen daughters. PMID:26482668

  14. The effect of acquiring life skills through humor on social adjustment rate of the female students

    PubMed Central

    Maghsoudi, Jahangir; sabour, Nazanin Hashemi; Yazdani, Mohsen; Mehrabi, Tayebeh

    2010-01-01

    BACKGROUND: Life skills have different effects on various aspects of the mental health. Social adjustment prepares adolescents for entering to the adulthood. On the other hand, humor and joking in the education is considered as a stress reducer and learning increaser. Therefore, the present study conducted aimed to determine the effect of acquiring life skills through humor on the social adjustment rate of the high school girls. METHODS: This was a two-group semi-experimental study including three phases. The study population included 69 first year high school female students of Isfahan Department of Education district 3 who were selected in simple random sampling. First of all, the social adjustment rate was measured using California Personality Inventory. Thereafter, life skills education was conducted using humor during five sessions. Finally, a test was taken in order to assess the acquisition of the life skills in which passing score was required for re-completing the questionnaire. The data were analyzed using software SPSS10 and independent and paired t-tests. RESULTS: The findings of the study indicated that the mean score of the social adjustment statistically had a significant difference in the intervention group before and after the intervention. Furthermore, statistically, there was a significant difference between mean score of the social adjustment in the control group and test group after conducting the intervention. CONCLUSIONS: The findings of the study indicated that life skills education has been increased through humor on the social adjustment rate of the high school girl students. Considering the efficacy of learning life skills on the social adjustment and results of the other studies which were in accordance with the present study, implementing such trainings with a new method comprehensively is recommended in the schools. PMID:22049280

  15. U.S. Cancer Death Rate Continues to Fall

    MedlinePlus

    ... gov/medlineplus/news/fullstory_157680.html U.S. Cancer Death Rate Continues to Fall But there's been a ... 2016 (HealthDay News) -- Overall rates of cancer and deaths from cancer in the United States continue to ...

  16. HPV-Associated Vulvar Cancer Rates by Race and Ethnicity

    MedlinePlus

    ... Is Doing Related Links Stay Informed Rates by Race and Ethnicity for Other Kinds of Cancer All ... Cancer Home HPV-Associated Vulvar Cancer Rates by Race and Ethnicity Language: English Español (Spanish) Recommend on ...

  17. 76 FR 590 - Adjustment or Determination of Compulsory License Rates for Making and Distributing Phonorecords

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-05

    ..., starting in the year 2006. A proceeding was commenced in 2006, 71 FR 1454 (January 9, 2006); on ] January... FR 4510 (January 26, 2009). Thus, in accordance with section 804(b)(4), a party may file a petition... Copyright Royalty Board Adjustment or Determination of Compulsory License Rates for Making and...

  18. 78 FR 67951 - Price Cap Rules for Certain Postal Rate Adjustments; Corrections

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-13

    ... document in the Federal Register on August 26, 2013 (78 FR 52694), revising Commission rules. Due to a... From the Federal Register Online via the Government Publishing Office POSTAL REGULATORY COMMISSION 39 CFR Part 3010 Price Cap Rules for Certain Postal Rate Adjustments; Corrections AGENCY:...

  19. 75 FR 51191 - Great Lakes Pilotage Rates-2011 Annual Review and Adjustment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-19

    ... in the January 17, 2008 issue of the Federal Register (73 FR 3316). D. Public Meeting We do not plan... was published on April 3, 2006 (71 FR 16501). Since then, rates have been reviewed under Appendix C and adjusted annually: 2007 (72 FR 53158, Sep. 18, 2007); 2008 (interim rule 73 FR 15092, Mar....

  20. 3 CFR 13641 - Executive Order 13641 of April 5, 2013. Adjustments of Certain Rates of Pay

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 3 The President 1 2014-01-01 2014-01-01 false Executive Order 13641 of April 5, 2013. Adjustments... Veterans Affairs (38 U.S.C. 7306, 7404; section 301(a) of Public Law 102-40) at Schedule 3. Sec. 2. Senior... hereof. Sec. 3. Certain Executive, Legislative, and Judicial Salaries. The rates of basic pay or...

  1. 5 CFR 9701.323 - Eligibility for pay increase associated with a rate range adjustment.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... with a rate range adjustment. 9701.323 Section 9701.323 Administrative Personnel DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM (DEPARTMENT OF HOMELAND SECURITY-OFFICE OF PERSONNEL MANAGEMENT) DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Setting...

  2. ADJUSTABLE OUTPUT RATE CHEMICAL FEEDING EQUIPMENT FOR SWIMMING POOLS. NATIONAL SANITATION FOUNDATION STANDARD NUMBER 19.

    ERIC Educational Resources Information Center

    National Sanitation Foundation, Ann Arbor, MI.

    THE SCOPE OF THIS STANDARD COVERS ADJUSTABLE OUTPUT RATE CHEMICAL FEEDERS, WHETHER USED FOR SOLUTIONS, SLURRIES OR SOLIDS. IT ALSO INCLUDES AUXILIARY EQUIPMENT SUCH AS PUMPS, STRAINERS, TUBING CONNECTIONS, TANKS, INJECTION FITTINGS AND OTHER REQUIRED COMPONENTS. THE FEEDERS DESCRIBED ARE INTENDED TO BE DESIGNED AND USED SPECIFICALLY FOR CHEMICAL…

  3. 78 FR 71501 - Cost of Living Adjustment to Satellite Carrier Compulsory License Royalty Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-29

    ...The Copyright Royalty Judges announce a cost of living adjustment (COLA) of 1% in the royalty rates satellite carriers pay for a compulsory license under the Copyright Act. The COLA is based on the change in the Consumer Price Index from October 2012 to October...

  4. Age-Adjustment and Related Epidemiology Rates in Education and Research

    ERIC Educational Resources Information Center

    Baker, John D.; Kruckman, Laurence; George, Joyce

    2006-01-01

    A quick review of introductory textbooks reveals that while gerontology authors and instructors introduce some aspect of demography and epidemiology data, there is limited focus on age adjustment or other important epidemiology rates. The goal of this paper is to reintroduce a variety of basic epidemiology strategies such as incidence, prevalence,…

  5. 78 FR 13521 - Great Lakes Pilotage Rates-2013 Annual Review and Adjustment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-28

    ... Accountant CPI Consumer Price Index E.O. Executive Order FR Federal Register GLPA Canadian Great Lakes...--2013 Annual Review and Adjustment'' in the Federal Register (77 FR 45539). We received six comments on..., methodology. The last full ratemaking established the current base rates in the 2012 final rule (77 FR...

  6. 3 CFR 13635 - Executive Order 13635 of December 27, 2012. Adjustments of Certain Rates of Pay

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 3 The President 1 2013-01-01 2013-01-01 false Executive Order 13635 of December 27, 2012. Adjustments of Certain Rates of Pay 13635 Order 13635 Presidential Documents Executive Orders Executive Order...) of Public Law 112-175. Sec. 8. Prior Order Superseded. Executive Order 13594 of December 19, 2011,...

  7. 3 CFR 13655 - Executive Order 13655 of December 23, 2013. Adjustments of Certain Rates of Pay

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 3 The President 1 2014-01-01 2014-01-01 false Executive Order 13655 of December 23, 2013. Adjustments of Certain Rates of Pay 13655 Order 13655 Presidential Documents Executive Orders Executive Order... Order Superseded. Executive Order 13641 of April 5, 2013, is superseded as of the effective...

  8. 3 CFR 13525 - Executive Order 13525 of December 23, 2009. Adjustments of Certain Rates of Pay

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 3 The President 1 2010-01-01 2010-01-01 false Executive Order 13525 of December 23, 2009. Adjustments of Certain Rates of Pay 13525 Order 13525 Presidential Documents Executive Orders Executive Order... day of the first applicable pay period beginning on or after January 1, 2010. Sec. 8. Prior...

  9. 3 CFR 13594 - Executive Order 13594 of December 19, 2011. Adjustments of Certain Rates of Pay

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 3 The President 1 2012-01-01 2012-01-01 false Executive Order 13594 of December 19, 2011. Adjustments of Certain Rates of Pay 13594 Order 13594 Presidential Documents Executive Orders Executive Order... Order Superseded. Executive Order 13561 of December 22, 2010, is superseded.Barack ObamaThe White...

  10. 3 CFR 13561 - Executive Order 13561 of December 22, 2010. Adjustments of Certain Rates of Pay

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 3 The President 1 2011-01-01 2011-01-01 false Executive Order 13561 of December 22, 2010. Adjustments of Certain Rates of Pay 13561 Order 13561 Presidential Documents Executive Orders Executive Order... January 1, 2011. Sec. 8. Prior Order Superseded. Executive Order 13525 of December 23, 2009, is...

  11. Age-adjustment and related epidemiology rates in education and research.

    PubMed

    Baker, John D; Kruckman, Laurence; George, Joyce

    2006-01-01

    A quick review of introductory textbooks reveals that while gerontology authors and instructors introduce some aspect of demography and epidemiology data, there is limited focus on age adjustment or other important epidemiology rates. The goal of this paper is to reintroduce a variety of basic epidemiology strategies such as incidence, prevalence, crude, age-specific and age-adjustment rates into the gerontology classroom. Background information and formulas for each rate, as well as examples of how they can be applied are provided. A recent change, encouraged by the U.S. Department of Health and Human Services, from a 1940 to a 2000 "standard million population" for ageadjusted rates, is reviewed. Finally, a teaching module with answers is provided for use in the gerontology classroom. PMID:16873207

  12. Ovarian Cancer Rates by Race and Ethnicity

    MedlinePlus

    ... any other group, followed by black, Hispanic, American Indian/Alaska Native, and Asian/Pacific Islander women. Ovarian Cancer Death Rates* by Race and Ethnicity, U.S., 1999–2012 Mortality source: U.S. Mortality Files, National Center for Health ...

  13. Nomenclature, categorization and usage of formulae to adjust QT interval for heart rate

    PubMed Central

    Rabkin, Simon W; Cheng, Xin Bo

    2015-01-01

    Assessment of the QT interval on a standard 12 lead electrocardiogram is of value in the recognition of a number of conditions. A critical part of its use is the adjustment for the effect of heart rate on QT interval. A systematic search was conducted to identify studies that proposed formulae to standardize the QT interval by heart rate. A nomenclature was developed for current and subsequent equations based on whether they are corrective (QTc) or predictive (QTp). QTc formulae attempt to separate the dependence of the length of the QT interval from the length of the RR interval. QTp formulae utilize heart rate and the output QTp is compared to the uncorrected QT interval. The nomenclature consists of the first letter of the first author’s name followed by the next two consonance (whenever possible) in capital letters; with subscripts in lower case alphabetical letter if the first author develops more than one equation. The single exception was the Framingham equation, because this cohort has developed its own “name” amongst cardiovascular studies. Equations were further categorized according to whether they were linear, rational, exponential, logarithmic, or power based. Data show that a person’s QT interval adjusted for heart rate can vary dramatically with the different QTc and QTp formulae depending on the person’s heart rate and QT interval. The differences in the QT interval adjustment equations encompasses values that are considered normal or significant prolonged. To further compare the equations, we considered that the slope of QTc versus heart rate should be zero if there was no correlation between QT and heart rate. Reviewing a sample of 107 patient ECGs from a hospital setting, the rank order of the slope - from best (closest to zero) to worst was QTcDMT, QTcRTHa, QTcHDG, QTcGOT, QTcFRM, QTcFRD, QTcBZT and QTcMYD. For two recent formulae based on large data sets specifically QTcDMT and QTcRTHa, there was no significant deviation of the slope

  14. Nomenclature, categorization and usage of formulae to adjust QT interval for heart rate.

    PubMed

    Rabkin, Simon W; Cheng, Xin Bo

    2015-06-26

    Assessment of the QT interval on a standard 12 lead electrocardiogram is of value in the recognition of a number of conditions. A critical part of its use is the adjustment for the effect of heart rate on QT interval. A systematic search was conducted to identify studies that proposed formulae to standardize the QT interval by heart rate. A nomenclature was developed for current and subsequent equations based on whether they are corrective (QTc) or predictive (QTp). QTc formulae attempt to separate the dependence of the length of the QT interval from the length of the RR interval. QTp formulae utilize heart rate and the output QTp is compared to the uncorrected QT interval. The nomenclature consists of the first letter of the first author's name followed by the next two consonance (whenever possible) in capital letters; with subscripts in lower case alphabetical letter if the first author develops more than one equation. The single exception was the Framingham equation, because this cohort has developed its own "name" amongst cardiovascular studies. Equations were further categorized according to whether they were linear, rational, exponential, logarithmic, or power based. Data show that a person's QT interval adjusted for heart rate can vary dramatically with the different QTc and QTp formulae depending on the person's heart rate and QT interval. The differences in the QT interval adjustment equations encompasses values that are considered normal or significant prolonged. To further compare the equations, we considered that the slope of QTc versus heart rate should be zero if there was no correlation between QT and heart rate. Reviewing a sample of 107 patient ECGs from a hospital setting, the rank order of the slope - from best (closest to zero) to worst was QTcDMT, QTcRTHa, QTcHDG, QTcGOT, QTcFRM, QTcFRD, QTcBZT and QTcMYD. For two recent formulae based on large data sets specifically QTcDMT and QTcRTHa, there was no significant deviation of the slope from zero

  15. SES discrepancies and Delaware cancer death rates.

    PubMed

    Frelick, Robert W

    2004-03-01

    Cancer can be monitored fairly effectively by using cancer registry data for site, stage, age, sex, and race. Adding to this the patient's years of education, now only found on death certificates, should not be difficult since it is an easily measured major SES factor. Most comorbidities should also be easy to obtain since hospitals usually code them. Capturing all treatment and response data remains a challenge as more and more cancer diagnosis and management is done in outpatient settings. Current efforts to establish electronic medical records in compliance with the Health Insurance Portability and Accountability Act (HIPAA) may be a blessing if adequate software can be standardized and used similar to that already present in the VA hospital in Delaware. Such information would aid efforts to reduce Delaware's high cancer incidence and mortality rates. A proposed state cancer plan should stimulate improved integration of the state's health resources to focus on the quality of individual health care and to use cost-effective measures to improve the public's health. A plan should (1) stimulate a public awareness to reduce risk factors for all major chronic diseases with a special focus on cancer deaths; (2) use medical office settings to provide simple screens to improve the early detection of a number of chronic diseases depending on such risks as age and sex (such studies might include weight, height, blood pressure, sugar, cholesterol, PSAs, exams of skin, oral cavities, breasts, abdomen, rectum, and vagina with pap smears, all of which can be accomplished in a cost-effective fashion); and (3) offer equitable access to a state's health care system for information, screening, and treatment. Current evidence shows that it is less expensive to manage patients with early cancers than those with advanced cases, which often occur because of ignorance and lack of access to health services, and by socioeconomic, educational, and cultural barriers. Implementing the

  16. Low Cloud Cover-Adjusted Ultraviolet B Irradiance Is Associated with High Incidence Rates of Leukemia: Study of 172 Countries

    PubMed Central

    2015-01-01

    There are 52,380 cases of leukemia and 24,090 deaths from it in the US annually. Its causes are unknown and no preventive strategies have been implemented. We hypothesized that leukemia is due mainly to vitamin D deficiency, which is due mainly to low solar ultraviolet B (UVB) irradiance. To test this hypothesis, we estimated age-standardized cloud-cover-adjusted winter UVB irradiance using cloud cover data from the International Satellite Cloud Climatology Project, latitudes of population centroids, and standard astronomical calculations. Incidence rates for 172 countries, available from the International Agency for Cancer Research, were plotted according to cloud-adjusted UVB irradiance. We used multiple regression to account for national differences in elevation and average life expectancy. Leukemia incidence rates were inversely associated with cloud-adjusted UVB irradiance in males (p ≤ 0.01) and females (p ≤ 0.01) in both hemispheres. There were few departures from the trend line, which was parabolic when plotted with the equator at the center of the display, northern hemisphere countries on the right side and southern hemisphere countries on the left. The bivariate association displayed by the polynomial trend line indicated that populations at higher latitudes had at least two times the risk of leukemia compared to equatorial populations. The association persisted in males (p ≤ 0.05) and females (p ≤ 0.01) after controlling for elevation and life expectancy. Incidence rates of leukemia were inversely associated with solar UVB irradiance. It is plausible that the association is due to vitamin D deficiency. This would be consistent with laboratory studies and a previous epidemiological study. Consideration should be given to prudent use of vitamin D for prevention of leukemia. PMID:26637119

  17. Low Cloud Cover-Adjusted Ultraviolet B Irradiance Is Associated with High Incidence Rates of Leukemia: Study of 172 Countries.

    PubMed

    Cuomo, Raphael E; Garland, Cedric F; Gorham, Edward D; Mohr, Sharif B

    2015-01-01

    There are 52,380 cases of leukemia and 24,090 deaths from it in the US annually. Its causes are unknown and no preventive strategies have been implemented. We hypothesized that leukemia is due mainly to vitamin D deficiency, which is due mainly to low solar ultraviolet B (UVB) irradiance. To test this hypothesis, we estimated age-standardized cloud-cover-adjusted winter UVB irradiance using cloud cover data from the International Satellite Cloud Climatology Project, latitudes of population centroids, and standard astronomical calculations. Incidence rates for 172 countries, available from the International Agency for Cancer Research, were plotted according to cloud-adjusted UVB irradiance. We used multiple regression to account for national differences in elevation and average life expectancy. Leukemia incidence rates were inversely associated with cloud-adjusted UVB irradiance in males (p ≤ 0.01) and females (p ≤ 0.01) in both hemispheres. There were few departures from the trend line, which was parabolic when plotted with the equator at the center of the display, northern hemisphere countries on the right side and southern hemisphere countries on the left. The bivariate association displayed by the polynomial trend line indicated that populations at higher latitudes had at least two times the risk of leukemia compared to equatorial populations. The association persisted in males (p ≤ 0.05) and females (p ≤ 0.01) after controlling for elevation and life expectancy. Incidence rates of leukemia were inversely associated with solar UVB irradiance. It is plausible that the association is due to vitamin D deficiency. This would be consistent with laboratory studies and a previous epidemiological study. Consideration should be given to prudent use of vitamin D for prevention of leukemia. PMID:26637119

  18. Female breast cancer mortality rates in Turkey.

    PubMed

    Dogan, Nurhan; Toprak, Dilek

    2014-01-01

    The main objective of this study was to analyze the mortality trends of female breast cancer in Turkey between the years 1987-2008. The rates per 100,000 age-standardized to the European standard population were assessed and time trends presented using joinpoint regression analysis. Average annual percent change (AAPC), anual percent change (APC) and 95% confidence interval (CI) was calculated. Nearly 23,000 breast cancer deaths occurred in Turkey during the period 1987-2008, with the average annual age-standardized mortality rate (ASR) being 11.9 per 100,000 women. In the last five years, significant increases were observed in all age groups, but there was no significant change over the age of 65. In this period, the biggest significant increase was in the 45-54 age group (AAPC=4.3, 95%CI=2.6 to 6.0). PMID:25292030

  19. Perceived Partner Reactions to Diagnosis and Treatment of Breast Cancer: Impact on Psychosocial and Psychosexual Adjustment

    ERIC Educational Resources Information Center

    Wimberly, Sarah R.; Carver, Charles S.; Laurenceau, Jean-Philippe; Harris, Suzanne D.; Antoni, Michael H.

    2005-01-01

    Two studies examined breast cancer patients' perceptions of their partners' reactions to their diagnosis and treatment as influences on 3 aspects of patients' well-being: psychosexual adjustment, emotional distress, and marital satisfaction. Study 1, cross-sectional, indicated that partner initiation of sex, frequency of sex, a positive 1st sexual…

  20. A Threshold Model of Social Support, Adjustment, and Distress after Breast Cancer Treatment

    ERIC Educational Resources Information Center

    Mallinckrodt, Brent; Armer, Jane M.; Heppner, P. Paul

    2012-01-01

    This study examined a threshold model that proposes that social support exhibits a curvilinear association with adjustment and distress, such that support in excess of a critical threshold level has decreasing incremental benefits. Women diagnosed with a first occurrence of breast cancer (N = 154) completed survey measures of perceived support…

  1. Curvilinear Associations between Benefit Finding and Psychosocial Adjustment to Breast Cancer

    ERIC Educational Resources Information Center

    Lechner, Suzanne C.; Carver, Charles S.; Antoni, Michael H.; Weaver, Kathryn E.; Phillips, Kristin M.

    2006-01-01

    Two previously studied cohorts of women with nonmetastatic breast cancer (Ns = 230 and 136) were reexamined. Participants were assessed during the year after surgery and 5-8 years later. Associations were examined between benefit finding (BF) and several indicators of psychosocial adjustment (e.g., perceived quality of life, positive affect,…

  2. Study: California Ethnic Groups Seeing Increased Cancer Rates

    ERIC Educational Resources Information Center

    Black Issues in Higher Education, 2005

    2005-01-01

    A statewide study on cancer and ethnicity hints that cancer rates among immigrant groups may be tied to their degree of assimilation into American culture. The study, released by the University of Southern California's Norris Comprehensive Cancer Center, marks the first statewide look at cancer rates among Vietnamese and South Asians and provides…

  3. Use of the mini-MAC scale in the evaluation of mental adjustment to cancer

    PubMed Central

    Marek, Ewelina; Deptała, Andrzej

    2015-01-01

    Aim of the study The objective of the study was to evaluate mental adjustment to cancer in patients diagnosed with an oncologic disease through identification of the coping strategies they had adopted. Material and methods Seventy-four patients of the Clinic of Oncology and Haematology at the Central Clinical Hospital (CSK) of the Ministry of Interior (MSW) in Warsaw were included in the study. The degree of adaptation to cancer was evaluated with the use of the mini-Mental Adjustment to Cancer (mini-MAC) scale. The individual subscales, i.e. fighting spirit, positive redefinition, helplessness-hopelessness, and anxious preoccupation, were collated with socio-demographic characteristics. Results Study findings indicate that: 1) tumour patients typically manifest behaviour that allows one to identify their adjustment to cancer; 2) in malignant tumour patients constructive behaviour prevails over destructive behaviour; 3) the helplessness-hopelessness response is more pronounced in men than women; 4) metastatic patients manifest stronger helplessness-hopelessness response than patients with locally limited tumours; 5) pensioners more often than people of working age adopt the helplessness-hopelessness strategy; and 6) patients with the shortest disease period manifest the strongest fighting spirit. Conclusions Cancer patients employ various strategies of coping with disease depending on socio-demographic factors. PMID:26793028

  4. Estimating the Burden of Cancers Attributable to Smoking Using Disability Adjusted Life Years in Indonesia.

    PubMed

    Kristina, Susi Ari; Endarti, Dwi; Sendjaya, Natalia; Pramestuty, Octy

    2016-01-01

    Tobacco use is a well-established risk factor for many types of cancers. Recent data on selected cancer incidence and mortality related to smoking in the Indonesian population are provided in this study. Morbidity and mortality data were derived from GLOBOCAN 2012 and the population attributable fraction (PAF) was estimated using the standard methodology developed by the World Health Organization. Using these data, we calculated disability adjusted life year (DALY) values for smoking-related cancer. The DALY was estimated by summation of the years lived with disability (YLD) and years life lost due to premature death (YLL). The cancer cases related to smoking in Indonesia numbered 45,132, accounting for 35,580 cancer deaths. The morbidity and mortality of lung cancer can be considered as the highest priority in both men and women. Furthermore the greatest YLD due to smoking in Indonesian men and women were from pancreas and lung cancers. For YLL among men, the highest years lost were from lung and liver cancers. On the other hand, among women lung oral cavity and lip were most important. Based on the DALY indicator, burden priorities for Indonesian men were lung cancer (298,980), liver cancer (60,367), and nasopharynx (46,185), while among Indonesian women they were lung cancer (34,119), cervix uteri (9,213) and pancreas cancer (5,433). In total, Indonesian burden of cancers attributed to smoking was 638,682 DALY. This study provides evidence about the burden of cancers caused by smoking as a rational basis for initiating national tobacco control policies in Indonesia. PMID:27039808

  5. Rising Lung Cancer Death Rates Among Black Men: The Importance of Occupation and Social Class

    PubMed Central

    Miller, William J.; Cooper, Richard

    1982-01-01

    From 1950 to 1977 the age-adjusted cancer death rates for nonwhite men in the United States rose an astonishing 63.2 percent, while rates for white men increased 22.2 percent and fell slightly for women of both races. The bulk of this increase can be accounted for by cancer of the lung. As a serious health problem that is increasing in severity, cancer in black men deserves close attention and definitive action. This discussion focuses on basic epidemiological relationships in the origins of this epidemic, particularly in regard to the relative importance of occupation, cigarette smoking, and social class. PMID:7120461

  6. 34 CFR 668.189 - General requirements for adjusting official cohort default rates and for appealing their...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false General requirements for adjusting official cohort... EDUCATION STUDENT ASSISTANCE GENERAL PROVISIONS Two Year Cohort Default Rates § 668.189 General requirements for adjusting official cohort default rates and for appealing their consequences. (a)...

  7. 34 CFR 668.208 - General requirements for adjusting official cohort default rates and for appealing their...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false General requirements for adjusting official cohort... EDUCATION STUDENT ASSISTANCE GENERAL PROVISIONS Cohort Default Rates § 668.208 General requirements for adjusting official cohort default rates and for appealing their consequences. (a) Remaining eligible. You...

  8. 77 FR 73456 - Update to the TR-12 Fuel Related Rate Adjustment Policy (SDDC Fuel Surcharge Policy)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-10

    ... Department of the Army Update to the TR-12 Fuel Related Rate Adjustment Policy (SDDC Fuel Surcharge Policy...: Reference: TR-12 Fuel Related Rate Adjustment Policy. Background: The following FRA policy applies to... increases in diesel fuel prices. Miscellaneous: A copy of the TR-12 FRA Policy can be accessed via the...

  9. 2007 Wholesale Power Rate Adjustment Proceeding (WP-07) : Administrator's Final Record of Decision.

    SciTech Connect

    United States. Bonneville Power Administration.

    2006-07-01

    This Record of Decision (ROD) contains the decisions of the Bonneville Power Administration (BPA), based on the record compiled in this rate proceeding, with respect to the adoption of power rates for the three-year rate period commencing October 1, 2006, through September 30, 2009. This ''2007 Wholesale Power Rate Adjustment Proceeding'' is designed to establish replacement rate schedules and General Rate Schedule Provisions (GRSPs) for those that expire on September 30, 2006. This power rate case also establishes the General Transfer Agreement (GTA) Delivery Charge for the period of October 1, 2007, through September 30, 2009. BPA's Power Subscription Strategy and Record of Decision (Subscription Strategy), as well as other Agency processes, provide much of the policy context for this rate case and are described in Section 2. This ROD follows a full evidentiary hearing and briefing, including an Oral Argument before the BPA Administrator. Sections 3 through 18, including any appendices or attachments, present the issues raised by parties in this proceeding, the parties positions, BPA staff positions on the issues, BPA's evaluations of the positions, and the Administrator's decisions. Parties had the opportunity to file briefs on exceptions to the Draft ROD, before issuance of this Final Record of Decision.

  10. Calibration and seasonal adjustment for matched case-control studies of vitamin D and cancer.

    PubMed

    Gail, Mitchell H; Wu, Jincao; Wang, Molin; Yaun, Shiaw-Shyuan; Cook, Nancy R; Eliassen, A Heather; McCullough, Marjorie L; Yu, Kai; Zeleniuch-Jacquotte, Anne; Smith-Warner, Stephanie A; Ziegler, Regina G; Carroll, Raymond J

    2016-06-15

    Vitamin D measurements are influenced by seasonal variation and specific assay used. Motivated by multicenter studies of associations of vitamin D with cancer, we formulated an analytic framework for matched case-control data that accounts for seasonal variation and calibrates to a reference assay. Calibration data were obtained from controls sampled within decile strata of the uncalibrated vitamin D values. Seasonal sine-cosine series were fit to control data. Practical findings included the following: (1) failure to adjust for season and calibrate increased variance, bias, and mean square error and (2) analysis of continuous vitamin D requires a variance adjustment for variation in the calibration estimate. An advantage of the continuous linear risk model is that results are independent of the reference date for seasonal adjustment. (3) For categorical risk models, procedures based on categorizing the seasonally adjusted and calibrated vitamin D have near nominal operating characteristics; estimates of log odds ratios are not robust to choice of seasonal reference date, however. Thus, public health recommendations based on categories of vitamin D should also define the time of year to which they refer. This work supports the use of simple methods for calibration and seasonal adjustment and is informing analytic approaches for the multicenter Vitamin D Pooling Project for Breast and Colorectal Cancer. Published 2016. This article has been contributed to by US Government employees and their work is in the public domain in the USA. PMID:27133461

  11. Adjustable high-repetition-rate pulse trains in a passively-mode-locked fiber laser

    NASA Astrophysics Data System (ADS)

    Si Fodil, Rachid; Amrani, Foued; Yang, Changxi; Kellou, Abdelhamid; Grelu, Ph.

    2016-07-01

    We experimentally investigate multipulse regimes obtained within a passively-mode-locked fiber laser that includes a Mach-Zehnder (MZ) interferometer. By adjusting the time delay imbalance of the MZ, ultrashort pulse trains at multi-GHz repetition rates are generated. We compare the observed dynamics with high-harmonic mode locking, and show that the multi-GHz pulse trains display an inherent instability, which has been overlooked. By using a recirculation loop containing the MZ, we demonstrate a significant improvement of the pulse train stability.

  12. Adjustment to cancer: exploring patients' experiences of participating in a psychodramatic group intervention.

    PubMed

    Menichetti, J; Giusti, L; Fossati, I; Vegni, E

    2016-09-01

    The main purpose of the present study was to understand the subjective experience of patients adjusting to cancer by focusing on how that experience might be affected by participating in a psychodramatic group intervention. In-depth interviews using an interpretative-phenomenological approach were conducted with eight cancer patients involved in a psychodrama group. Four key themes were identified: (1) outside and inside relationships; (2) identities: nurturing other selves; (3) a feelings' gym: performing the internal world; and (4) many ends: mourning death and dying. Participation in cancer group using a psychodramatic approach provided positive results. In detail, the group setting: (1) favoured relationships in which it was possible to freely express oneself and (2) empowered patients in their feelings of being able to give and receive help; the psychodramatic approach: (1) supported the physical mobilisation of sense of agency and (2) permitted to deal with the grieving process. Cancer healthcare pathways would benefit from psychotherapeutic programmes using a similar approach, since psychodrama by actively involving body seems to works on areas that are often underwhelmed by other approaches, such as (i.e., physical mobilisation, body engagement, grieving adjustment). Psychodrama supports patients to achieve insights into their own possibilities to actively participate in their own life situations despite having cancer and undergoing treatment for it. PMID:26515989

  13. The Relationship of Medicaid Payment Rates, Bed Constraint Policies, and Risk-Adjusted Pressure Ulcers

    PubMed Central

    Grabowski, David C; Angelelli, Joseph J

    2004-01-01

    Objective To examine the effect of Medicaid reimbursement rates on nursing home quality in the presence of certificate-of-need (CON) and construction moratorium laws. Data Sources/Study Setting A single cross-section of Medicaid certified nursing homes in 1999 (N=13,736). Study Design A multivariate regression model was used to examine the effect of Medicaid payment rates and other explanatory variables on risk-adjusted pressure ulcer incidence. The model is alternatively considered for all U.S. nursing home markets, those most restrictive markets, and those high-Medicaid homes to isolate potentially resource-poor environments. Data Extraction Methods A merged data file was constructed with resident-level information from the Minimum Data Set, facility-level information from the On-Line, Survey, Certification, and Reporting (OSCAR) system and market- and state-level information from various published sources. Principal Findings In the analysis of all U.S. markets, there was a positive relationship between the Medicaid payment rate and nursing home quality. The results from this analysis imply that a 10 percent increase in Medicaid payment was associated with a 1.5 percent decrease in the incidence of risk-adjusted pressure ulcers. However, there was a limited association between Medicaid payment rates and quality in the most restrictive markets. Finally, there was a strong relationship between Medicaid payment and quality in high-Medicaid homes providing strong evidence that the level of Medicaid payment is especially important within resource poor facilities. Conclusions These findings provide support for the idea that increased Medicaid reimbursement may be an effective means toward improving nursing home quality, although CON and moratorium laws may mitigate this relationship. PMID:15230928

  14. Essays in applied macroeconomics: Asymmetric price adjustment, exchange rate and treatment effect

    NASA Astrophysics Data System (ADS)

    Gu, Jingping

    This dissertation consists of three essays. Chapter II examines the possible asymmetric response of gasoline prices to crude oil price changes using an error correction model with GARCH errors. Recent papers have looked at this issue. Some of these papers estimate a form of error correction model, but none of them accounts for autoregressive heteroskedasticity in estimation and testing for asymmetry and none of them takes the response of crude oil price into consideration. We find that time-varying volatility of gasoline price disturbances is an important feature of the data, and when we allow for asymmetric GARCH errors and investigate the system wide impulse response function, we find evidence of asymmetric adjustment to crude oil price changes in weekly retail gasoline prices. Chapter III discusses the relationship between fiscal deficit and exchange rate. Economic theory predicts that fiscal deficits can significantly affect real exchange rate movements, but existing empirical evidence reports only a weak impact of fiscal deficits on exchange rates. Based on US dollar-based real exchange rates in G5 countries and a flexible varying coefficient model, we show that the previously documented weak relationship between fiscal deficits and exchange rates may be the result of additive specifications, and that the relationship is stronger if we allow fiscal deficits to impact real exchange rates non-additively as well as nonlinearly. We find that the speed of exchange rate adjustment toward equilibrium depends on the state of the fiscal deficit; a fiscal contraction in the US can lead to less persistence in the deviation of exchange rates from fundamentals, and faster mean reversion to the equilibrium. Chapter IV proposes a kernel method to deal with the nonparametric regression model with only discrete covariates as regressors. This new approach is based on recently developed least squares cross-validation kernel smoothing method. It can not only automatically smooth

  15. An Investigation of Cancer Rates in the Argentia Region, Newfoundland and Labrador: An Ecological Study

    PubMed Central

    Duke, Pauline; Godwin, Marshall; Peach, Mandy; Fortier, Jacqueline; Bornstein, Stephen; Buehler, Sharon; McCrate, Farah; Pike, Andrea; Wang, Peizhong Peter; Cullen, Richard M.

    2015-01-01

    Background. The Argentia region of Newfoundland and Labrador, Canada, was home to a US naval base during a 40-year period between the 1940s and the 1990s. Activities on the base resulted in contamination of the soil and groundwater in the region with chemicals such as heavy metals and dioxins, and residents have expressed concern about higher rates of cancer in their community. This study investigated the rate of cancer diagnosis that is disproportionately high in the Argentia region. Methods. Cases of cancer diagnosed between 1985 and 2011 were obtained for the Argentia region, two comparison communities, and the province of Newfoundland and Labrador. Crude and age-standardized incidence rates of cancer diagnosis were calculated and compared. The crude incidence rate was adjusted for differences in age demographics using census data, and age-standardized incidence rates were compared. Results. Although the Argentia region had a higher crude rate of cancer diagnosis, the age-standardized incidence rate did not differ significantly from the comparison communities or the provincial average. Argentia has an aging population, which may have influenced the perception of increased cancer diagnosis in the community. Conclusions. We did not detect an increased burden of cancer in the Argentia region. PMID:26633979

  16. Attachment styles in patients with lung cancer and their spouses: associations with patient and spouse adjustment

    PubMed Central

    Keefe, Francis J.; Davis, Deborah; Rumble, Meredith; Scipio, Cindy; Garst, Jennifer

    2013-01-01

    Purpose This study examined attachment styles in patients with lung cancer and their spouses and associations between attachment styles and patient and spouse adjustment. Methods One hundred twenty-seven patients with early stage lung cancer completed measures of attachment style, marital quality, self-efficacy, pain, depression, anxiety, and quality of life. Their spouses completed measures of attachment style, marital quality, self-efficacy, caregiver strain, and mood. Results Analyses indicated that, among patients, those high in either attachment anxiety or avoidance had significantly higher levels of anxiety and poorer social well-being. Attachment avoidance was also significantly associated with higher levels of depression and poorer marital quality and functional well-being. Spouse avoidant attachment was significantly associated with patient reports of increased pain and poorer functional well-being, and spouse anxious attachment was associated with poorer patient marital quality. Among spouses, those high in attachment avoidance reported significantly higher levels of caregiver strain, anger, depressed mood, and poorer marital quality; those high in attachment anxiety reported higher anxious mood. Dyads in which both partners were insecurely attached had significantly poorer adjustment compared to dyads in which both partners reported secure attachment. Conclusions These preliminary findings raise the possibility that attachment styles of cancer patients and their spouses as individuals and as a dyad may be important factors affecting adjustment in multiple domains. PMID:22246596

  17. Achieving high bit rate logical stochastic resonance in a bistable system by adjusting parameters

    NASA Astrophysics Data System (ADS)

    Yang, Ding-Xin; Gu, Feng-Shou; Feng, Guo-Jin; Yang, Yong-Min; Ball, Andrew

    2015-11-01

    The phenomenon of logical stochastic resonance (LSR) in a nonlinear bistable system is demonstrated by numerical simulations and experiments. However, the bit rates of the logical signals are relatively low and not suitable for practical applications. First, we examine the responses of the bistable system with fixed parameters to different bit rate logic input signals, showing that an arbitrary high bit rate LSR in a bistable system cannot be achieved. Then, a normalized transform of the LSR bistable system is introduced through a kind of variable substitution. Based on the transform, it is found that LSR for arbitrary high bit rate logic signals in a bistable system can be achieved by adjusting the parameters of the system, setting bias value and amplifying the amplitudes of logic input signals and noise properly. Finally, the desired OR and AND logic outputs to high bit rate logic inputs in a bistable system are obtained by numerical simulations. The study might provide higher feasibility of LSR in practical engineering applications. Project supported by the National Natural Science Foundation of China (Grant No. 51379526).

  18. 5 CFR 591.228 - How does OPM convert the price index plus adjustment factor to a COLA rate?

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false How does OPM convert the price index plus... Differential-Nonforeign Areas Cost-Of-Living Allowances § 591.228 How does OPM convert the price index plus adjustment factor to a COLA rate? (a) OPM converts the price index plus the adjustment factor to a COLA...

  19. 5 CFR 591.228 - How does OPM convert the price index plus adjustment factor to a COLA rate?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false How does OPM convert the price index plus... Differential-Nonforeign Areas Cost-Of-Living Allowances § 591.228 How does OPM convert the price index plus adjustment factor to a COLA rate? (a) OPM converts the price index plus the adjustment factor to a COLA...

  20. 5 CFR 591.228 - How does OPM convert the price index plus adjustment factor to a COLA rate?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false How does OPM convert the price index plus... Differential-Nonforeign Areas Cost-Of-Living Allowances § 591.228 How does OPM convert the price index plus adjustment factor to a COLA rate? (a) OPM converts the price index plus the adjustment factor to a COLA...

  1. 5 CFR 591.228 - How does OPM convert the price index plus adjustment factor to a COLA rate?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false How does OPM convert the price index plus... Differential-Nonforeign Areas Cost-Of-Living Allowances § 591.228 How does OPM convert the price index plus adjustment factor to a COLA rate? (a) OPM converts the price index plus the adjustment factor to a COLA...

  2. 5 CFR 591.228 - How does OPM convert the price index plus adjustment factor to a COLA rate?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false How does OPM convert the price index plus... Differential-Nonforeign Areas Cost-Of-Living Allowances § 591.228 How does OPM convert the price index plus adjustment factor to a COLA rate? (a) OPM converts the price index plus the adjustment factor to a COLA...

  3. International variation in reported livebirth prevalence rates of Down syndrome, adjusted for maternal age.

    PubMed

    Carothers, A D; Hecht, C A; Hook, E B

    1999-05-01

    Reported livebirth prevalence of Down syndrome (DS) may be affected by the maternal age distribution of the population, completeness of ascertainment, accuracy of diagnosis, extent of selective prenatal termination of affected pregnancies, and as yet unidentified genetic and environmental factors. To search for evidence of the latter, we reviewed all published reports in which it was possible to adjust both for effects of maternal age and for selective termination (where relevant). We constructed indices that allowed direct comparisons of prevalence rates after standardising for maternal age. Reference rates were derived from studies previously identified as having near complete ascertainment. An index value significantly different from 1 may result from random fluctuations, as well as from variations in the factors listed above. We found 49 population groups for which an index could be calculated. Methodological descriptions suggested that low values could often be attributed to under-ascertainment. A possible exception concerned African-American groups, though even among these most acceptable studies were compatible with an index value of 1. As we have reported elsewhere, there was also a suggestive increase in rates among US residents of Mexican or Central American origin. Nevertheless, our results suggest that "real" variation between population groups reported to date probably amounts to no more than +/-25%. However, reliable data in many human populations are lacking including, surprisingly, some jurisdictions with relatively advanced health care systems. We suggest that future reports of DS livebirth prevalence should routinely present data that allow calculation of an index standardised for maternal age and adjusted for elective prenatal terminations. PMID:10353785

  4. Psychosocial adjustments in patients with prostate cancer from pre-diagnosis to 6 months post-treatment.

    PubMed

    Chien, Ching-Hui; Chuang, Cheng-Keng; Liu, Kuan-Lin; Huang, Xuan-Yi; Liu, Hsueh-Erh

    2016-02-01

    We evaluated changes in psychosocial adjustment over time and its associated factors in prostate cancer patients. A total of 69 patients with prostate cancer were surveyed at pre-diagnosis, 1 month and 6 months post-treatment. The questionnaires distributed to the patients consisted of the Psychosocial Adjustment to Illness Scale and the UCLA Prostate Cancer Index. The generalized estimating equations were used to analyse the collected data. The results of adjustments to psychological distress, the domestic environment and the social environment worsened post-treatment. However, the adjustment to health-care orientation was worst at the time of pre-diagnosis and improved during post-treatment. Patients who perceived an unfavourable health status reported poor adjustment in psychological distress. Patients exhibiting poor urinary function poorly adjusted to the domestic environment. Patients with sexual dysfunction exhibited poor adjustment to the social environment. Patients with low education demonstrated poor adjustment to health-care orientation. Further studies should assess the psychosocial adjustment among prostate cancer patients and provide interventions following pre-diagnosis. PMID:25307968

  5. Comparisons of prostate cancer mortality rates with dietary practices in the United States.

    PubMed

    Colli, Janet Laura; Colli, Albert

    2005-01-01

    From 1930 to 1992, prostate cancer mortality rates in the United States doubled and then declined somewhat until 2000. The objective of this study is to determine whether variations in prostate cancer mortality rates correlate with dietary changes that occurred over that period. Simple linear regression models were applied to age-adjusted prostate cancer mortality rates and per-capita consumption rates for 18 foods from 1930 to 2000. Correlation coefficients were calculated while comparing food consumption rates to prostate cancer mortality rates for the same year. Correlation coefficients were then recalculated when the prostate cancer mortality rates were compared with food consumption rates that occurred: 1 yr; 2 yr; 3 yr; and continuing in progression for 21 yr before the occurrence of the prostate cancer mortality. The largest positive correlation coefficients were associated with the consumption of: total meat (red meat, poultry and fish) (R = 0.83, T between 0 and 1); added fats and oils (R = 0.83, T = 21); ice cream (R = 0.83, T = 20); margarine (R = 0.81, T = 4); salad/cooking oil (R = 0.82, T between 3 and 4) and; vegetable shortening (R = 0.81, T between 1 and 2) where R is the correlation coefficient and T is the time in years between consumption and mortality. In conclusion, this study found strong positive correlations between prostate cancer mortality and the consumption of: total meat; added fats and oils, ice cream, salad/cooking oils, margarine, and vegetable shortening. The connection between total meat consumption and prostate cancer risk is consistent with previous studies in the literature. The link between salad/cooking oil consumption and prostate cancer risk may be consistent with past studies which suggest that mu-linolenic acid (a component of salad/cooking oils) is a suspected risk factor for prostate cancer. PMID:16301115

  6. Picosecond supercontinuum light source for stroboscopic white-light interferometry with freely adjustable pulse repetition rate.

    PubMed

    Novotny, Steffen; Durairaj, Vasuki; Shavrin, Igor; Lipiäinen, Lauri; Kokkonen, Kimmo; Kaivola, Matti; Ludvigsen, Hanne

    2014-06-01

    We present a picosecond supercontinuum light source designed for stroboscopic white-light interferometry. This source offers a potential for high-resolution characterization of vibrational fields in electromechanical components with frequencies up to the GHz range. The light source concept combines a gain-switched laser diode, the output of which is amplified in a two-stage fiber amplifier, with supercontinuum generation in a microstructured optical fiber. Implemented in our white-light interferometer setup, optical pulses with optimized spectral properties and below 310 ps duration are used for stroboscopic illumination at freely adjustable repetition rates. The performance of the source is demonstrated by characterizing the surface vibration field of a square-plate silicon MEMS resonator at 3.37 MHz. A minimum detectable vibration amplitude of less than 100 pm is reached. PMID:24921556

  7. Cancer rates after the Three Mile Island nuclear accident and proximity of residence to the plant.

    PubMed Central

    Hatch, M C; Wallenstein, S; Beyea, J; Nieves, J W; Susser, M

    1991-01-01

    BACKGROUND: In the light of a possible link between stress and cancer promotion or progression, and of previously reported distress in residents near the Three Mile Island (TMI) nuclear power plant, we attempted to evaluate the impact of the March 1979 accident on community cancer rates. METHODS: Proximity of residence to the plant, which related to distress in previous studies, was taken as a possible indicator of accident stress; the postaccident pattern in cancer rates was examined in 69 "study tracts" within a 10-mile radius of TMI, in relation to residential proximity. RESULTS: A modest association was found between postaccident cancer rates and proximity (OR = 1.4; 95% CI = 1.3, 1.6). After adjusting for a gradient in cancer risk prior to the accident, the odds ratio contrasting those closest to the plant with those living farther out was 1.2 (95% CI = 1.0, 1.4). A postaccident increase in cancer rates near the Three Mile Island plant was notable in 1982, persisted for another year, and then declined. Radiation emissions, as modeled mathematically, did not account for the observed increase. CONCLUSION: Interpretation in terms of accident stress is limited by the lack of an individual measure of stress and by uncertainty about whether stress has a biological effect on cancer in humans. An alternative mechanism for the cancer increase near the plant is through changes in care-seeking and diagnostic practice arising from postaccident concern. PMID:2029040

  8. Worldwide trends show oropharyngeal cancer rates increasing

    Cancer.gov

    NCI scientists report that the incidence of oropharyngeal cancer significantly increased during the period 1983-2002 among people in countries that are economically developed. Oropharyngeal cancer occurs primarily in the middle part of the throat behind t

  9. A Distributed Transmission Rate Adjustment Algorithm in Heterogeneous CSMA/CA Networks

    PubMed Central

    Xie, Shuanglong; Low, Kay Soon; Gunawan, Erry

    2015-01-01

    Distributed transmission rate tuning is important for a wide variety of IEEE 802.15.4 network applications such as industrial network control systems. Such systems often require each node to sustain certain throughput demand in order to guarantee the system performance. It is thus essential to determine a proper transmission rate that can meet the application requirement and compensate for network imperfections (e.g., packet loss). Such a tuning in a heterogeneous network is difficult due to the lack of modeling techniques that can deal with the heterogeneity of the network as well as the network traffic changes. In this paper, a distributed transmission rate tuning algorithm in a heterogeneous IEEE 802.15.4 CSMA/CA network is proposed. Each node uses the results of clear channel assessment (CCA) to estimate the busy channel probability. Then a mathematical framework is developed to estimate the on-going heterogeneous traffics using the busy channel probability at runtime. Finally a distributed algorithm is derived to tune the transmission rate of each node to accurately meet the throughput requirement. The algorithm does not require modifications on IEEE 802.15.4 MAC layer and it has been experimentally implemented and extensively tested using TelosB nodes with the TinyOS protocol stack. The results reveal that the algorithm is accurate and can satisfy the throughput demand. Compared with existing techniques, the algorithm is fully distributed and thus does not require any central coordination. With this property, it is able to adapt to traffic changes and re-adjust the transmission rate to the desired level, which cannot be achieved using the traditional modeling techniques. PMID:25822140

  10. 42 CFR 422.308 - Adjustments to capitation rates, benchmarks, bids, and payments.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Secretary) as the PACE program. (5) Application of coding adjustment. (i) In applying the adjustment under... adjustment reflects changes in treatment and coding practices in the fee-for-service sector and reflects differences in coding patterns between MA plans and providers under Part A and B to the extent that...

  11. 42 CFR 422.308 - Adjustments to capitation rates, benchmarks, bids, and payments.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Secretary) as the PACE program. (5) Application of coding adjustment. (i) In applying the adjustment under... adjustment reflects changes in treatment and coding practices in the fee-for-service sector and reflects differences in coding patterns between MA plans and providers under Part A and B to the extent that...

  12. Two Models of Caregiver Strain and Bereavement Adjustment: A Comparison of Husband and Daughter Caregivers of Breast Cancer Hospice Patients

    ERIC Educational Resources Information Center

    Bernard, Lori L.; Guarnaccia, Charles A.

    2003-01-01

    Purpose: Caregiver bereavement adjustment literature suggests opposite models of impact of role strain on bereavement adjustment after care-recipient death--a Complicated Grief Model and a Relief Model. This study tests these competing models for husband and adult-daughter caregivers of breast cancer hospice patients. Design and Methods: This…

  13. The report of coping strategies and psychosocial adjustment in Korean mothers of children with cancer

    PubMed Central

    Han, Hae-Ra; Cho, Eun Joo; Kim, Daehee; Kim, Jiyun

    2011-01-01

    Objective Parents of children with cancer must cope with multiple challenges over time. As most research on parental coping has been conducted in Western countries, little information is available on the parental experience of coping in non-Western countries. Using a new cultural sample of Korean mothers, this study describes their coping strategies. In addition, the association of particular coping patterns with mothers’ report of psychosocial adjustment is investigated. Methods A total of 200 Korean mothers of children with cancer participated in the study. Coping strategies were measured by the Coping Health Inventory for Parents in the following three categories: Maintaining Family Integration and an Optimistic Outlook for the Situation, Seeking Social Support, and Seeking Information. Maternal psychosocial adjustment was measured by psychological distress, family relationship, and social relationship subscales from the Psychosocial Adjustment to Illness Scale. Results Korean mothers reported coping strategies related to Maintaining Family Integration and an Optimistic Outlook for the Situation as being most helpful. More frequent use of coping pattern, Maintaining Family Integration and an Optimistic Outlook for the Situation, and less frequent use of coping pattern, Information-Seeking were significantly associated with lower psychological distress and better family relationship after children’s medical and maternal characteristics were controlled for. Coping pattern, Seeking Social Support was only predictive of social relationships. Conclusions This study suggests that culture may play a significant role in the report of coping among Korean mothers. Future studies should consider culturally preferred coping methods and available resources as they relate to different adjustment outcomes. PMID:19117279

  14. Report to the Nation shows cancer death rates dropping

    Cancer.gov

    The Annual Report to the Nation on the Status of Cancer, 1975–2009, shows that overall cancer death rates continued to decline in the United States among both men and women, among all major racial and ethnic groups, and for all of the most common cancer s

  15. Smoking, air pollution, and the high rates of lung cancer in Shenyang, China

    SciTech Connect

    Xu, Z.Y.; Blot, W.J.; Xiao, H.P.; Wu, A.; Feng, Y.P.; Stone, B.J.; Sun, J.; Ershow, A.G.; Henderson, B.E.; Fraumeni, J.F. Jr. )

    1989-12-06

    A case-control study involving interviews with 1,249 patients with lung cancer and 1,345 population-based controls was conducted in Shenyang, an industrial city in northeastern China, where mortality rates are high among men and women. Cigarette smoking was found to be the principal cause of lung cancer in this population, accounting for 55% of the lung cancers in males and 37% in females. The attributable risk percentage among females is high compared to elsewhere in China, largely because of a higher prevalence of smoking among women. After adjustment for smoking, there were also significant increases in lung cancer risk associated with several measures of exposure to air pollutants. Risks were twice as high among those who reported smoky outdoor environments, and increased in proportion to years of sleeping on beds heated by coal-burning stoves (kang), and to an overall index of indoor air pollution. Threefold increases in lung cancer risk were found among men who worked in the nonferrous smelting industry, where heavy exposures to inorganic arsenic have been reported. The associations with both smoking and indoor air pollution were stronger for squamous cell and small cell carcinomas than for adenocarcinoma of the lung. Risks due to smoking or air pollution were not greatly altered by adjustment for consumption of fresh vegetables or sources of beta carotene or retinol, prior chronic lung diseases, or education level. The findings suggest that smoking and environmental pollution combine to account for the elevated rates of lung cancer mortality in Shenyang.

  16. QuickStats: Age-Adjusted Death Rates* for Females Aged 15-44 Years, by the Five Leading Causes of Death(†) - United States, 1999 and 2014.

    PubMed

    2016-01-01

    The age-adjusted death rate for females aged 15-44 years was 5% lower in 2014 (82.1 per 100,000 population) than in 1999 (86.5). Among the five leading causes of death, the age-adjusted rates of three were lower in 2014 than in 1999: cancer (from 19.6 to 15.3, a 22% decline), heart disease (8.9 to 8.2, an 8% decline), and homicide (4.2 to 2.8, a 33% decline). The age-adjusted death rates for two of the five causes were higher in 2014 than in 1999: unintentional injuries (from 17.0 to 20.1, an 18% increase) and suicide (4.8 to 6.5, a 35% increase). Unintentional injuries replaced cancer as the leading cause of death in this demographic group. PMID:27362608

  17. High Altitude Remains Associated with Elevated Suicide Rates after Adjusting for Socioeconomic Status: A Study from South Korea

    PubMed Central

    Kim, Jaelim; Choi, Nari; Lee, Yu-Jin; An, Hyonggin; Kim, Namkug; Yoon, Ho-Kyoung

    2014-01-01

    There have been several studies supporting a possible relationship between high suicide rate and high altitude. However socioeconomic status may confound this association because low socioeconomic status, which is known to be related to a high suicide rate, is also associated with living at high altitude. This study aims to explore whether the relationship between high altitude and high suicide rate remains after adjusting for socioeconomic status in South Korea. We collected demographic data of completed suicides, the mean altitude of the district where each suicide took place, and the mean income of each district. We analyzed the data using regression analysis before and after adjustment for mean income. We found that there is a positive correlation between altitude and suicide rate, even after adjustment for mean income. Thus, altitude appears to be an independent risk factor for suicide. PMID:25395983

  18. Cancer Screening Rates in a Student-Run Free Clinic

    PubMed Central

    Hu, Zishuo Ian; Smith, Dylan M.

    2016-01-01

    Background: In the United States and in New York State, individuals with no health insurance have consistently lower screening rates for breast and cervical cancer than those with health insurance and are also more likely to be diagnosed with advanced stages of cancer. Our objective was to compare the cancer screening rates among patients at a free student-run clinic to state and national data. To our knowledge, ours is the first study examining breast and cervical screening rates and their relation to insurance status, income level, education level, race, and marital status in a suburban free student-run clinic. Methods: As part of their intake from fall 2012 to spring 2013, patients at the Stony Brook Health Outreach and Medical Education Clinic in Stony Brook, NY, filled out a 26-item survey that included questions about race, income, education level, marital status, and cancer screening status. We compared the screening rates reported by our patients to published state and national rates. Results: Breast and cervical cancer screening rates reported by 165 patients treated at our free student-run clinic were lower than the overall state and national averages. No significant associations between race, income, education level, or marital status and cancer screening rates were detected. Conclusion: Cancer screening rates at our free student-run clinic for the uninsured were lower than the overall state and national rates. These findings are consistent with previous reports of lower cancer preventive care utilization among the uninsured and suggest that insurance status has been a significant barrier to obtaining cancer screenings among our clinic population. Increasing cancer screening rates at student-run clinics may be a cost-effective secondary prevention activity that can decrease cancer mortality. PMID:27046402

  19. 77 FR 51681 - Adjustment of Appendices to the Dairy Tariff-Rate Import Quota Licensing Regulation for the 2012...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-27

    ... 7 CFR Part 6 Adjustment of Appendices to the Dairy Tariff-Rate Import Quota Licensing Regulation for...: This document sets forth the revised appendices to the Dairy Tariff-Rate Import Quota Licensing... for certain dairy product import licenses permanently surrendered by licensees or revoked by...

  20. 78 FR 46491 - Adjustment of Appendices to the Dairy Tariff-Rate Import Quota Licensing Regulation for the 2013...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-01

    ... 7 CFR Part 6 Adjustment of Appendices to the Dairy Tariff-Rate Import Quota Licensing Regulation for...: This document sets forth the revised appendices to the Dairy Tariff-Rate Import Quota Licensing... for certain dairy product import licenses permanently surrendered by licensees or revoked by...

  1. 76 FR 63538 - Adjustment of Appendices to the Dairy Tariff-Rate Import Quota Licensing Regulation for the 2011...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-13

    ... Office of the Secretary 7 CFR Part 6 Adjustment of Appendices to the Dairy Tariff-Rate Import Quota...: Final rule. SUMMARY: This document sets forth the revised appendices to the Dairy Tariff-Rate Import... Appendix 1 to Appendix 2 for certain dairy product import licenses permanently surrendered by licensees...

  2. 75 FR 53565 - Adjustment of Appendices to the Dairy Tariff-Rate Import Quota Licensing Regulation for the 2010...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-01

    ... Secretary 7 CFR Part 6 Adjustment of Appendices to the Dairy Tariff-Rate Import Quota Licensing Regulation...: This document sets forth the revised appendices to the Dairy Tariff-Rate Import Quota Licensing... for certain dairy product import licenses permanently surrendered by licensees or revoked by...

  3. 48 CFR 252.216-7003 - Economic price adjustment-wage rates or material prices controlled by a foreign government.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 3 2013-10-01 2013-10-01 false Economic price adjustment... Economic price adjustment—wage rates or material prices controlled by a foreign government. As prescribed in 216.203-4-70(c)(1), use the following clause: Economic Price Adjustment—Wage Rates or...

  4. 48 CFR 252.216-7003 - Economic price adjustment-wage rates or material prices controlled by a foreign government.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 3 2014-10-01 2014-10-01 false Economic price adjustment... Economic price adjustment—wage rates or material prices controlled by a foreign government. As prescribed in 216.203-4-70(c)(1), use the following clause: Economic Price Adjustment—Wage Rates or...

  5. 48 CFR 252.216-7003 - Economic price adjustment-wage rates or material prices controlled by a foreign government.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 3 2012-10-01 2012-10-01 false Economic price adjustment... Economic price adjustment—wage rates or material prices controlled by a foreign government. As prescribed in 216.203-4-70(c)(1), use the following clause: Economic Price Adjustment—Wage Rates or...

  6. 48 CFR 252.216-7003 - Economic price adjustment-wage rates or material prices controlled by a foreign government.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Economic price adjustment... Economic price adjustment—wage rates or material prices controlled by a foreign government. As prescribed in 216.203-4-70(c), use the following clause: Economic Price Adjustment—Wage Rates or Material...

  7. 48 CFR 252.216-7003 - Economic price adjustment-wage rates or material prices controlled by a foreign government.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 3 2011-10-01 2011-10-01 false Economic price adjustment... Economic price adjustment—wage rates or material prices controlled by a foreign government. As prescribed in 216.203-4-70(c), use the following clause: Economic Price Adjustment—Wage Rates or Material...

  8. 77 FR 66966 - Fiscal Year (FY) 2014-2015 Proposed Power and Transmission Rate Adjustments; Public Hearing and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-08

    ... (BPA or Bonneville), Department of Energy (DOE). ACTIONS: Notice of FY 2014-2015 Proposed Power and Transmission Rate Adjustments. SUMMARY: BPA is holding a consolidated rate proceeding, Docket No. BP- 14, to... Conservation Act (Northwest Power Act) provides that BPA must establish and periodically review and revise...

  9. 76 FR 5811 - Adjusted Federal Medical Assistance Percentage (FMAP) Rate for the First Quarter of Fiscal Year...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-02

    ...This notice provides the adjusted Federal Medical Assistance Percentage (FMAP) rate for the first quarter of Fiscal Year 2011 (FY11) as required under Section 5001 of the American Recovery and Reinvestment Act of 2009 (ARRA). Section 5001 of the ARRA provides for temporary increases in the FMAP rates to provide fiscal relief to states and to protect and maintain state Medicaid and certain......

  10. Colorectal Cancer Rates by Race and Ethnicity

    MedlinePlus

    ... getting colorectal cancer, followed by white, Hispanic, Asian/Pacific Islander (A/PI), and American Indian/Alaska Native ( ... white, Hispanic, American Indian/Alaska Native, and Asian/Pacific Islander women. Sources: CDC’s National Program of Cancer ...

  11. Report to nation finds continued declines in many cancer rates

    Cancer.gov

    Rates of death in the United States from all cancers for men and women continued to decline between 2003 and 2007, the most recent reporting period available, according to the latest Annual Report to the Nation on the Status of Cancer. The report also finds that the overall rate of new cancer diagnoses for men and women combined decreased an average of slightly less than 1 percent per year for the same period.

  12. How Spirituality Helps Cancer Patients with the Adjustment to their Disease.

    PubMed

    Garssen, Bert; Uwland-Sikkema, Nicoline F; Visser, Anja

    2015-08-01

    It has been suggested that spirituality is associated with higher well-being, because it offers social support, improves the relationship with the partner, provides meaning, and reduces self-focus and worry. We performed a qualitative study among ten people with cancer, using the Consensual Qualitative Research method for the analysis of semi-structured interviews. Support was found for the mechanisms of meaning provision and of reduction of self-focus and worries. Participants also mentioned emotion-focused roles of spirituality: Feeling supported by a transcendental confidant, the expression of negative emotions (in prayer), acceptance, allowing feelings of misery, and viewing problems from a distance. There was no mention of a contribution of spirituality to adjustment through improved social support per se or a higher quality of the relationship with the partner. The results of the present study indicate that the role of spirituality in emotion regulation deserves attention in understanding how spirituality helps cancer patients to adjust to their disease. PMID:24748130

  13. Social support and adjustment among wives of men with prostate cancer.

    PubMed

    Gottlieb, Benjamin H; Maitland, Scott B; Brown, Jamie

    2014-01-01

    This study aims to understand how wives' mental health and life enjoyment are affected by their perceptions of the sufficiency of the support they render to their husbands who have prostate cancer. Its specific purpose is to determine whether these outcomes accrue more strongly to wives who perceive their husbands coping in avoidant ways. Drawing on data from an interview study of 51 wives of men diagnosed with prostate cancer, the authors employ heiarchical regression analysis to examine the wives' adjustment in relation to their provision of support to their husbands. Our findings reveal a significant moderating effect of the husbands' avoidant coping; consistent with cognitive dissonance theory, wives who provided sufficient support to more avoidant husbands demonstrated better mental health and life enjoyment than wives of men who were less avoidant. In addition, the perceived sufficiency of the support provided by the wives' social networks had a stronger bearing on their adjustment than the support provided by their husbands. These findings add to our understanding of the psychological benefits that support providers derive when they communicate support in ways that suit the recipient's style of managing threat. PMID:24428249

  14. Use of GRACE determined secular gravity rates for glacial isostatic adjustment studies in North-America

    NASA Astrophysics Data System (ADS)

    van der Wal, Wouter; Wu, Patrick; Sideris, Michael G.; Shum, C. K.

    2008-10-01

    Monthly geopotential spherical harmonic coefficients from the GRACE satellite mission are used to determine their usefulness and limitations for studying glacial isostatic adjustment (GIA) in North-America. Secular gravity rates are estimated by unweighted least-squares estimation using release 4 coefficients from August 2002 to August 2007 provided by the Center for Space Research (CSR), University of Texas. Smoothing is required to suppress short wavelength noise, in addition to filtering to diminish geographically correlated errors, as shown in previous studies. Optimal cut-off degrees and orders are determined for the destriping filter to maximize the signal to noise ratio. The halfwidth of the Gaussian filter is shown to significantly affect the sensitivity of the GRACE data (with respect to upper mantle viscosity and ice loading history). Therefore, the halfwidth should be selected based on the desired sensitivity. It is shown that increase in water storage in an area south west of Hudson Bay, from the summer of 2003 to the summer of 2006, contributes up to half of the maximum estimated gravity rate. Hydrology models differ in the predictions of the secular change in water storage, therefore even 4-year trend estimates are influenced by the uncertainty in water storage changes. Land ice melting in Greenland and Alaska has a non-negligible contribution, up to one-fourth of the maximum gravity rate. The estimated secular gravity rate shows two distinct peaks that can possibly be due to two domes in the former Pleistocene ice cover: west and south east of Hudson Bay. With a limited number of models, a better fit is obtained with models that use the ICE-3G model compared to the ICE-5G model. However, the uncertainty in interannual variations in hydrology models is too large to constrain the ice loading history with the current data span. For future work in which GRACE will be used to constrain ice loading history and the Earth's radial viscosity profile, it is

  15. 42 CFR 422.308 - Adjustments to capitation rates, benchmarks, bids, and payments.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Payments to... years before 2004. (c) Risk adjustment—(1) General rule. CMS will adjust the payment amounts under § 422...) General rule. For 2011 and subsequent years, for purposes of the adjustment under paragraph (c)(1) of...

  16. 76 FR 26324 - Order Making Fiscal Year 2012 Annual Adjustments to Section 31 Fee Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-06

    ... FR 24757 (May 5, 2010). \\7\\ The annual adjustments, as well as the mid-year adjustments required in... Table B. Next, calculate the change in the natural logarithm of ADS from month to month. The average... as t = log (ADS t /ADS t-1 ), where log (x) denotes the natural logarithm of x. 3. Calculate the...

  17. Optimal Strategy for the Integrated Vendor-buyer Inventory Model with Fuzzy Annual Demand and Fuzzy Adjustable Production Rate

    NASA Astrophysics Data System (ADS)

    Yang, M. F.

    In this research we present a stylized model to find the optimal strategy for integrated vendor-buyer inventory model with fuzzy annual demand and fuzzy adjustable production rate. This model with such consideration is based on the total cost optimization under a common stock strategy. However, the supposition of known annual demand and adjustable production rate in most related publications may not be realistic. This paper proposes the triangular fuzzy number of annual demand and adjustable production rate and then employs the signed distance, to find the estimation of the common total cost in the fuzzy sense and derives the corresponding optimal buyer`s quantity consequently and the integer number of lots in which the items are delivered from the vendor to the purchaser. A numerical example is provided and the results of fuzzy and crisp models are compared.

  18. Survival rates of cervical cancer patients in Malaysia.

    PubMed

    Muhamad, Nor Asiah; Kamaluddin, Muhammad Amir; Adon, Mohd Yusoff; Noh, Mohamed Asyraf; Bakhtiar, Mohammed Faizal; Ibrahim Tamim, Nor Saleha; Mahmud, Siti Haniza; Aris, Tahir

    2015-01-01

    Cervical cancer is the most common malignant cancer of the female reproductive organs worldwide. Currently, cervical cancer can be prevented by vaccination and detected at an early stage via various screening methods. Malaysia, as a developing country faces a heavy disease burden of cervical cancer as it is the second most common cancer among Malaysian women. This population based study was carried out to fulfil the primary aim of determining the survival rates of Malaysian women with cervical cancer and associated factors. Data were obtained from two different sources namely, the Malaysian National Cancer Registry (MNCR) and National Health Informatics Centre (NHIC) from 1st January 2000 to 31st December 2005. Kaplan Meier analyses were conducted to identify the overall survival rates and median survival time. Differences in survival among different ethnic and age group were compared using the log-rank test. A total of 5,859 patients were included. The median survival time for cervical cancer in this study was 65.8 months and the 5-year survival rate was 71.1%. The overall observed survival rates at 1, 3 and 5 years were 94.1%, 79.3% and 71.1% respectively. The log-rank test finding also showed that there were significant differences in the 5-year survival rate among different ethnic groups. Malays had the lowest survival rate of 59.2% followed by Indians (69.5%) and Chinese (73.8%). The overall 5-year survival rate among patients with cervical cancer in Malaysia is relatively good. Age and ethnic groups remain as significant determining factors for cervical cancer survival rate. PMID:25854407

  19. Correlation between heart rate variability and pulmonary function adjusted by confounding factors in healthy adults.

    PubMed

    Bianchim, M S; Sperandio, E F; Martinhão, G S; Matheus, A C; Lauria, V T; da Silva, R P; Spadari, R C; Gagliardi, A R T; Arantes, R L; Romiti, M; Dourado, V Z

    2016-03-01

    The autonomic nervous system maintains homeostasis, which is the state of balance in the body. That balance can be determined simply and noninvasively by evaluating heart rate variability (HRV). However, independently of autonomic control of the heart, HRV can be influenced by other factors, such as respiratory parameters. Little is known about the relationship between HRV and spirometric indices. In this study, our objective was to determine whether HRV correlates with spirometric indices in adults without cardiopulmonary disease, considering the main confounders (e.g., smoking and physical inactivity). In a sample of 119 asymptomatic adults (age 20-80 years), we evaluated forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1). We evaluated resting HRV indices within a 5-min window in the middle of a 10-min recording period, thereafter analyzing time and frequency domains. To evaluate daily physical activity, we instructed participants to use a triaxial accelerometer for 7 days. Physical inactivity was defined as <150 min/week of moderate to intense physical activity. We found that FVC and FEV1, respectively, correlated significantly with the following aspects of the RR interval: standard deviation of the RR intervals (r =0.31 and 0.35), low-frequency component (r =0.38 and 0.40), and Poincaré plot SD2 (r =0.34 and 0.36). Multivariate regression analysis, adjusted for age, sex, smoking, physical inactivity, and cardiovascular risk, identified the SD2 and dyslipidemia as independent predictors of FVC and FEV1 (R2=0.125 and 0.180, respectively, for both). We conclude that pulmonary function is influenced by autonomic control of cardiovascular function, independently of the main confounders. PMID:26840706

  20. Evaluating hospital readmission rates in dialysis facilities; adjusting for hospital effects.

    PubMed

    He, Kevin; Kalbfleisch, Jack D; Li, Yijiang; Li, Yi

    2013-10-01

    Motivated by the national evaluation of readmission rates among kidney dialysis facilities in the United States, we evaluate the impact of including discharging hospitals on the estimation of facility-level standardized readmission ratios (SRRs). The estimation of SRRs consists of two steps. First, we model the dependence of readmission events on facilities and patient-level characteristics, with or without an adjustment for discharging hospitals. Second, using results from the models, standardization is achieved by computing the ratio of the number of observed events to the number of expected events assuming a population norm and given the case-mix in that facility. A challenging aspect of our motivating example is that the number of parameters is very large and estimation of high-dimensional parameters is troublesome. To solve this problem, we propose a structured Newton-Raphson algorithm for a logistic fixed effects model and an approximate EM algorithm for the logistic mixed effects model. We consider a re-sampling and simulation technique to obtain p-values for the proposed measures. Finally, our method of identifying outlier facilities involves converting the observed p-values to Z-statistics and using the empirical null distribution, which accounts for overdispersion in the data. The finite-sample properties of proposed measures are examined through simulation studies. The methods developed are applied to national dialysis data. It is our great pleasure to present this paper in honor of Ross Prentice, who has been instrumental in the development of modern methods of modeling and analyzing life history and failure time data, and in the inventive applications of these methods to important national data problem. PMID:23709309

  1. Correlation between heart rate variability and pulmonary function adjusted by confounding factors in healthy adults

    PubMed Central

    Bianchim, M.S.; Sperandio, E.F.; Martinhão, G.S.; Matheus, A.C.; Lauria, V.T.; da Silva, R.P.; Spadari, R.C.; Gagliardi, A.R.T.; Arantes, R.L.; Romiti, M.; Dourado, V.Z.

    2016-01-01

    The autonomic nervous system maintains homeostasis, which is the state of balance in the body. That balance can be determined simply and noninvasively by evaluating heart rate variability (HRV). However, independently of autonomic control of the heart, HRV can be influenced by other factors, such as respiratory parameters. Little is known about the relationship between HRV and spirometric indices. In this study, our objective was to determine whether HRV correlates with spirometric indices in adults without cardiopulmonary disease, considering the main confounders (e.g., smoking and physical inactivity). In a sample of 119 asymptomatic adults (age 20-80 years), we evaluated forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1). We evaluated resting HRV indices within a 5-min window in the middle of a 10-min recording period, thereafter analyzing time and frequency domains. To evaluate daily physical activity, we instructed participants to use a triaxial accelerometer for 7 days. Physical inactivity was defined as <150 min/week of moderate to intense physical activity. We found that FVC and FEV1, respectively, correlated significantly with the following aspects of the RR interval: standard deviation of the RR intervals (r =0.31 and 0.35), low-frequency component (r =0.38 and 0.40), and Poincaré plot SD2 (r =0.34 and 0.36). Multivariate regression analysis, adjusted for age, sex, smoking, physical inactivity, and cardiovascular risk, identified the SD2 and dyslipidemia as independent predictors of FVC and FEV1 (R 2=0.125 and 0.180, respectively, for both). We conclude that pulmonary function is influenced by autonomic control of cardiovascular function, independently of the main confounders. PMID:26840706

  2. Regularized logistic regression with adjusted adaptive elastic net for gene selection in high dimensional cancer classification.

    PubMed

    Algamal, Zakariya Yahya; Lee, Muhammad Hisyam

    2015-12-01

    Cancer classification and gene selection in high-dimensional data have been popular research topics in genetics and molecular biology. Recently, adaptive regularized logistic regression using the elastic net regularization, which is called the adaptive elastic net, has been successfully applied in high-dimensional cancer classification to tackle both estimating the gene coefficients and performing gene selection simultaneously. The adaptive elastic net originally used elastic net estimates as the initial weight, however, using this weight may not be preferable for certain reasons: First, the elastic net estimator is biased in selecting genes. Second, it does not perform well when the pairwise correlations between variables are not high. Adjusted adaptive regularized logistic regression (AAElastic) is proposed to address these issues and encourage grouping effects simultaneously. The real data results indicate that AAElastic is significantly consistent in selecting genes compared to the other three competitor regularization methods. Additionally, the classification performance of AAElastic is comparable to the adaptive elastic net and better than other regularization methods. Thus, we can conclude that AAElastic is a reliable adaptive regularized logistic regression method in the field of high-dimensional cancer classification. PMID:26520484

  3. Prostate Cancer Rates by Race and Ethnicity

    MedlinePlus

    ... P25–1130). For more information, see the USCS technical notes. †Race categories are not mutually exclusive ... with caution. For more information, see the USCS technical notes. ¶ Data are compiled from cancer registries ...

  4. Cervical Cancer Rates by Race and Ethnicity

    MedlinePlus

    ... P25–1130). For more information, see the USCS technical notes. †Race categories are not mutually exclusive ... with caution. For more information, see the USCS technical notes. ¶ Data are compiled from cancer registries ...

  5. Breast Cancer Rates by Race and Ethnicity

    MedlinePlus

    ... P25–1130). For more information, see the USCS technical notes. †Race categories are not mutually exclusive ... with caution. For more information, see the USCS technical notes. ¶ Data are compiled from cancer registries ...

  6. Risk Prediction for Prostate Cancer Recurrence Through Regularized Estimation with Simultaneous Adjustment for Nonlinear Clinical Effects*

    PubMed Central

    Long, Qi; Chung, Matthias; Moreno, Carlos S.; Johnson, Brent A.

    2011-01-01

    In biomedical studies, it is of substantial interest to develop risk prediction scores using high-dimensional data such as gene expression data for clinical endpoints that are subject to censoring. In the presence of well-established clinical risk factors, investigators often prefer a procedure that also adjusts for these clinical variables. While accelerated failure time (AFT) models are a useful tool for the analysis of censored outcome data, it assumes that covariate effects on the logarithm of time-to-event are linear, which is often unrealistic in practice. We propose to build risk prediction scores through regularized rank estimation in partly linear AFT models, where high-dimensional data such as gene expression data are modeled linearly and important clinical variables are modeled nonlinearly using penalized regression splines. We show through simulation studies that our model has better operating characteristics compared to several existing models. In particular, we show that there is a non-negligible effect on prediction as well as feature selection when nonlinear clinical effects are misspecified as linear. This work is motivated by a recent prostate cancer study, where investigators collected gene expression data along with established prognostic clinical variables and the primary endpoint is time to prostate cancer recurrence. We analyzed the prostate cancer data and evaluated prediction performance of several models based on the extended c statistic for censored data, showing that 1) the relationship between the clinical variable, prostate specific antigen, and the prostate cancer recurrence is likely nonlinear, i.e., the time to recurrence decreases as PSA increases and it starts to level off when PSA becomes greater than 11; 2) correct specification of this nonlinear effect improves performance in prediction and feature selection; and 3) addition of gene expression data does not seem to further improve the performance of the resultant risk

  7. 17 CFR Appendix B to Part 4 - Adjustments for Additions and Withdrawals in the Computation of Rate of Return

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Adjustments for Additions and Withdrawals in the Computation of Rate of Return B Appendix B to Part 4 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION COMMODITY POOL OPERATORS AND COMMODITY TRADING ADVISORS Pt. 4, App....

  8. 78 FR 36231 - 60-Day Notice of Proposed Information Collection: FHA-Disclosure of Adjustable Rate Mortgages...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-17

    ... URBAN DEVELOPMENT 60-Day Notice of Proposed Information Collection: FHA--Disclosure of Adjustable Rate... the proposed forms or other available information. Persons with hearing or speech impairments may... speech impairments may access this number through TTY by calling the toll-free Federal Relay Service...

  9. NIH study finds sigmoidoscopy reduces colorectal cancer rates

    Cancer.gov

    Study finds that flexible sigmoidoscopy is effective in reducing the rates of new cases and deaths due to colorectal cancer. Researchers found that overall colorectal cancer mortality was reduced by 26 percent and incidence was reduced by 21 percent as a

  10. Parametric approaches to quality-adjusted survival analysis. International Breast Cancer Study Group.

    PubMed

    Cole, B F; Gelber, R D; Anderson, K M

    1994-09-01

    We present a parametric methodology for performing quality-of-life-adjusted survival analysis using multivariate censored survival data. It represents a generalization of the nonparametric Q-TWiST method (Quality-adjusted Time without Symptoms and Toxicity). The event times correspond to transitions between states of health that differ in terms of quality of life. Each transition is governed by a competing risks model where the health states are the competing risks. Overall survival is the sum of the amount of time spent in each health state. The first step of the proposed methodology consists of defining a quality function that assigns a "score" to a life having given health state transitions. It is a composite measure of both quantity and quality of life. In general, the quality function assigns a small value to a short life with poor quality and a high value to a long life with good quality. In the second step, parametric survival models are fit to the data. This is done by repeatedly modeling the conditional cause-specific hazard functions given the previous transitions. Covariates are incorporated by accelerated failure time regression, and the model parameters are estimated by maximum likelihood. Lastly, the modeling results are used to estimate the expectation of quality functions. Standard errors and confidence intervals are computed using the bootstrap and delta methods. The results are useful for simultaneously evaluating treatments in terms of quantity and quality of life. To demonstrate the proposed methods, we perform an analysis of data from the International Breast Cancer Study Group Trial V, which compared short-duration chemotherapy versus long-duration chemotherapy in the treatment of node-positive breast cancer. The events studied are: (1) the end of treatment toxicity, (2) disease recurrence, and (3) overall survival. PMID:7981389

  11. Promoting adjustment among women with breast cancer and their partners: a program of research.

    PubMed

    Hoskins, C N

    2001-01-01

    A three-phase program of research consisted of: (1) data collection at eight data points across one year on predictors and outcomes of adjustment among 128 women diagnosed with breast cancer and 121 partners; (2) development of phase-specific interventions: standardized education by videotape (SE), and telephone counseling (TC); and (3) a pilot study among 12 patient-partner pairs. Four phases were identified: diagnostic, post-surgical, adjuvant therapy, and ongoing recovery. Needs were categorized as those related to: (1) physical well-being, (2) emotional well-being; (3) support; and (4) the healthcare system. In the pilot study, each group consisted of 4 patient-partner pairs, randomly assigned to one of four groups. At each of the four phases, all groups received the currently accepted disease management (DM). Group 1: DM * Group 2: DM+SE * Group 3: DM+TC * Group 4: DM+SE+TC. Measures of outcomes validated in the longitudinal study were administered. The feasibility of a confirmatory randomized clinical trial was demonstrated. Preliminary evidence indicates the importance of research-based, phase-specific educational and counseling interventions that have a positive effect on adjustment among both patients and their families. PMID:16052904

  12. Risk adjusting community rated health plan premiums: a survey of risk assessment literature and policy applications.

    PubMed

    Giacomini, M; Luft, H S; Robinson, J C

    1995-01-01

    This paper surveys recent health care reform debates and empirical evidence regarding the potential role for risk adjusters in addressing the problem of competitive risk segmentation under capitated financing. We discuss features of health plan markets affecting risk selection, methodological considerations in measuring it, and alternative approaches to financial correction for risk differentials. The appropriate approach to assessing risk differences between health plans depends upon the nature of market risk selection allowed under a given reform scenario. Because per capita costs depend on a health plan's population risk, efficiency, and quality of service, risk adjustment will most strongly promote efficiency in environments with commensurately strong incentives for quality care. PMID:7639879

  13. Greater Heart Rate Responses to Acute Stress Are Associated with Better Post-Error Adjustment in Special Police Cadets.

    PubMed

    Yao, Zhuxi; Yuan, Yi; Buchanan, Tony W; Zhang, Kan; Zhang, Liang; Wu, Jianhui

    2016-01-01

    High-stress jobs require both appropriate physiological regulation and behavioral adjustment to meet the demands of emergencies. Here, we investigated the relationship between the autonomic stress response and behavioral adjustment after errors in special police cadets. Sixty-eight healthy male special police cadets were randomly assigned to perform a first-time walk on an aerial rope bridge to induce stress responses or a walk on a cushion on the ground serving as a control condition. Subsequently, the participants completed a Go/No-go task to assess behavioral adjustment after false alarm responses. Heart rate measurements and subjective reports confirmed that stress responses were successfully elicited by the aerial rope bridge task in the stress group. In addition, greater heart rate increases during the rope bridge task were positively correlated with post-error slowing and had a trend of negative correlation with post-error miss rate increase in the subsequent Go/No-go task. These results suggested that stronger autonomic stress responses are related to better post-error adjustment under acute stress in this highly selected population and demonstrate that, under certain conditions, individuals with high-stress jobs might show cognitive benefits from a stronger physiological stress response. PMID:27428280

  14. Greater Heart Rate Responses to Acute Stress Are Associated with Better Post-Error Adjustment in Special Police Cadets

    PubMed Central

    Yao, Zhuxi; Yuan, Yi; Buchanan, Tony W.; Zhang, Kan; Zhang, Liang; Wu, Jianhui

    2016-01-01

    High-stress jobs require both appropriate physiological regulation and behavioral adjustment to meet the demands of emergencies. Here, we investigated the relationship between the autonomic stress response and behavioral adjustment after errors in special police cadets. Sixty-eight healthy male special police cadets were randomly assigned to perform a first-time walk on an aerial rope bridge to induce stress responses or a walk on a cushion on the ground serving as a control condition. Subsequently, the participants completed a Go/No-go task to assess behavioral adjustment after false alarm responses. Heart rate measurements and subjective reports confirmed that stress responses were successfully elicited by the aerial rope bridge task in the stress group. In addition, greater heart rate increases during the rope bridge task were positively correlated with post-error slowing and had a trend of negative correlation with post-error miss rate increase in the subsequent Go/No-go task. These results suggested that stronger autonomic stress responses are related to better post-error adjustment under acute stress in this highly selected population and demonstrate that, under certain conditions, individuals with high-stress jobs might show cognitive benefits from a stronger physiological stress response. PMID:27428280

  15. 76 FR 57992 - Assessment Rate Adjustment Guidelines for Large and Highly Complex Institutions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-19

    ... scoring range Core ROA 0 0 2 2.08 4 Tier 1 Capital Ratio 0 6 13 17 57 Before initiating an adjustment... 100. Table 4 shows that Bank B's Criticized and Classified Items to Tier 1 Capital and Reserves ratio... and quality of capital protection may not be correctly reflected in the Tier 1 leverage ratio...

  16. Launch-rated kinematic mirror mount with six-degree-of-freedom adjustments

    NASA Astrophysics Data System (ADS)

    Sawyer, Kevin A.; Hurley, Barbara N.; Brindos, Raymond R.; Wong, James

    1999-09-01

    A kinematic, fully adjustable, six degree-of-freedom mirror mount has been developed for a space-based optical system. The optics vary in size from five inches to 10-inches and weigh up to 1.75 Kg. Many of the optics require multiple degrees-of-freedom for alignment and all elements need to be held to micron tolerances during orbit. The mount design described herein provides three-axis linear motions of at least three millimeters and multiple degrees of tilt. Each mount weighs approximately the same as its optic and exhibits gravity deflections less than .0002 radian. Natural frequencies for even the largest mirror mounts in the system are greater than 100 Hz. A unique feature of the mount design is the ability to easily adjust the mirror from behind without the need for complex jigs or tooling. The mirror mount is entirely self contained and is mechanically locked after final adjustments are made. A motion algorithm based on hexapod simulator control laws has been adopted to calculate the leg adjustments required to perform the mirror motions of tip, tilt, yaw, focus, and the two lateral shifts.

  17. Secondary traumatization and self-rated health among wives of former prisoners of war: the moderating role of marital adjustment.

    PubMed

    Zerach, Gadi; Greene, Talya; Solomon, Zahava

    2015-02-01

    We investigated the relationships between secondary traumatization, marital adjustment, and self-rated health among wives of former prisoners of war. Participants were Israeli wives of former prisoners of war (N = 116) and a matched control group of wives of combat veterans (N = 56). Wives of former prisoners of war reported worse self-rated health compared to the control group of wives of combat veterans. Wives of former prisoners of war also reported higher levels of secondary traumatization, and marital adjustment moderated the relationship between wives' secondary traumatization and their general health. The experience of living with former prisoners of war who might also suffer from posttraumatic stress disorder is associated with wives' own psychological and self-rated health outcomes. PMID:24058125

  18. QuickStats: Age-Adjusted Death Rates* for Males Aged 15-44 Years, by the Five Leading Causes of Death(†) - United States, 1999 and 2014.

    PubMed

    2016-01-01

    The age-adjusted death rate for males aged 15-44 years was 10% lower in 2014 (156.6 per 100,000 population) than in 1999 (174.1). Among the five leading causes of death, the age-adjusted rates for three were lower in 2014 than in 1999: cancer (from 17.1 to 12.8; 25% decline), heart disease (20.1 to 17.0; 15% decline), and homicide (15.7 to 13.8; 12% decline). The age-adjusted death rates for two of the five causes were higher in 2014 than in 1999: suicide (20.1 to 22.5; 12% increase), and unintentional injuries (from 48.7 to 51.0; 5% increase). PMID:27513718

  19. 42 CFR 484.220 - Calculation of the adjusted national prospective 60-day episode payment rate for case-mix and...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...-day episode payment rate for case-mix and area wage levels. 484.220 Section 484.220 Public Health... Calculation of the adjusted national prospective 60-day episode payment rate for case-mix and area wage levels. CMS adjusts the national prospective 60-day episode payment rate to account for the following: (a)...

  20. Meaning Making and Psychological Adjustment following Cancer: The Mediating Roles of Growth, Life Meaning, and Restored Just-World Beliefs

    ERIC Educational Resources Information Center

    Park, Crystal L.; Edmondson, Donald; Fenster, Juliane R.; Blank, Thomas O.

    2008-01-01

    Cancer survivors' efforts at meaning making may influence the extent to which they successfully make meaning from their experience (i.e., experience posttraumatic growth, find life meaningful, and restore beliefs in a just world), which may, in turn, influence their psychological adjustment. Previous research regarding both meaning making…

  1. Standardization of the Korean version of Mini-Mental Adjustment to Cancer (K-Mini-MAC) scale: factor structure, reliability and validity.

    PubMed

    Kang, Jee In; Chung, Hyun Cheol; Kim, Se Joo; Choi, Hye Jin; Ahn, Joong Bae; Jeung, Hei-Cheul; Namkoong, Kee

    2008-06-01

    Mental adjustment and coping affect the physical outcome and survival as well as quality of life in cancer patients. The Mini-Mental Adjustment to Cancer (Mini-MAC) scale is a new refined, economical and reliable self-rating instrument measuring cognitive and behavioral responses to cancer. The aim of this study was to evaluate the psychometric properties of the Mini-MAC in Korean cancer patients. A total of 208 cancer patients recruited from the Yonsei Cancer Center were assessed with the Mini-MAC and the Hospital Anxiety and Depression Scale (HADS). Principal component analysis with varimax rotation for the Korean version of Mini-MAC (K-Mini-MAC) confirmed four factors. Three had psychometric properties similar to Helpless-Hopeless (HH), Anxious Preoccupation (AP) and Cognitive Avoidance (CA) of the original Mini-MAC. A novel factor, named Positive Attitude, included items of both Fatalism (FA) and Fighting Spirit (FS) from the original version. The five subscales from the original version (AP, HH, FS, FA and CA) and Positive Attitude had acceptable internal reliabilities in our sample (Cronbach's alpha coefficient 0.50-0.86; correlation coefficient of test-retest 0.68-0.88). For the validity, significant interscale correlation was observed in the original five subscales and Positive Attitude. Each subscale including Positive Attitude was also significantly related to Depression and Anxiety of HADS. As a whole, the K-Mini-MAC was a reliable, valid and acceptable tool for Korean cancer patients. These findings can provide information about the cross-cultural validity of Mini-MAC scale's factor structure. Cultural differences were also discussed. PMID:17957732

  2. Changing Rates for Liver and Lung Cancer in Qidong, China

    PubMed Central

    Chen, Jian-Guo; Kensler, Thomas W.

    2013-01-01

    Residents of Qidong, China are undergoing a rapid fluctuation in cancer incidence rates at many organ sites, reflecting a dynamic interplay of socio-behavioral, economic and environmental factors. This Perspective On Statistical Trends examines the China age-standardized incidence rates (CASR), as tracked by the Qidong Cancer Registry for the past 40 years, for the two leading cancer killers in Qidong, liver and lung. Both cancer types are strongly influenced by environmental factors. The CASR for liver cancer has dropped nearly 50% in the last 4 decades, in part from access to deep-well drinking water in the 1970s with consequent diminished exposure to tumor promoting microcystins produced by blue-green algae. There have also been substantive reductions in exposures to dietary aflatoxins, as economic reform in the mid-1980s fostered a wholesale change in dietary staple from maize to rice. In men, lung cancer CASR has trebled over this period, likely driven by a high prevalence of smokers (~65%) and an ever increasing smoking frequency in this population. Qidong women, by contrast, rarely smoke and have exhibited a flat CASR until the last decade where lung cancer rates have now doubled. This upturn may reflect an increasing burden of indoor and outdoor air pollution. PMID:24215631

  3. Changing rates for liver and lung cancers in Qidong, China.

    PubMed

    Chen, Jian-Guo; Kensler, Thomas W

    2014-01-21

    Residents of Qidong, China are undergoing a rapid fluctuation in cancer incidence rates at many organ sites, reflecting a dynamic interplay of socio-behavioral, economic, and environmental factors. This Perspective On Statistical Trends examines the China age-standardized incidence rates (CASR), as tracked by the Qidong Cancer Registry for the past 40 years, for the two leading cancer killers in Qidong, liver and lung. Both cancer types are strongly influenced by environmental factors. The CASR for liver cancer has dropped nearly 50% in the last 4 decades, in part from access to deep-well drinking water in the 1970s with consequent diminished exposure to tumor promoting microcystins produced by blue-green algae. There have also been substantive reductions in exposures to dietary aflatoxins, as economic reform in the mid-1980s fostered a wholesale change in dietary staple from maize to rice. In men, lung cancer CASR has trebled over this period, likely driven by a high prevalence of smokers (∼65%) and an ever increasing smoking frequency in this population. Qidong women, by contrast, rarely smoke and have exhibited a flat CASR until the past decade where lung cancer rates have now doubled. This upturn may reflect an increasing burden of indoor and outdoor air pollution. PMID:24215631

  4. Age, Race and Regional Disparities in Colorectal Cancer Incidence Rates in Georgia between 2000 and 2012

    PubMed Central

    Yoo, Wonsuk; De, Subhendu; Wilkins, Thad; Smith, Selina A.; Blumenthal, Daniel

    2016-01-01

    Colorectal cancer (CRC) incidence rates and mortality have been decreasing in the United States. Currently, states in the South have the smallest reduction in CRC mortality. The trends of CRC incidence rates in Georgia in comparison to the United States have not been investigated. We analyzed age-adjusted incidence rates of CRC in Georgia and the United States from 2000 to 2012 using data from SEER 18 registries. Age-adjusted incidence rates (95% CI) were calculated as cases per 100,000 to the 2000 US Standard population. CRC incidence rates were calculated for groupings based on age at time of diagnosis, race, sex, and geographic location within Georgia. Incidence rates were higher in males compared to females in Georgia. In Georgians age 50–64, incidence rates were higher compared to the US, while those ages 65+ displayed lower incidence rates. Black Georgians age 50–64 generally exhibited higher incidence rates of CRC and lower rates of decrease in incidence compared to other races in Georgia. Asian/Pacific Islander females age 50–64 in Georgia exhibited an increasing trend in incidence rate. Whites and blacks Georgians age 50–64 displayed higher incidence rates compared to the US, while Asian/Pacific Islanders displayed lower incidence rates. Greater incidence rates of CRC in rural and Greater Georgia were seen across all races when compared to overall rates in Georgia. Efforts should be made to address disparities in Georgia based on race and geographic location. Increased screening by colonoscopy or fecal occult blood testing, reduction of risk factors and promotion of healthy lifestyles can reduce CRC incidence rates. PMID:27042701

  5. Resting heart rate as a prognostic factor for mortality in patients with breast cancer.

    PubMed

    Lee, Dong Hoon; Park, Seho; Lim, Sung Mook; Lee, Mi Kyung; Giovannucci, Edward L; Kim, Joo Heung; Kim, Seung Il; Jeon, Justin Y

    2016-09-01

    Although elevated resting heart rate (RHR) has been shown to be associated with mortality in the general population and patients with certain diseases, no study has examined this association in patients with breast cancer. A total of 4786 patients with stage I-III breast cancer were retrospectively selected from the Severance hospital breast cancer registry in Seoul, Korea. RHR was measured at baseline and the mean follow-up time for all patients was 5.0 ± 2.5 years. Hazard ratios (HRs) with 95 % confidence intervals (CIs) were calculated using Cox regression models. After adjustment for prognostic factors, patients in the highest quintile of RHR (≥85 beat per minute (bpm)) had a significantly higher risk of all-cause mortality (HR: 1.57; 95 %CI 1.05-2.35), breast cancer-specific mortality (HR: 1.69; 95 %CI 1.07-2.68), and cancer recurrence (HR: 1.49; 95 %CI 0.99-2.25), compared to those in the lowest quintile (≤67 bpm). Moreover, every 10 bpm increase in RHR was associated with 15, 22, and 6 % increased risk of all-cause mortality, breast cancer-specific mortality, and cancer recurrence, respectively. However, the association between RHR and cancer recurrence was not statistically significant (p = 0.26). Elevated RHR was associated with an increased risk of mortality in patients with breast cancer. The findings from this study suggest that RHR may be used as a prognostic factor for patients with breast cancer in clinical settings. PMID:27544225

  6. Impact of work-related cancers in Taiwan-Estimation with QALY (quality-adjusted life year) and healthcare costs.

    PubMed

    Lee, Lukas Jyuhn-Hsiarn; Lin, Cheng-Kuan; Hung, Mei-Chuan; Wang, Jung-Der

    2016-12-01

    This study estimates the annual numbers of eight work-related cancers, total losses of quality-adjusted life years (QALYs), and lifetime healthcare expenditures that possibly could be saved by improving occupational health in Taiwan. Three databases were interlinked: the Taiwan Cancer Registry, the National Mortality Registry, and the National Health Insurance Research Database. Annual numbers of work-related cancers were estimated based on attributable fractions (AFs) abstracted from a literature review. The survival functions for eight cancers were estimated and extrapolated to lifetime using a semi-parametric method. A convenience sample of 8846 measurements of patients' quality of life with EQ-5D was collected for utility values and multiplied by survival functions to estimate quality-adjusted life expectancies (QALEs). The loss-of-QALE was obtained by subtracting the QALE of cancer from age- and sex-matched referents simulated from national vital statistics. The lifetime healthcare expenditures were estimated by multiplying the survival probability with mean monthly costs paid by the National Health Insurance for cancer diagnosis and treatment and summing this for the expected lifetime. A total of 3010 males and 726 females with eight work-related cancers were estimated in 2010. Among them, lung cancer ranked first in terms of QALY loss, with an annual total loss-of-QALE of 28,463 QALYs and total lifetime healthcare expenditures of US$36.6 million. Successful prevention of eight work-related cancers would not only avoid the occurrence of 3736 cases of cancer, but would also save more than US$70 million in healthcare costs and 46,750 QALYs for the Taiwan society in 2010. PMID:27413666

  7. Parent-youth discrepancies in ratings of youth victimization: associations with psychological adjustment.

    PubMed

    Goodman, Kimberly

    2013-01-01

    This study extends research examining the implications of parent-youth informant discrepancies on youth victimization. Latent class analysis (LCA) identified dyads distinguished by patterns of parent and youth report of victimization. Analyses examined how latent classes were related to adjustment (i.e., anxiety/depression, aggression, and delinquency) concurrently and at follow-up assessment (~2.5 years) in a socioeconomically and ethnically diverse sample. Participants were 485 youths (58.1% male; M age = 12.83 years, SD = 1.60) and their primary caregivers from the Project on Human Development in Chicago Neighborhoods. This study compared three classes of youths: (a) Parent > Youth (24.0%), (b) Youth > Parent (21.5%), and (c) Relative Agreement (54.5%). Findings did not support the hypothesis that groups reflecting parental underreporting of youth victimization experiences would show poor adjustment relative to all other classes longitudinally. Surprisingly, youths who self-reported lower levels of victimization than parents reported were at risk for maladjustment over time. This type of discrepant dyad may deserve more careful attention than previously considered in the literature. PMID:23330621

  8. An ecological study of cancer mortality rates in California, 1950–64, with respect to solar UVB and smoking indices

    PubMed Central

    2012-01-01

    Purpose: This paper addresses whether nonmelanoma skin cancer (NMSC) mortality rates can serve as a useful index of population ultraviolet-B (UVB) irradiance and vitamin D production in a manner that affects the risk of internal cancers Methods: This analysis uses the ecological study approach with cancer mortality rate data from 19 state economic areas in California. This paper uses age-adjusted data for those aged 40 y or older. Two additional indices for solar UVB doses were also used: latitude and surface UVB doses for July 1992 from the total ozone mapping spectrometer. Lung cancer mortality rates served as the index of the health effects of smoking Results: Significant inverse correlations with NMSC mortality rate in multiple linear regression analyses were found during the period 1950–64 for eight types of cancer for males: bladder, brain, colon, gastric, prostate, and rectal cancer; multiple myeloma; and non-Hodgkin lymphoma. No similar results emerged for females with respect to all three UVB indices. Their NMSC mortality rates averaged 60% lower than those for males. Lung cancer mortality rates were directly correlated with three types of cancer for males: laryngeal, oral, and renal. No significant correlations with NMSC mortality rates appeared for later periods Conclusions: NMSC mortality rates were found inversely correlated with internal cancers for males in the period 1950–64. After that period, no further such correlations were found. The reasons may hypothetically include reduced NMSC mortality rates, high immigration rates, movement from rural to urban locations and reduced solar UVB irradiance. PMID:22928074

  9. 75 FR 78690 - Fiscal Year (FY) 2012-2013 Proposed Transmission Rate Adjustments Public Hearing and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-16

    ...BPA is holding a consolidated rate proceeding, Docket No. BP- 12, to establish power and transmission rates for FY 2012-2013. The purpose of this Federal Register Notice is to provide notice of the proposed rates for transmission and for the two required ancillary services (listed below, part IV.C.). BPA has previously issued a separate Federal Register Notice to provide notice of the proposed......

  10. 75 FR 7580 - Proposed Rate Adjustment for Kerr-Philpott System

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-22

    ... and approved Rate Schedules VA-1-A, VA-2-A, VA-3-A, VA-4-A, CP&L-1-A, CP&L-2-A, CP&L-3-A, CP&L-4-A, AP... arrangement with the Government and for providing a transmission arrangement. Rate Schedule CP&L-1-B Available... Carolinas). Rate Schedule CP&L-2-B Available to public bodies and cooperatives in North Carolina to...

  11. Comparing Trends in Cancer Rates Across Overlapping Regions

    PubMed Central

    Li, Yi; Tiwari, Ram C.

    2008-01-01

    Monitoring and comparing trends in cancer rates across geographic regions or over different time periods has been one main task of the National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results (SEER) Program as it profiles health care quality as well as decides health care resource allocations within a spatial-temporal framework. A fundamental difficulty, however, arises when such comparisons have to be made for regions or time intervals that overlap, e.g. comparing the change in trends of mortality rates in a local area (e.g. the mortality rate of Breast Cancer in California) with a more global level (i.e. the national mortality rate of Breast Cancer). In view of sparsity of available methodologies, this paper develops a simple corrected Z-test that accounts for such overlapping. The performance of the proposed test over the two-sample “pooled” t-test that assumes independence across comparison groups is assessed via the Pitman asymptotic relative efficiency as well as Monte Carlo simulations and applications to the SEER cancer data. The proposed test will be important for the SEER*STAT software, maintained by the NCI, for the analysis of the SEER data. PMID:18371122

  12. A Cross-Cultural Comparison of Teacher Ratings of Child Adjustment and Behavioral Problems

    ERIC Educational Resources Information Center

    Rowe, Ellen W.; Rivers, Lanee; Kamphaus, Randy W.

    2013-01-01

    This study examines similarities and differences in teacher ratings of behavioral problems and adaptive skills between a sample of 320 students from Anguilla, BWI and 315 children from the United States of America using the Behavior Assessment System for Children (BASC; Reynolds & Kamphaus, 1992). The study also compared teacher ratings of…

  13. 75 FR 53198 - Rate Adjustment for the Satellite Carrier Compulsory License

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-31

    ... (collectively, the ``Copyright Owners'') and DIRECTV, Inc., DISH Network, LLC, and National Programming Service... rates in the Federal Register. 75 FR 39891 (July 13, 2010). Section 119(c)(1)(D)(ii)(III) provides that... proposed rates as published on July 13, 2010. See 75 FR 39891. List of Subjects in 37 CFR Part...

  14. Childhood cancer incidence rates and hazardous air pollutants in California: an exploratory analysis.

    PubMed Central

    Reynolds, Peggy; Von Behren, Julie; Gunier, Robert B; Goldberg, Debbie E; Hertz, Andrew; Smith, Daniel F

    2003-01-01

    Hazardous air pollutants (HAPs) are compounds shown to cause cancer or other adverse health effects. We analyzed population-based childhood cancer incidence rates in California (USA) from 1988 to 1994, by HAP exposure scores, for all California census tracts. For each census tract, we calculated exposure scores by combining cancer potency factors with outdoor HAP concentrations modeled by the U.S. Environmental Protection Agency. We evaluated the relationship between childhood cancer rates and exposure scores for 25 potentially carcinogenic HAPs emitted from mobile, area, and point sources and from all sources combined. Our study period saw 7,143 newly diagnosed cancer cases in California; of these, 6,989 (97.8%) could be assigned to census tracts and included in our analysis. Using Poisson regression, we estimated rate ratios (RRs) adjusted for age, race/ethnicity, and sex. We found little evidence for elevated cancer RRs for all sites or for gliomas among children living in high-ranking combined-source exposure areas. We found elevated RRs and a significant trend with increasing exposure level for childhood leukemia in tracts ranked highest for exposure to the combined group of 25 HAPs (RR = 1.21; 95% confidence interval, 1.03, 1.42) and in tracts ranked highest for point-source HAP exposure (RR = 1.32; 95% confidence interval, 1.11, 1.57). Our findings suggest an association between increased childhood leukemia rates and high HAP exposure, but studies involving more comprehensive exposure assessment and individual-level exposure data will be important for elucidating this relationship. PMID:12676632

  15. Adjustments of ejaculation rates in response to risk of sperm competition in a fish, the bitterling (Rhodeus sericeus).

    PubMed Central

    Candolin, Ulrika; Reynolds, John D

    2002-01-01

    Game theory models of sperm competition predict that within species, males should increase their sperm expenditure when they have one competitor, but decrease expenditure with increasing numbers of competitors. So far, there have been few tests or support for this prediction. Here, we show that males of a freshwater fish, the European bitterling, Rhodeus sericeus, do indeed adjust their ejaculation rate to the number of male competitors by first increasing and then decreasing their ejaculation rates as the number of competitors increases. However, this occurred only under restricted conditions. Specifically, the prediction was upheld as long as no female had deposited eggs in the live mussels that are used as spawning sites. After one or more females had spawned, males did not decrease their ejaculation rates with the number of competitors, but instead they became more aggressive. This indicates that decreased ejaculation rate and increased aggression are alternative responses to increased risk of sperm competition. PMID:12184824

  16. Comparison of hurricane exposure methods and associations with county fetal death rates, adjusting for environmental quality

    EPA Science Inventory

    Adverse effects of hurricanes are increasing as coastal populations grow and events become more severe. Hurricane exposure during pregnancy can influence fetal death rates through mechanisms related to healthcare, infrastructure disruption, nutrition, and injury. Estimation of hu...

  17. Improving cervical cancer screening rates in an urban HIV clinic

    PubMed Central

    Cross, Sara L.; Suharwardy, Sanaa H.; Bodavula, Phani; Schechtman, Kenneth; Overton, E. Turner; Onen, Nur F.; Lane, Michael A.

    2014-01-01

    HIV-infected women are at increased risk of invasive cervical cancer, however screening rates remain low. The objectives of this study were to analyze a quality improvement intervention to increase cervical cancer screening rates in an urban academic HIV clinic and to identify factors associated with inadequate screening. Barriers to screening were identified by a multi-disciplinary quality improvement committee at the Washington University Infectious Diseases clinic. Several strategies were developed to address these barriers. The years pre- and post-implementation were analyzed to examine the clinical impact of the intervention. A total of 422 women were seen in both the pre-implementation and post-implementation periods. In the pre-implementation period, 222 women (53%) underwent cervical cancer screening in the form of Papanicolaou (Pap) testing. In the post-implementation period, 318 women (75.3%) underwent cervical cancer screening (p<0.01). Factors associated with lack of screening included fewer visits attended (pre: 4.2 ± 1.5; post: 3.4 ± 1.4; p<0.01). A multidisciplinary quality improvement intervention was successful in overcoming barriers and increasing cervical cancer screening rates in an urban academic HIV clinic. PMID:24625234

  18. Esophageal cancer epidemiology in blacks and whites: racial and gender disparities in incidence, mortality, survival rates and histology.

    PubMed Central

    Baquet, Claudia R.; Commiskey, Patricia; Mack, Kelly; Meltzer, Stephen; Mishra, Shiraz I.

    2005-01-01

    BACKGROUND: Esophageal cancer rate disparities are pronounced for blacks and whites. This study presents black-white esophageal cancer incidence, mortality, relative survival rates, histology and trends for two five-year time periods--1991-1995 and 1996-2000--and for the time period 1991-2000. METHODS: The study used data from the National Cancer Institute's population-based Surveillance Epidemiology End Results (SEER) program with submission dates 1991-2000. Age-adjusted incidence, mortality, relative survival rates and histology for esophageal carcinoma were calculated for nine SEER cancer registries for 1991-2000. Rates were analyzed by race and gender for changes over specified time periods. RESULTS: Esophageal cancer age-adjusted incidence of blacks was about twice that of whites (8.63 vs. 4.39/100,000, p < 0.05). Age-adjusted mortality for blacks, although showing a declining trend, was nearly twice that of whites (7.79 vs. 3.96, p < 0.05). Although survival was poor for all groups, it was significantly poorer in blacks than in whites. Squamous cell carcinoma was more commonly diagnosed in blacks and white females, whereas adenocarcinoma was more common among white males (p < 0.001). CONCLUSIONS: Racial disparities in esophageal cancer incidence, mortality, survival and histology exist. Survival rates from this disease have not significantly improved over the decade. These data support the need for advances in prevention, early detection biomarker research and research on new, more effective treatment modalities for this disease. Images Figure 1 PMID:16334494

  19. Using a detailed uncertainty analysis to adjust mapped rates of forest disturbance derived from Landsat time series data (Invited)

    NASA Astrophysics Data System (ADS)

    Cohen, W. B.; Yang, Z.; Stehman, S.; Huang, C.; Healey, S. P.

    2013-12-01

    Forest ecosystem process models require spatially and temporally detailed disturbance data to accurately predict fluxes of carbon or changes in biodiversity over time. A variety of new mapping algorithms using dense Landsat time series show great promise for providing disturbance characterizations at an annual time step. These algorithms provide unprecedented detail with respect to timing, magnitude, and duration of individual disturbance events, and causal agent. But all maps have error and disturbance maps in particular can have significant omission error because many disturbances are relatively subtle. Because disturbance, although ubiquitous, can be a relatively rare event spatially in any given year, omission errors can have a great impact on mapped rates. Using a high quality reference disturbance dataset, it is possible to not only characterize map errors but also to adjust mapped disturbance rates to provide unbiased rate estimates with confidence intervals. We present results from a national-level disturbance mapping project (the North American Forest Dynamics project) based on the Vegetation Change Tracker (VCT) with annual Landsat time series and uncertainty analyses that consist of three basic components: response design, statistical design, and analyses. The response design describes the reference data collection, in terms of the tool used (TimeSync), a formal description of interpretations, and the approach for data collection. The statistical design defines the selection of plot samples to be interpreted, whether stratification is used, and the sample size. Analyses involve derivation of standard agreement matrices between the map and the reference data, and use of inclusion probabilities and post-stratification to adjust mapped disturbance rates. Because for NAFD we use annual time series, both mapped and adjusted rates are provided at an annual time step from ~1985-present. Preliminary evaluations indicate that VCT captures most of the higher

  20. Automatic learning rate adjustment for self-supervising autonomous robot control

    NASA Technical Reports Server (NTRS)

    Arras, Michael K.; Protzel, Peter W.; Palumbo, Daniel L.

    1992-01-01

    Described is an application in which an Artificial Neural Network (ANN) controls the positioning of a robot arm with five degrees of freedom by using visual feedback provided by two cameras. This application and the specific ANN model, local liner maps, are based on the work of Ritter, Martinetz, and Schulten. We extended their approach by generating a filtered, average positioning error from the continuous camera feedback and by coupling the learning rate to this error. When the network learns to position the arm, the positioning error decreases and so does the learning rate until the system stabilizes at a minimum error and learning rate. This abolishes the need for a predetermined cooling schedule. The automatic cooling procedure results in a closed loop control with no distinction between a learning phase and a production phase. If the positioning error suddenly starts to increase due to an internal failure such as a broken joint, or an environmental change such as a camera moving, the learning rate increases accordingly. Thus, learning is automatically activated and the network adapts to the new condition after which the error decreases again and learning is 'shut off'. The automatic cooling is therefore a prerequisite for the autonomy and the fault tolerance of the system.

  1. 77 FR 29259 - Adjustment of Determination of Compulsory License Rates for Mechanical and Digital Phonorecords

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-17

    ... the section 115 license on January 9, 2006, 71 FR 1454, and their final determination of said rates and terms was published in the Federal Register on January 26, 2009. 74 FR 4510. Therefore, the next.... 76 FR 590 (January 5, 2011). Petitions to Participate were received from: Microsoft...

  2. 78 FR 67938 - Adjustment of Determination of Compulsory License Rates for Mechanical and Digital Phonorecords

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-13

    ...The Copyright Royalty Judges are publishing final regulations setting the rates and terms for the section 115 statutory license for the use of musical works in physical phonorecord deliveries, permanent digital downloads, ringtones, interactive streaming, limited downloads, limited offerings, mixed service bundles, music bundles, paid locker services, and purchased content locker...

  3. Work Adjustment Theory: An Empirical Test Using a Fuzzy Rating Scale.

    ERIC Educational Resources Information Center

    Hesketh, Beryl; And Others

    1992-01-01

    A fuzzy graphic rating scale elicited work preferences and job perceptions of 166 (of 170) Australian bank employees. Correspondence between preferences and perceptions correlated significantly with job satisfaction. Satisfaction and performance related to tenure intentions; this relation was higher for poorer performers. (SK)

  4. 77 FR 45539 - Great Lakes Pilotage Rates-2013 Annual Review and Adjustment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-01

    ... FR 3316). D. Public Meeting We do not now plan to hold a public meeting. But you may submit a request.... Abbreviations AMOU American Maritime Officers Union CFR Code of Federal Regulations CPI Consumer Price Index FR... full ratemaking established the current base rates in 2012 (Final Rule, 77 FR 11752, February 28,...

  5. 5 CFR 9701.334 - Setting and adjusting locality and special rate supplements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... special rate supplements. 9701.334 Section 9701.334 Administrative Personnel DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM (DEPARTMENT OF HOMELAND SECURITY-OFFICE OF PERSONNEL MANAGEMENT) DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Locality...

  6. 78 FR 48374 - Great Lakes Pilotage Rates-2014 Annual Review and Adjustment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-08

    ..., 2008 issue of the Federal Register (73 FR 3316). D. Public Meeting We do not now plan to hold a public.... Executive Order FR Federal Register GLPAC Great Lakes Pilotage Advisory Committee MISLE Marine Information... base rates in 2013 (78 FR 13521; Feb. 28, 2013). Among other things, the Appendix A...

  7. Validation and adjustment of the mathematical prediction model for human sweat rate responses to outdoor environmental conditions.

    PubMed

    Shapiro, Y; Moran, D; Epstein, Y; Stroschein, L; Pandolf, K B

    1995-05-01

    Under outdoor conditions this model was over estimating sweat loss response in shaded (low solar radiation) environments, and underestimating the response when solar radiation was high (open field areas). The present study was conducted in order to adjust the model to be applicable under outdoor environmental conditions. Four groups of fit acclimated subjects participated in the study. They were exposed to three climatic conditions (30 degrees, 65% rh; 31 degrees C, 40% rh; and 40 degrees C, 20% rh) and three levels of metabolic rate (100, 300 and 450 W) in shaded and sunny areas while wearing shorts, cotton fatigues (BDUs) or protective garments. The original predictive equation for sweat loss was adjusted for the outdoor conditions by evaluating separately the radiative heat exchange, short-wave absorption in the body and long-wave emission from the body to the atmosphere and integrating them in the required evaporation component (Ereq) of the model, as follows: Hr = 1.5SL0.6/I(T) (watt) H1 = 0.047Me.th/I(T) (watt), where SL is solar radiation (W.m-2), Me.th is the Stephan Boltzman constant, and I(T) is the effective clothing insulation coefficient. This adjustment revealed a high correlation between the measured and expected values of sweat loss (r = 0.99, p < 0.0001). PMID:7737107

  8. A Multicountry Ecological Study of Cancer Incidence Rates in 2008 with Respect to Various Risk-Modifying Factors

    PubMed Central

    Grant, William B.

    2013-01-01

    Observational and ecological studies are generally used to determine the presence of effect of cancer risk-modifying factors. Researchers generally agree that environmental factors such as smoking, alcohol consumption, poor diet, lack of physical activity, and low serum 25-hdyroxyvitamin D levels are important cancer risk factors. This ecological study used age-adjusted incidence rates for 21 cancers for 157 countries (87 with high-quality data) in 2008 with respect to dietary supply and other factors, including per capita gross domestic product, life expectancy, lung cancer incidence rate (an index for smoking), and latitude (an index for solar ultraviolet-B doses). The factors found to correlate strongly with multiple types of cancer were lung cancer (direct correlation with 12 types of cancer), energy derived from animal products (direct correlation with 12 types of cancer, inverse with two), latitude (direct correlation with six types, inverse correlation with three), and per capita gross national product (five types). Life expectancy and sweeteners directly correlated with three cancers, animal fat with two, and alcohol with one. Consumption of animal products correlated with cancer incidence with a lag time of 15–25 years. Types of cancer which correlated strongly with animal product consumption, tended to correlate weakly with latitude; this occurred for 11 cancers for the entire set of countries. Regression results were somewhat different for the 87 high-quality country data set and the 157-country set. Single-country ecological studies have inversely correlated nearly all of these cancers with solar ultraviolet-B doses. These results can provide guidance for prevention of cancer. PMID:24379012

  9. Age-Adjusted PSA Levels in Prostate Cancer Prediction: Updated Results of the Tyrol Prostate Cancer Early Detection Program

    PubMed Central

    Heidegger, Isabel; Fritz, Josef; Klocker, Helmut; Pichler, Renate

    2015-01-01

    Objective To reduce the number of unnecessary biopsies in patients with benign prostatic disease, however, without missing significant PCa the present study re-evaluates the age-dependent PSA cut-offs in the Tyrol Prostate Cancer (PCa) early detection program. Patients and Methods The study population included 2225 patients who underwent prostate biopsy due to elevated PSA levels at our department. We divided our patient collective into four age groups: ≤49 years (n = 178), 50-59 years (n = 597), 60-69 years (n = 962) and ≥70 years (n = 488). We simulated different scenarios for PSA cut-off values between 1.25 and 6 ng/mL and fPSA% between 15 and 21% for all four age groups and calculated sensitivity, specificity, confidence intervals and predictive values. Results PCa was detected in 1218 men (54.7%). We found that in combination with free PSA ≤21% the following PSA cut-offs had the best cancer specificity: 1.75 ng/ml for men ≤49 years and 50-59 years, 2.25 ng/ml for men aged 60-69 years and 3.25 ng/ml for men ≥70 years. Using these adjusted PSA cut-off values all significant tumors are recognized in all age groups, yet the number of biopsies is reduced. Overall, one biopsy is avoided in 13 to 14 men (number needed to screen = 13.3, reduction of biopsies = 7.5%) when decision regarding biopsy is done according to the “new” cut-off values instead of the “old” ones. For the different age groups the number needed to screen to avoid one biopsy varied between 9.2 (≤49 years) and 17.4 (50-59 years). Conclusion With “new”, fine-tuned PSA cut-offs we detect all relevant PCa with a significant reduction of biopsies compared to the “old” cut-off values. Optimization of age-specific PSA cut-offs is one step towards a smarter strategy in the Tyrol PCa Early Detection Program. PMID:26218594

  10. Implant survival rate after oral cancer therapy: a review.

    PubMed

    Javed, Fawad; Al-Hezaimi, Khalid; Al-Rasheed, Abdulaziz; Almas, Khalid; Romanos, George E

    2010-12-01

    The overall impression regarding the success of dental implants (DI) in patients having undergone oral cancer therapy remains unclear. The aim of the present review study was to assess the implant survival rate after oral cancer therapy. Databases were explored from 1986 up to and including September 2010 using the following keywords in various combinations: "cancer", "chemotherapy", "dental implant", "oral", "osseointegration", "radiotherapy", "surgery" and "treatment". The eligibility criteria were: (1) original research articles; (2) clinical studies; (3) reference list of pertinent original and review studies; (4) intervention: patients having undergone radio- and chemotherapy following oral cancer surgery; and (5) articles published only in English. Twenty-one clinical studies were included. Results from 16 studies reported that DI can osseointegrate and remain functionally stable in patients having undergone radiotherapy following oral cancer surgery; whereas three studies showed irradiation to have negative effects on the survival of DI. Two studies reported that DI can osseointegrate and remain functionally stable in patients having undergone chemotherapy. It is concluded that DI can osseointegrate and remain functionally stable in patients having undergone oral cancer treatment. PMID:21055997

  11. Clinical approval success rates for investigational cancer drugs.

    PubMed

    DiMasi, J A; Reichert, J M; Feldman, L; Malins, A

    2013-09-01

    We examined development risks for new cancer drugs. For the full study period, the estimated clinical approval success rate for cancer compounds was 13.4% (9.9% for the first half of the study period, 19.8% for the second half). Small molecules had a somewhat higher clinical approval success rate than did large molecules (14.3 vs. 11.5%). Compounds studied solely in hematologic indications had markedly higher estimated clinical approval success rates than did compounds studied only in solid tumor indications (36.0 vs. 9.8%). The first, second, and third cancer indications pursued had estimated clinical approval success rates of 9.0, 8.2, and 6.9%, respectively. Success rates of second and third indications were found to be highly dependent on the success or failure of the first indication pursued (54.9 and 42.4%, respectively, for second and third indications if the first indication is a success, but 2.5 and 1.8%, respectively, if the first indication is a failure). PMID:23739536

  12. The relationship between safety climate and injury rates across industries: the need to adjust for injury hazards.

    PubMed

    Smith, Gordon S; Huang, Yueng-Hsiang; Ho, Michael; Chen, Peter Y

    2006-05-01

    Previous studies have suggested that strong safety climates (shared perceptions of safe conducts at work) are associated with lower workplace-injury rates, but they rarely control for differences in industry hazards. Based on 33 companies, we assessed its association with injury rates using three rate based injury measures (claims per 100 employees, claims per 100,000 h worked, and claims per 1 million US dollars payroll), which were derived from workers' compensation injury claims. Linear regression models were used to test the predictability of safety climate on injury rates, followed by controlling for differences in hazard across industries gauged by national industry-specific injury rates. In the unadjusted model, company level safety climate were negatively and significantly associated with injury rates. However, all of the above associations were no longer apparent when controlling for the hazardousness of the specific industry. These findings may be due to over adjustment of hazard risk, or the overwhelming effects of industry specific hazards relative to safety climate effects that could not be differentiated with the statistical power in our study. Industry differences in hazard, conceptualized as one type of injury risk, however need to be considered when testing the association between safety climate and injury across different industries. PMID:16430845

  13. Tribological development of TiCN coatings by adjusting the flowing rate of reactive gases

    NASA Astrophysics Data System (ADS)

    Tillmann, Wolfgang; Momeni, Soroush

    2016-03-01

    TiCN coatings were deposited by means of direct current magnetron sputtering of Ti targets in presence of N2 and C2H2 reactive gases. The microstructure, composition, mechanical and tribological properties of the deposited thin films were analyzed by using X-ray diffraction (XRD), field emission scanning electron microscopy (FESEM), nanoindentation, ball-on-disc, scratch test, and three dimensional (3D) optical microscopy. The obtained results presents a reproducible processing route for tailoring microstructure, mechanical and tribological behavior of TiCN coatings by controlling flowing rate of the reactive gases.

  14. France. Country profile. [France's economy adjusts to a declining birth rate].

    PubMed

    Inserra, P

    1984-09-01

    This discussion of France focuses on regions and cities, age distribution, households and families, housing, labor force, consumption, education, and communications. France counted 54,334,871 citizens as of March 4, 1982. There were 250,000 more people than in 1975, yielding a 7-year growth rate of 3.3%. If present trends continue, there will be 56 million French by the end of the 1980s. Since 1975 when the last census was conducted, cities of more than 200,000 lost an average of 5% of their residents. For the 1st time in more than a century, urban areas of 20,000 or more did not gain population but merely held their own. France continues to experience the effects of the large-scale decimation of its male population during the 2 world wars. The World war i loss showed up March 1982 as a relatively smaller 60-74 group. Conversely the population aged 75 and over is growing, both in absolute numbers and as a percent of the population. There were 3.6 million aged 75 and over (6.6% of the population) in 1982 compared with 3 million (5.6%) in 1975. The 19 and under age group declined between 1975-85, from 31% (16.2 million) to 29% (15.6 million). The 20-59 year old group constitutes the largest segment of the population--about double the group aged 19 and under--and its growing. This group was 50% of the population in 1973 and 53% in 1982. The infant mortality rate has declined steadily in France, from 18.2 deaths/1000 births in 1970 to 13.6 in 1975 and 9.5 at present. The total fertility rate has continued to decline: 1.8 children/woman in the 1982 census a rate less than the number needed to replace the present French population. Between 1975-82 households grew 10.4% to a total of 19.6 million. The growth in the number of households is attributed to the increase in divorce and the tendency for French children to leave the parental home at an earlier age. France has nearly 23 million dwelling places. More than half of householders own their own homes. New housing starts

  15. Multiple comparison of trends in cancer rates taking into account overlapping cases*

    PubMed Central

    Martín, Nirian; Li, Yi

    2012-01-01

    Summary When analyzing trends in cancer rates, it is common to rely on the so-called Annual Percent Change (APC). For dealing with such a measure of trend, directly age-adjusted rates are usually considered. Classical methods such as pooled t-tests are often applied for comparing APCs of two groups of individuals in a simple way under independence assumption. In practice, it is quite common to find groups of interest for which the independence assumption fails because their regions or periods of time overlap. No one of the papers that deal this problem consider the case where more than two APCs are compared. In this work we propose a Wald-type test-statistic which is not difficult to compute once we provide the estimators of two or more APCs to be compared. These estimators are the minimum power divergence estimators that cover as special case those obtained by maximum likelihood. PMID:23060943

  16. Improved Outcomes Associated with Higher Surgery Rates for Older Patients with Early-Stage Non-Small Cell Lung Cancer

    PubMed Central

    Gray, Stacy W.; Landrum, Mary Beth; Lamont, Elizabeth B.; McNeil, Barbara J.; Jaklitsch, Michael T.; Keating, Nancy L.

    2011-01-01

    Background Although surgery offers the greatest chance of cure for patients with early stage non-small cell lung cancer (NSCLC), older and sicker patients often fail to undergo resection. The benefits of surgery in older patients and patients with multiple co-morbidities are uncertain. Methods We identified a national cohort of 17,638 Medicare beneficiaries, aged ≥66 years living in Surveillance, Epidemiology, and End Results (SEER) areas who were diagnosed with stage I or II NSCLC during 2001–2005. We compared areas with high and low rates of curative surgery for early-stage lung cancer to estimate the effectiveness of surgery in older and sicker patients. We used logistic regression models to assess mortality by quintile of area-level surgery rates, adjusting for potential confounders. Findings Fewer than 63% of patients underwent surgery in low-surgery areas while >79% underwent surgery in high-surgery areas. High-surgery areas operated on more patients with advanced age and COPD than low-surgery areas. Adjusted all-cause one year mortality was 18.0% in high-surgery areas vs. 22.8% in low-surgery areas (adjusted odds ratio (OR)=0.89 (95% confidence interval [CI] 0.86–0.93) for each 10% increase in surgery rates). One year lung-cancer-specific mortality was similarly lower in high-versus low-surgery areas (12.0% versus 16.9%), adjusted OR=0.86 (95% CI 0.82–0.91) for each 10% increase in surgery rates. Interpretations Higher rates of surgery for stage I/II NSCLC are associated with improved survival, even when older patients and sicker patients undergo resection. More work is needed to identify and reduce barriers to surgery for early-stage NSCLC. PMID:21800285

  17. Estimating and validating disability-adjusted life years at the global level: a methodological framework for cancer

    PubMed Central

    2012-01-01

    Background Disability-adjusted life years (DALYs) link data on disease occurrence to health outcomes, and they are a useful aid in establishing country-specific agendas regarding cancer control. The variables required to compute DALYs are however multiple and not readily available in many countries. We propose a methodology that derives global DALYs and validate variables and DALYs based on data from various cancer registries. Methods We estimated DALYs for four countries (Norway, Bulgaria, India and Uganda) within each category of the human development index (HDI). The following sources (indicators) were used: Globocan2008 (incidence and mortality), various cancer registries (proportion cured, proportion treated and duration of disease), treatment guidelines (duration of treatment), specific burden of disease studies (sequelae and disability weights), alongside expert opinion. We obtained country-specific population estimates and identified resource levels using the HDI, DALYs are computed as the sum of years of life lost and years lived with disabilities. Results Using mortality:incidence ratios to estimate country-specific survival, and by applying the human development index we derived country-specific estimates of the proportion cured and the proportion treated. The fit between the estimates and observed data from the cancer registries was relatively good. The final DALY estimates were similar to those computed using observed values in Norway, and in WHO’s earlier global burden of disease study. Marked cross-country differences in the patterns of DALYs by cancer sites were observed. In Norway and Bulgaria, breast, colorectal, prostate and lung cancer were the main contributors to DALYs, representing 54% and 45%, respectively, of the totals. These cancers contributed only 27% and 18%, respectively, of total DALYs in India and Uganda. Conclusions Our approach resulted in a series of variables that can be used to estimate country-specific DALYs, enabling global

  18. Problem of small numbers in reporting of cancer incidence and mortality rates in Indian cancer registries.

    PubMed

    Takiar, Ramnath; Nadayil, Deenu; Nandakumar, A

    2009-01-01

    The present paper examines the problem of small numbers (<20 cases) associated with many sites of cancers in Indian cancer registries. The cancer incidence data of 14 Population Based Cancer Registries for the periods of 2001-03 and 2004-05 were utilized for the analysis. Nine out of 14 registries had more than 50% of their sites being associated with small numbers while seven registries had 50% of their sites having as low as 5 cases. Sites associated with small numbers showed a lot of variation and significant differences in their incidence rates within two years duration which are not feasible. The percentage age distribution was also found to vary with different periods. The paper has effectively shown the effect of population size on incidence rates. For a registry of population size 300,000, the incidence rate of 6 can very well be unstable. There are many registries in the world with their population size less than 200,000. Even in the case of registries with high population (>or= 500,000) the practice is to report the cancer incidence by different ethnic groups with populations less than 200,000 and thereby introduce the problem of small numbers in reporting the incidences of various cancer sites. To overcome this problem, pooling of data over broad age groups or ten years age groups or 3 to 5 years periods is one immediate solution. PMID:19827889

  19. 75 FR 24757 - Order Making Fiscal Year 2011 Annual Adjustments to the Fee Rates Applicable Under Section 6(b...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-05

    ...), 75 FR 9964 (March 4, 2010). \\10\\ The annual adjustments, as well as the mid-year adjustments required... decade. More specifically, an ARIMA model was used to forecast the value of the aggregate...

  20. Religious Practice and Spirituality in the Psychological Adjustment of Survivors of Breast Cancer

    ERIC Educational Resources Information Center

    Purnell, Jason Q.; Andersen, Barbara L.

    2009-01-01

    Religion and spirituality are resources regularly used by patients with cancer coping with diagnosis and treatment, yet there is little research that examines these factors separately. This study investigated the relationships between religious practice and spirituality and quality of life (QoL) and stress in survivors of breast cancer. The sample…

  1. Hormone therapy and radiotherapy for early prostate cancer: A utility-adjusted number needed to treat (NNT) analysis

    SciTech Connect

    Jani, Ashesh B.; Kao, Johnny; Heimann, Ruth; Hellman, Samuel . E-mail: s-hellman@uchicago.edu

    2005-03-01

    Purpose: To quantify, using the number needed to treat (NNT) methodology, the benefit of short-term ({<=}6 months) hormone therapy adjuvant to radiotherapy in the group of patients with early (clinical stage T1-T2c) prostate cancer. Methods and materials: The absolute biochemical control benefit for the use of hormones adjuvant to radiotherapy in early-stage disease was determined by literature review. A model was developed to estimate the utility-adjusted survival detriment due to the side effects of hormone therapy. The NNTs before and after the incorporation of hormone sequelae were computed; the sign and magnitude of the NNTs were used to gauge the effect of the hormones. Results: The absolute NNT analysis, based on summarizing the results of 8 reports including a total of 3652 patients, demonstrated an advantage to the addition of hormones for the general early-stage prostate cancer population as well as for all prognostic groups. After adjustment for hormone-induced functional loss, the advantage of hormones remained considerable in the high- and intermediate-risk groups, with the utility-adjusted NNT becoming weakened in the low-risk group when the utility compromise from complications of hormones was assumed to be considerable. Conclusions: Short-term hormone therapy seems to be beneficial for selected early-stage prostate cancer patients. The advantage seems to be greatest in the intermediate- and high-risk groups; with current follow-up, the side effects of hormones may outweigh their benefit in certain clinical situations in the favorable group. The present investigation demonstrates the significant role of the NNT technique for oncologic and radiotherapeutic management decisions when treatment complications need to be considered and balanced with the beneficial effects of the treatment.

  2. High-Dose-Rate Brachytherapy Boost for Prostate Cancer: Comparison of Two Different Fractionation Schemes

    SciTech Connect

    Kaprealian, Tania; Weinberg, Vivian; Speight, Joycelyn L.; Gottschalk, Alexander R.; Roach, Mack; Shinohara, Katsuto; Hsu, I.-Chow

    2012-01-01

    Purpose: This is a retrospective study comparing our experience with high-dose-rate (HDR) brachytherapy boost for prostate cancer, using two different fractionation schemes, 600 cGy Multiplication-Sign 3 fractions (patient group 1) and 950 cGy Multiplication-Sign 2 fractions (patient group 2). Methods and Materials: A total of 165 patients were treated for prostate cancer using external beam radiation therapy up to a dose of 45 Gy, followed by an HDR brachytherapy prostate radiation boost. Between July 1997 and Nov 1999, 64 patients were treated with an HDR boost of 600 cGy Multiplication-Sign 3 fractions; and between June 2000 and Nov 2005, 101 patients were treated with an HDR boost of 950 cGy Multiplication-Sign 2 fractions. All but 9 patients had at least one of the following risk features: pretreatment prostate-specific antigen (PSA) level >10, a Gleason score {>=}7, and/or clinical stage T3 disease. Results: Median follow-up was 105 months for group 1 and 43 months for group 2. Patients in group 2 had a greater number of high-risk features than group 1 (p = 0.02). Adjusted for comparable follow-up, there was no difference in biochemical no-evidence-of-disease (bNED) rate between the two fractionation scheme approaches, with 5-year Kaplan-Meier estimates of 93.5% in group 1 and 87.3% in group 2 (p = 0.19). The 5-year estimates of progression-free survival were 86% for group 1 and 83% for group 2 (p = 0.53). Among high-risk patients, there were no differences in bNED or PFS rate due to fractionation. Conclusions: Results were excellent for both groups. Adjusted for comparable follow-up, no differences were found between groups.

  3. Colorectal Cancer Screening Rates Increased after Exposure to the Patient-Centered Medical Home (PCMH)

    PubMed Central

    Green, Beverly B.; Anderson, Melissa L.; Chubak, Jessica; Baldwin, Laura Mae; Tuzzio, Leah; Catz, Sheryl; Cole, Alison; Vernon, Sally W.

    2016-01-01

    Objective The patient-centered medical home (PCMH) includes comprehensive chronic illness and preventive services, including identifying patients who are overdue for colorectal cancer screening (CRCS). The association between PCMH implementation and CRCS during the Systems of Support to Increase Colorectal Cancer Screening Trial (SOS) is described. Methods The SOS enrolled 4664 patients from 21 clinics from August 2008 to November 2009. Patients were randomized to usual care, mailed fecal kits, kits plus brief assistance, or kits plus assistance and navigation. A PCMH model that included a workflow for facilitating CRCS was implemented at all study clinics in late 2009. Patients enrolled early had little exposure to the PCMH, whereas patients enrolled later were exposed during most of their first year in the trial. Logistic regression models were used to assess the association between PCMH exposure and CRCS. Results Usual care patients with ≥8 months in the PCMH had higher CRCS rates than those with ≤4 months in the PCMH (adjusted difference, 10.1%; 95% confidence interval, 5.7–14.6). SOS interventions led to significant increases in CRCS, but the magnitude of effect was attenuated by exposure to the PCMH (P for interaction = .01). Conclusion Exposure to a PCMH was associated with higher CRCS rates. Automated mailed and centrally delivered stepped interventions increased CRCS rates, even in the presence of a PCMH. (J Am Board Fam Med 2016;29:191–200.) PMID:26957375

  4. Running Head: Control and Adjustment of the Rate of Photosynthesis Above Present CO{sub 2} Levels

    SciTech Connect

    Ball, J. Timothy

    1996-12-01

    The adjustment of photosynthesis to different environmental conditions and especially to elevated CO{sub 2} is often characterized in terms of changes in the processes that establish (limit) the net CO{sub 2} assimilation rate. At slightly above present ambient pCO{sub 2} light-saturated photosynthetic responses to CO{sub 2} depart limitation by the catalytic capacity of tissue rubisco content. An hypothesis attributing this departure to limited thylakoid reaction/electron transport capacity is widely accepted, although we find no experimental evidence in the literature supporting this proposition.. The results of several tests point to the conclusion that the capacity of the thyiakoid reactions cannot be generally responsible for the deviation from rubisco limitation. This conclusion leaves a significant gap in the interpretation of gas exchange responses to CO{sub 2}. Since the inputs to the photosynthetic carbon reduction cycle (CO{sub 2} and photon-capture/electron-transport products) do not limit photosynthesis on the shoulder of the A=f(c{sub i}) curve, the control of photosynthesis can be characterized as: due to feedback. Several characteristics of gas exchange and fluorescence that occur when steady-states in this region are perturbed by changes in CO{sub 2} or O{sub 2} suggest significant regulation by conditions other than directly by substrate RuBP levels. A strong candidate to explain these responses is the triose-phosphate flux/ inorganic phosphate regulatory sequence, although not all of the gas exchange characteristics expected with ''TPU-limitation'' are present (e.g. oxygen-insensitive photosynthesis). Interest in nitrogen allocation between rubisco and light capture/electron transport as the basis for photosynthetic adjustment to elevated CO{sub 2} may need to be reconsidered as a result of these findings. Contributors to the feedback regulation of photosynthesis (which may include sucrose phosphate synthase and fructose bisphosphatase activities

  5. High Dose-Rate Versus Low Dose-Rate Brachytherapy for Lip Cancer

    SciTech Connect

    Ghadjar, Pirus; Bojaxhiu, Beat; Simcock, Mathew; Terribilini, Dario; Isaak, Bernhard; Gut, Philipp; Wolfensberger, Patrick; Broemme, Jens O.; Geretschlaeger, Andreas; Behrensmeier, Frank; Pica, Alessia; Aebersold, Daniel M.

    2012-07-15

    Purpose: To analyze the outcome after low-dose-rate (LDR) or high-dose-rate (HDR) brachytherapy for lip cancer. Methods and Materials: One hundred and three patients with newly diagnosed squamous cell carcinoma of the lip were treated between March 1985 and June 2009 either by HDR (n = 33) or LDR brachytherapy (n = 70). Sixty-eight patients received brachytherapy alone, and 35 received tumor excision followed by brachytherapy because of positive resection margins. Acute and late toxicity was assessed according to the Common Terminology Criteria for Adverse Events 3.0. Results: Median follow-up was 3.1 years (range, 0.3-23 years). Clinical and pathological variables did not differ significantly between groups. At 5 years, local recurrence-free survival, regional recurrence-free survival, and overall survival rates were 93%, 90%, and 77%. There was no significant difference for these endpoints when HDR was compared with LDR brachytherapy. Forty-two of 103 patients (41%) experienced acute Grade 2 and 57 of 103 patients (55%) experienced acute Grade 3 toxicity. Late Grade 1 toxicity was experienced by 34 of 103 patients (33%), and 5 of 103 patients (5%) experienced late Grade 2 toxicity; no Grade 3 late toxicity was observed. Acute and late toxicity rates were not significantly different between HDR and LDR brachytherapy. Conclusions: As treatment for lip cancer, HDR and LDR brachytherapy have comparable locoregional control and acute and late toxicity rates. HDR brachytherapy for lip cancer seems to be an effective treatment with acceptable toxicity.

  6. Cells deficient in base-excision repair reveal cancer hallmarks originating from adjustments to genetic instability

    PubMed Central

    Markkanen, Enni; Fischer, Roman; Ledentcova, Marina; Kessler, Benedikt M.; Dianov, Grigory L.

    2015-01-01

    Genetic instability, provoked by exogenous mutagens, is well linked to initiation of cancer. However, even in unstressed cells, DNA undergoes a plethora of spontaneous alterations provoked by its inherent chemical instability and the intracellular milieu. Base excision repair (BER) is the major cellular pathway responsible for repair of these lesions, and as deficiency in BER activity results in DNA damage it has been proposed that it may trigger the development of sporadic cancers. Nevertheless, experimental evidence for this model remains inconsistent and elusive. Here, we performed a proteomic analysis of BER deficient human cells using stable isotope labelling with amino acids in cell culture (SILAC), and demonstrate that BER deficiency, which induces genetic instability, results in dramatic changes in gene expression, resembling changes found in many cancers. We observed profound alterations in tissue homeostasis, serine biosynthesis, and one-carbon- and amino acid metabolism, all of which have been identified as cancer cell ‘hallmarks’. For the first time, this study describes gene expression changes characteristic for cells deficient in repair of endogenous DNA lesions by BER. These expression changes resemble those observed in cancer cells, suggesting that genetically unstable BER deficient cells may be a source of pre-cancerous cells. PMID:25800737

  7. Further follow-up and adjustment for smoking in a study of lung cancer and acid mists

    SciTech Connect

    Steenland, K.; Beaumont, J. )

    1989-01-01

    Follow-up of a cohort of 1,165 steelworkers exposed to acid mists has been extended from 1981 to early 1986 for most cohort members, and information on smoking has also been collected. We obtained an SMR for lung cancer (unadjusted for smoking) of 1.56 (95% CI 1.12-2.11, 41 observed). For those with 20 years or more since first exposure, the SMR was 1.72 (1.21-2.39). However, no trend was found with duration of exposure. To adjust for smoking, we used an indirect adjustment as suggested by Axelson to account for the fact that the exposed cohort smoked slightly more than the U.S. referent population. The SMR for the whole cohort dropped to 1.36 (0.97-1.84), while for those with more than 20 years since first exposure, the SMR was 1.50 (1.05-2.07). These results indicate that an excess risk for lung cancer persists after control for confounding by smoking.

  8. Impact of acquired comorbidities on all-cause mortality rates among older breast cancer survivors

    PubMed Central

    Ahern, Thomas P.; Lash, Timothy L.; Thwin, Soe Soe; Silliman, Rebecca A.

    2010-01-01

    Background Breast cancer survivors with higher numbers of comorbidities at the time of primary treatment suffer higher rates of all-cause mortality than comparatively healthier survivors. The effect of time-varying comorbidity status on mortality in breast cancer survivors, however, has not been well investigated. Objective We examined longitudinal comorbidity in a cohort of women treated for primary breast cancer to determine whether accounting for comorbidities acquired after baseline assessment influenced the hazard ratio of all-cause mortality compared with an analysis using only baseline comorbidity. Methods Cox proportional hazards adjusted for age, race/ethnicity, and exercise habits were modeled using (1) only a baseline Charlson index; (2) four Charlson index values collected longitudinally and entered as time-varying covariates, with missing values addressed by carrying forward the prior observation; and (3) the four longitudinal Charlson scores entered as time-varying covariates, with missing values multiply imputed. Results The three modeling strategies yielded similar results; Model 1 HR: 1.4 per unit increase in Charlson index, 95% CI: 1.2, 1.7; Model 2 HR: 1.3, 95% CI: 1.1, 1.5 and Model 3 HR: 1.4, 95% CI: 1.2, 1.6. Conclusions Our findings indicate that a unit increase in the Charlson comorbidity index raises the hazard rate for all-cause mortality by approximately 1.4-fold in older women treated for primary breast cancer. The conclusion is essentially the same whether accounting only for baseline comorbidity or accounting for acquired comorbidity over a median follow-up period of 85 months. PMID:19106734

  9. Foreign capital and the impact of exchange rate adjustments in oil-exporting developing countries with an application to Indonesia

    SciTech Connect

    Tadjuddin, A.

    1989-01-01

    The efficacy of exchange rate adjustments as an instrument of economic policy in developing countries has long been the subject of considerable controversy. Theoretical treatments of currency devaluation generally conclude that it improves the trade balance and stimulates economic activity. However, this traditional view has been challenged in recent years on the grounds that trade flows, including factor imports, are relatively insensitive to price and exchange rate changes, especially in developing countries. This study analyzes the effects of exchange rate changes in oil exporting developing countries which host foreign capital by using a modified model of the Krugman-Taylor (l978) and Barbone-Batiz (1987) types. It is shown that the impact of devaluation on GNP is influenced by (a) the initial state of the current account balance, (b) the elasticity of demand for non-oil exports, (c) the elasticity of demand for final good imports, (d) the foreign ownership effects, and (e) the impact of devaluation on the government revenues. Devaluation can lead to an increase in national output, but only if the elasticity effects in the non-oil export sector and in the final good imports are large enough to dominate the government revenue effect, the foreign-ownership effect in the oil sector and the impact of any initial current account deficit. The model was applied to the economy of Indonesia, an oil exporting developing country. The net effect of devaluation on national output is known to be contradictory following devaluation, thus supporting the structuralist view that devaluation has negative real effects in this country, at least in the short run. It was also found that the estimated price elasticities of non-oil imports and exports are low in the short-run. Devaluation would lead to improvement in the non-oil trade account in the long run after devaluation.

  10. FEASIBILITY OF DOSE ADJUSTMENT BASED ON DIFFERENCE IN LONG-TERM CLEARANCE RATES OF INHALED PARTICULATE MATTER IN HUMANS AND LABORATORY ANIMALS

    EPA Science Inventory

    Long-term pulmonary clearance rates were evaluated for several laboratory animal species, dogs, and humans to determine if differences among species exist, and if so, the adequacy of the data for dose adjustment. Within each species, large variations in clearance rates were seen,...

  11. High versus Low-Dose Rate Brachytherapy for Cervical Cancer

    PubMed Central

    Patankar, Sonali S.; Tergas, Ana I.; Deutsch, Israel; Burke, William M.; Hou, June Y.; Ananth, Cande V.; Huang, Yongmei; Neugut, Alfred I.; Hershman, Dawn L.; Wright, Jason D.

    2015-01-01

    Objectives Brachytherapy plays an important role in the treatment of cervical cancer. While small trials have shown comparable survival outcomes between high (HDR) and low-dose rate (LDR) brachytherapy, little data is available in the US. We examined the utilization of HDR brachytherapy and analyzed the impact of type of brachytherapy on survival for cervical cancer. Methods Women with stage IB2–IVA cervical cancer treated with primary (external beam and brachytherapy) radiotherapy between 2003–2011 and recorded in the National Cancer Database (NCDB) were analyzed. Generalized linear mixed models and Cox proportional hazards regression were used to examine predictors of HDR brachytherapy use and the association between HDR use and survival. Results A total of 10,564 women including 2681 (25.4%) who received LDR and 7883 (74.6%) that received HDR were identified. Use of HDR increased from 50.2% in 2003 to 83.9% in 2011 (P<0.0001). In a multivariable model, year of diagnosis was the strongest predictor of use of HDR. While patients in the Northeast were more likely to receive HDR therapy, there were no other clinical or socioeconomic characteristics associated with receipt of HDR. In a multivariable Cox model, survival was similar between the HDR and LDR groups (HR=0.93; 95% 0.83–1.03). Similar findings were noted in analyses stratified by stage and histology. Kaplan-Meier analyses demonstrated no difference in survival based on type of brachytherapy for stage IIB (P=0.68), IIIB (P=0.17), or IVA (P=0.16) tumors. Conclusions The use of HDR therapy has increased rapidly. Overall survival is similar for LDR and HDR brachytherapy. PMID:25575481

  12. Mathematical Modeling of Therapy-induced Cancer Drug Resistance: Connecting Cancer Mechanisms to Population Survival Rates

    PubMed Central

    Sun, Xiaoqiang; Bao, Jiguang; Shao, Yongzhao

    2016-01-01

    Drug resistance significantly limits the long-term effectiveness of targeted therapeutics for cancer patients. Recent experimental studies have demonstrated that cancer cell heterogeneity and microenvironment adaptations to targeted therapy play important roles in promoting the rapid acquisition of drug resistance and in increasing cancer metastasis. The systematic development of effective therapeutics to overcome drug resistance mechanisms poses a major challenge. In this study, we used a modeling approach to connect cellular mechanisms underlying cancer drug resistance to population-level patient survival. To predict progression-free survival in cancer patients with metastatic melanoma, we developed a set of stochastic differential equations to describe the dynamics of heterogeneous cell populations while taking into account micro-environment adaptations. Clinical data on survival and circulating tumor cell DNA (ctDNA) concentrations were used to confirm the effectiveness of our model. Moreover, our model predicted distinct patterns of dose-dependent synergy when evaluating a combination of BRAF and MEK inhibitors versus a combination of BRAF and PI3K inhibitors. These predictions were consistent with the findings in previously reported studies. The impact of the drug metabolism rate on patient survival was also discussed. The proposed model might facilitate the quantitative evaluation and optimization of combination therapeutics and cancer clinical trial design. PMID:26928089

  13. Mathematical Modeling of Therapy-induced Cancer Drug Resistance: Connecting Cancer Mechanisms to Population Survival Rates.

    PubMed

    Sun, Xiaoqiang; Bao, Jiguang; Shao, Yongzhao

    2016-01-01

    Drug resistance significantly limits the long-term effectiveness of targeted therapeutics for cancer patients. Recent experimental studies have demonstrated that cancer cell heterogeneity and microenvironment adaptations to targeted therapy play important roles in promoting the rapid acquisition of drug resistance and in increasing cancer metastasis. The systematic development of effective therapeutics to overcome drug resistance mechanisms poses a major challenge. In this study, we used a modeling approach to connect cellular mechanisms underlying cancer drug resistance to population-level patient survival. To predict progression-free survival in cancer patients with metastatic melanoma, we developed a set of stochastic differential equations to describe the dynamics of heterogeneous cell populations while taking into account micro-environment adaptations. Clinical data on survival and circulating tumor cell DNA (ctDNA) concentrations were used to confirm the effectiveness of our model. Moreover, our model predicted distinct patterns of dose-dependent synergy when evaluating a combination of BRAF and MEK inhibitors versus a combination of BRAF and PI3K inhibitors. These predictions were consistent with the findings in previously reported studies. The impact of the drug metabolism rate on patient survival was also discussed. The proposed model might facilitate the quantitative evaluation and optimization of combination therapeutics and cancer clinical trial design. PMID:26928089

  14. Meta-analysis of lung cancer in asphalt roofing and paving workers with external adjustment for confounding by coal tar

    SciTech Connect

    Fayerweather, W.E.

    2007-07-01

    The study's objectives were to update Partanen's and Boffetta's 1994 meta-analysis of lung cancer among roofing and paving asphalt workers and explore the role of coal tar in explaining the statistical heterogeneity among these studies. Information retrieval strategies and eligibility criteria were defined for identifying the epidemiologic studies to be included in the analysis. The relative risk ratio (RR) for lung cancer was selected as the effect measure of interest. Coal tar bias factors were developed and used to externally adjust each eligible study's published RR for confounding by coal tar. The meta-Relative Risk (meta-RR) and its variance were estimated by general variance-based methods. Heterogeneity of the RRs was assessed by heterogeneity chi-square and I{sup 2} tests. The results from this update were similar to those in Partanen's and Boffetta's original meta-analysis. Although the meta-RRs for the roofers and the pavers were no longer statistically significantly different from one another, significant heterogeneity remained within each of the coal tar-adjusted sectors. Meta-analysis of non-experimental epidemiologic studies is subject to significant uncertainties as is externally correcting studies for confounding. Given these uncertainties, the specific quantitative estimates in this (or any similar) analysis must be viewed with caution. Nevertheless, this analysis provides support for the hypothesis proposed by several major reviewers that confounding by coal tar-related PAH exposures may explain most or all of the lung cancer risks found in the epidemiologic literature on asphalt roofing and paving workers.

  15. Low heart rate variability and cancer-related fatigue in breast cancer survivors

    PubMed Central

    Crosswell, Alexandra D.; Lockwood, Kimberly G.; Ganz, Patricia A.; Bower, Julienne E.

    2015-01-01

    Cancer-related fatigue is a common and often long lasting symptom for many breast cancer survivors. Fatigued survivors show evidence of elevated inflammation, but the physiological mechanisms driving inflammatory activity have not been determined. Alterations in the autonomic nervous system, and particularly parasympathetic nervous system activity, are a plausible, yet understudied contributor to cancer-related fatigue. The goal of this study was to replicate one previous study showing an association between lower parasympathetic activity and higher fatigue in breast cancer survivors (Fagundes et al., 2011), and to examine whether inflammation mediates this association. Study participants were drawn from two samples and included 84 women originally diagnosed with early-stage breast cancer prior to age 50. Participants completed questionnaires, provided blood samples for determination of interleukin (IL)-6 and C-reactive protein (CRP), and underwent electrocardiography (ECG) assessment for evaluation of resting heart rate variability (HRV), a measure of parasympathetic activity. Results showed that lower HRV was associated with higher fatigue (p < .05), as predicted. In bivariate analyses, HRV was also correlated with circulating concentrations of IL-6 and CRP. However, path analyses did not support inflammation as a mediator of the association between HRV and fatigue; instead, associations among these variables appeared to be driven by age and BMI. These findings identify HRV as a potential contributor to cancer-related fatigue, but suggest that inflammation does not mediate this association in younger, healthy breast cancer survivors who are several years post-treatment. The autonomic nervous system merits additional attention in research on the etiology of cancer-related fatigue. PMID:24845177

  16. Impact of urine concentration adjustment method on associations between urine metals and estimated glomerular filtration rates (eGFR) in adolescents

    SciTech Connect

    Weaver, Virginia M.; Vargas, Gonzalo García; Silbergeld, Ellen K.; Rothenberg, Stephen J.; Fadrowski, Jeffrey J.; Rubio-Andrade, Marisela; Parsons, Patrick J.; Steuerwald, Amy J.; and others

    2014-07-15

    Positive associations between urine toxicant levels and measures of glomerular filtration rate (GFR) have been reported recently in a range of populations. The explanation for these associations, in a direction opposite that of traditional nephrotoxicity, is uncertain. Variation in associations by urine concentration adjustment approach has also been observed. Associations of urine cadmium, thallium and uranium in models of serum creatinine- and cystatin-C-based estimated GFR (eGFR) were examined using multiple linear regression in a cross-sectional study of adolescents residing near a lead smelter complex. Urine concentration adjustment approaches compared included urine creatinine, urine osmolality and no adjustment. Median age, blood lead and urine cadmium, thallium and uranium were 13.9 years, 4.0 μg/dL, 0.22, 0.27 and 0.04 g/g creatinine, respectively, in 512 adolescents. Urine cadmium and thallium were positively associated with serum creatinine-based eGFR only when urine creatinine was used to adjust for urine concentration (β coefficient=3.1 mL/min/1.73 m{sup 2}; 95% confidence interval=1.4, 4.8 per each doubling of urine cadmium). Weaker positive associations, also only with urine creatinine adjustment, were observed between these metals and serum cystatin-C-based eGFR and between urine uranium and serum creatinine-based eGFR. Additional research using non-creatinine-based methods of adjustment for urine concentration is necessary. - Highlights: • Positive associations between urine metals and creatinine-based eGFR are unexpected. • Optimal approach to urine concentration adjustment for urine biomarkers uncertain. • We compared urine concentration adjustment methods. • Positive associations observed only with urine creatinine adjustment. • Additional research using non-creatinine-based methods of adjustment needed.

  17. Automatic adjustment clauses in public-utility rate schedules. A staff report on the implementation of Section 208 of the Public Utility Regulatory Policies Act of 1978

    SciTech Connect

    Not Available

    1982-02-01

    The Public Utility Regulatory Policies Act (PURPA), enacted November 8, 1978, directs the Federal Energy Regulatory Commission to make a comprehensive review of certain matters related to automatic adjustment clauses in electric rate schedules used by public utilities subject to the Commission's jurisdiction. The first requirement is that the Commission review automatic adjustment clauses in utility rate schedules to examine whether the clauses effectively provide incentives for efficient use of resources and also whether the clauses reflect only those costs that are either subject to periodic fluctuations or not susceptible to precise determinations in rate cases prior to the time the costs are incurred. The second requirement is that the Commission review the practices of each public utility under automatic adjustment clauses to insure efficient use of resources under such clauses. In response to these requirements, the Commission instituted a study and a staff investigation to examine the matters specifically identified in the Act. This report describes the progress that has been made in the study during the first two years since the passage of the Act related to the issues involved. The principal types of automatic adjustment clauses appearing in rate schedules subject to FERC jurisdiction are described and the extent of use of the types of clauses is indicated. The nature and results of the efforts made to analyze incentive effects, variability and predictability of certain costs, and the fuel procurement practices of utilities as related to automatic adjustment clauses are discussed. Preliminary staff conclusions from the review and analysis effort are presented.

  18. Report to the nation finds continuing declines in cancer death rates

    Cancer.gov

    Death rates from all cancers combined for men, women, and children continued to decline in the United States between 2004 and 2008, according to the Annual Report to the Nation on the Status of Cancer, 1975-2008. The overall rate of new cancer diagnoses,

  19. What implementation interventions increase cancer screening rates? a systematic review

    PubMed Central

    2011-01-01

    Background Appropriate screening may reduce the mortality and morbidity of colorectal, breast, and cervical cancers. However, effective implementation strategies are warranted if the full benefits of screening are to be realized. As part of a larger agenda to create an implementation guideline, we conducted a systematic review to evaluate interventions designed to increase the rate of breast, cervical, and colorectal cancer (CRC) screening. The interventions considered were: client reminders, client incentives, mass media, small media, group education, one-on-one education, reduction in structural barriers, reduction in out-of-pocket costs, provider assessment and feedback interventions, and provider incentives. Our primary outcome, screening completion, was calculated as the overall median post-intervention absolute percentage point (PP) change in completed screening tests. Methods Our first step was to conduct an iterative scoping review in the research area. This yielded three relevant high-quality systematic reviews. Serving as our evidentiary foundation, we conducted a formal update. Randomized controlled trials and cluster randomized controlled trials, published between 2004 and 2010, were searched in MEDLINE, EMBASE and PSYCHinfo. Results The update yielded 66 studies new eligible studies with 74 comparisons. The new studies ranged considerably in quality. Client reminders, small media, and provider audit and feedback appear to be effective interventions to increase the uptake of screening for three cancers. One-on-one education and reduction of structural barriers also appears effective, but their roles with CRC and cervical screening, respectively, are less established. More study is required to assess client incentives, mass media, group education, reduction of out-of-pocket costs, and provider incentive interventions. Conclusion The new evidence generally aligns with the evidence and conclusions from the original systematic reviews. This review served as

  20. HIV infection connected to rising anal cancer rates in men in the U.S.

    Cancer.gov

    Human immunodeficiency virus (HIV) infection contributes substantially to the epidemic of anal cancer in men, but not women in the United States, according to new research from NCI. Chart shows overall incidence rates of anal cancers in general population

  1. 48 CFR 52.222-30 - Construction Wage Rate Requirements-Price Adjustment (None or Separately Specified Method).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Contracting Officer will make no adjustment in contract price, other than provided for elsewhere in this contract, to cover any increases or decreases in wages and benefits as a result of— (1) Incorporation...

  2. Parents of children with cancer: a longitudinal study of emotional distress, coping style, and marital adjustment two and twenty months after diagnosis.

    PubMed

    Dahlquist, L M; Czyzewski, D I; Jones, C L

    1996-08-01

    Evaluated emotional distress, coping style, and marital adjustment in 84 parents (42 couples) of children with cancer 2 months after diagnosis and again about 20 months after diagnosis. As expected, mothers' mean state anxiety and trait anxiety scores decreased to near normal levels over time. Fathers' scores were lower initially and did not change. Neither mothers' nor fathers' mean marital adjustment scores changed over time. Marital adjustment at treatment follow-up was predicted by depression and the spouse's marital satisfaction in mothers, and depression, child health status, and spouse's marital satisfaction in fathers. In contrast to findings obtained 2 months after diagnosis, coping style was not related to marital adjustment at follow-up. Results are discussed in terms of possible gender differences in the role of social support in marital adjustment and the stability versus situational specificity of coping styles. PMID:8863463

  3. Impact of urine concentration adjustment method on associations between urine metals and estimated glomerular filtration rates (eGFR) in adolescents☆

    PubMed Central

    Weaver, Virginia M.; Vargas, Gonzalo García; Silbergeld, Ellen K.; Rothenberg, Stephen J.; Fadrowski, Jeffrey J.; Rubio-Andrade, Marisela; Parsons, Patrick J.; Steuerwald, Amy J.; Navas-Acien, Ana; Guallar, Eliseo

    2014-01-01

    Positive associations between urine toxicant levels and measures of glomerular filtration rate (GFR) have been reported recently in a range of populations. The explanation for these associations, in a direction opposite that of traditional nephrotoxicity, is uncertain. Variation in associations by urine concentration adjustment approach has also been observed. Associations of urine cadmium, thallium and uranium in models of serum creatinine- and cystatin-C-based estimated GFR (eGFR) were examined using multiple linear regression in a cross-sectional study of adolescents residing near a lead smelter complex. Urine concentration adjustment approaches compared included urine creatinine, urine osmolality and no adjustment. Median age, blood lead and urine cadmium, thallium and uranium were 13.9 years, 4.0 μg/dL, 0.22, 0.27 and 0.04 g/g creatinine, respectively, in 512 adolescents. Urine cadmium and thallium were positively associated with serum creatinine-based eGFR only when urine creatinine was used to adjust for urine concentration (β coefficient=3.1 mL/min/1.73 m2; 95% confidence interval=1.4, 4.8 per each doubling of urine cadmium). Weaker positive associations, also only with urine creatinine adjustment, were observed between these metals and serum cystatin-C-based eGFR and between urine uranium and serum creatinine-based eGFR. Additional research using non-creatinine-based methods of adjustment for urine concentration is necessary. PMID:24815335

  4. The incidence rate of corpus uteri cancer among females in Saudi Arabia: an observational descriptive epidemiological analysis of data from Saudi Cancer Registry 2001–2008

    PubMed Central

    Alghamdi, Ibrahim G; Hussain, Issam I; Alghamdi, Mohamed S; El-Sheemy, Mohamed A

    2014-01-01

    Background The present study reviews the epidemiological data on corpus uteri cancer among Saudi women, including its frequency, crude incidence rate, and age-standardized incidence rate (ASIR), adjusted by region and year of diagnosis. Methods A retrospective, descriptive epidemiological analysis was conducted of all the corpus uteri cancer cases recorded in the Saudi Cancer Registry between January 2001 and December 2008. The statistical analyses were performed using descriptive statistics, analysis of variance, Poisson regression, and a simple linear model. Results A total of 1,060 corpus uteri cancer cases were included. Women aged 60–74 years of age were most affected by the disease. The region of Riyadh in Saudi Arabia had the highest overall ASIR, at 4.4 cases per 100,000 female patients, followed by the eastern region, at 4.2, and Makkah, at 3.7. Jazan, Najran, and Qassim had the lowest average ASIRs, ranging from 0.8 to 1.4. A Poisson regression model using Jazan as the reference revealed that the corpus uteri cancer incidence rate ratio was significantly higher for the regions of Makkah, at 16.5 times (95% confidence interval [CI]: 8.0–23.0), followed by Riyadh, at 16.0 times (95% CI: 9.0–22.0), and the eastern region, at 9.9 times (95% CI: 5.6–17.6). The northern region experienced the highest changes in ASIRs of corpus uteri cancer among female Saudi patients between 2001 and 2008. Conclusion There was a slight increase in the crude incidence rates and ASIRs for corpus uteri cancer in Saudi Arabia between 2001 and 2008. Older Saudi women were most affected by the disease. Riyadh, the eastern region, and Makkah had the highest overall disease ASIRs and incidence rate ratios, while Jazan, Najran, and Qassim had the lowest rates. Finally, the northern region experienced the greatest changes in ASIR during the studied period. Further analytical studies are necessary to determine potential risk factors of corpus uteri cancer among female Saudi

  5. Cancer Rates by Race/Ethnicity and Sex

    MedlinePlus

    ... of getting cancer, followed by white, Hispanic, Asian/Pacific Islander (A/PI), and American Indian/Alaska Native ( ... of getting cancer, followed by black, Hispanic, Asian/Pacific Islander, and American Indian/Alaska Native women. Sources: ...

  6. Tobacco Smoking, NBS1 Polymorphisms, and Survival in Lung and Upper Aerodigestive Tract Cancers with Semi-Bayes Adjustment for Hazard-ratio Variation

    PubMed Central

    Yang, Tingting; Chang, Po-Yin; Park, Sungshim Lani; Bastani, Delara; Chang, Shen-Chih; Morgenstern, Hal; Tashkin, Donald P.; Mao, Jenny T.; Papp, Jeanette C.; Rao, Jian-Yu; Cozen, Wendy; Mack, Thomas M.; Greenland, Sander; Zhang, Zuo-Feng

    2013-01-01

    Purpose Although single nucleotide polymorphisms (SNPs) of NBS1 have been associated with susceptibility to lung and upper aerodigestive tract (UADT) cancers, their relations to cancer survival and measures of effect are largely unknown. Methods Using follow-up data from 611 lung-cancer cases and 601 UADT-cancer cases from a population-based case-control study in Los Angeles, we prospectively evaluated associations of tobacco smoking and 5 NBS1 SNPs with all-cause mortality. Mortality data were obtained from the Social Security Death Index. We used Cox regression to estimate adjusted hazard ratios (HR) for main effects and ratios of hazard ratios (RHR) derived from product terms to assess hazard-ratio variations by each SNP. Bayesian methods were used to account for multiple comparisons. Results We observed 406 (66%) deaths in lung-cancer cases and 247 (41%) deaths in UADT-cancer cases with median survival of 1.43 and 1.72 years, respectively. Ever tobacco smoking was positively associated with mortality for both cancers. We observed an upward dose-response association between smoking pack-years and mortality in UADT squamous cell carcinoma. The adjusted HR relating smoking to mortality in non-small cell lung cancer (NSCLC) was greater for cases with the GG genotype of NBS1 rs1061302 than for cases with AA/AG genotypes (semi-Bayes adjusted RHR = 1.97; 95% limits = 1.14, 3.41). Conclusions A history of tobacco smoking at cancer diagnosis was associated with mortality among patients with lung cancer or UADT squamous cell carcinoma. The HR relating smoking to mortality appeared to vary with the NBS1 rs1061302 genotype among NSCLC cases. PMID:24166361

  7. Predictive value of the age-adjusted charlson comorbidity index on perioperative complications and survival in patients undergoing primary debulking surgery for advanced epithelial ovarian cancer

    PubMed Central

    Suidan, Rudy S.; Leitao, Mario M.; Zivanovic, Oliver; Gardner, Ginger J.; Long Roche, Kara C.; Sonoda, Yukio; Levine, Douglas A.; Jewell, Elizabeth L.; Brown, Carol L.; Abu-Rustum, Nadeem R.; Charlson, Mary E.; Chi, Dennis S.

    2016-01-01

    Objective To assess the ability of the Age-Adjusted Charlson Comorbidity index (ACCI) to predict perioperative complications and survival in patients undergoing primary debulking for advanced epithelial ovarian cancer (EOC). Methods Data were analyzed for all patients with stage IIIB-IV EOC who underwent primary cytoreduction from 1/2001–1/2010 at our institution. Patients were divided into 3 groups based on an ACCI of 0–1, 2–3, and ≥4. Clinical and survival outcomes were assessed and compared. Results We identified 567 patients; 199 (35%) had an ACCI of 0–1, 271 (48%) had an ACCI of 2–3, and 97 (17%) had an ACCI of ≥4. The ACCI was significantly associated with the rate of complete gross resection (0–1=44%, 2–3=32%, and ≥4=32%; p=0.02), but was not associated with the rate of minor (47% vs 47% vs 43%, p=0.84) or major (18% vs 19% vs 16%, p=0.8) complications. The ACCI was also significantly associated with progression-free (PFS) and overall survival (OS). Median PFS for patients with an ACCI of 0–1, 2–3, and ≥4 was 20.3, 16, and 15.4 months, respectively (p=0.02). Median OS for patients with an ACCI of 0–1, 2–3, and ≥4 was 65.3, 49.9, and 42.3 months, respectively (p<0.001). On multivariate analysis, the ACCI remained a significant prognostic factor for both PFS (p=0.02) and OS (p<0.001). Conclusions The ACCI was not associated with perioperative complications in patients undergoing primary cytoreduction for advanced EOC, but was a significant predictor of PFS and OS. Prospective clinical trials in ovarian cancer should consider stratifying for an age-comorbidity covariate. PMID:26037900

  8. The relations of Arab Jordanian adolescents' perceived maternal parenting to teacher-rated adjustment and problems: the intervening role of perceived need satisfaction.

    PubMed

    Ahmad, Ikhlas; Vansteenkiste, Maarten; Soenens, Bart

    2013-01-01

    Although the effects of important parenting dimensions, such as responsiveness and psychological control, are well documented among Western populations, research has only recently begun to systematically identify psychological processes that may account for the cross-cultural generalization of these effects. A first aim of this study was to examine whether perceived maternal responsiveness and psychological control would relate differentially to teacher ratings of adolescent adjustment in a vertical-collectivist society (i.e., Jordan). The most important aim of this study was to examine, on the basis of self-determination theory, whether these associations would be accounted for by perceived satisfaction of the basic psychological needs for autonomy, competence, and relatedness. Results in a large sample of Jordanian adolescents (N = 545) showed that perceived maternal psychological control and responsiveness yielded, respectively, a positive and negative association with teacher-rated problems, whereas psychological control was negatively related to teacher-rated adjustment. Further, these 2 parenting dimensions related to adjustment and problems via perceived satisfaction of the basic psychological needs for autonomy and competence (but not relatedness). The findings are discussed in light of the ongoing debate between universalistic and relativistic perspectives on parenting and adolescent adjustment. PMID:22468568

  9. 2 CFR 200.411 - Adjustment of previously negotiated indirect (F&A) cost rates containing unallowable costs.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... by the cognizant agency for indirect costs. The choice of method must be at the discretion of the cognizant agency for indirect costs, based on its judgment as to which method would be most practical. (e... Cost Principles Basic Considerations § 200.411 Adjustment of previously negotiated indirect (F&A)...

  10. 39 CFR 3010.22 - Calculation of annual limitation when notices of rate adjustment are less than 12 months apart.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Adjusted, Base Period 1982-84 = 100. The current Series ID for the index is “CUUR0000SA0.” (b) If a notice... = 100. The current Series ID for the index is “CUUR0000SA0.” (b) If a notice of a Type 1-A or Type...

  11. Health Information Seeking and Cancer Screening Adherence Rates.

    PubMed

    Shneyderman, Yuliya; Rutten, Lila J Finney; Arheart, Kristopher L; Byrne, Margaret M; Kornfeld, Julie; Schwartz, Seth J

    2016-03-01

    Effective screening tools are available for many of the top cancer killers in the USA. Searching for health information has previously been found to be associated with adhering to cancer screening guidelines, but Internet information seeking has not been examined separately. The current study examines the relationship between health and cancer Internet information seeking and adherence to cancer screening guidelines for breast, cervical, and colorectal cancer in a large nationally representative dataset. The current study was conducted using data from the Health Information National Trends Survey from 2003 and 2007. The study examined age-stratified models which correlated health and cancer information seeking with getting breast, cervical, and colorectal cancer screening on schedule, while controlling for several key variables. Internet health and cancer information seeking was positively associated with getting Pap screening on schedule, while information seeking from any sources was positively associated with getting colorectal screening on schedule. People who look for health or cancer information are more likely to get screened on schedule. Some groups of people, however, do not exhibit this relationship and, thus, may be more vulnerable to under-screening. These groups may benefit more from targeted interventions that attempt to engage people in their health care more actively. PMID:25619195

  12. Lung cancer treatment rates and the role of the lung cancer nurse specialist: a qualitative study

    PubMed Central

    Redman, Judy; McDonnell, Ann; Borthwick, Diana; White, John

    2015-01-01

    Objectives This qualitative study examines how the Lung Cancer Nurse Specialist (LCNS) role operates and why they may be able to increase access to treatment. Setting 4 Hospital NHS Foundation Trusts in England. Design A multiple case study design using semistructured interviews, observation and Framework Analysis techniques. Participants Four LCNSs, comprised the ‘cases’. Twenty four clinicians who worked with the LCNS participated in individual interviews. Six LCNSs took part in a group interview and 60 lung cancer multidisciplinary team (MDT) members and co-ordinators were observed in the MDT meeting. Results The LCNS is crucial within the MDT and can act as a catalyst to patient access to treatment. The study identified the clinical activity (assessment, managing symptoms, psychological support and information provision) and role characteristics that can facilitate treatment access. These characteristics are the LCNS's presence across the patient pathway, acting as the ‘hub’ of the MDT, maintaining a holistic patient focus and working to an advanced level of practice. The findings indicate how factors may have a cumulative impact on treatment access. Conclusions If UK patient with lung cancer survival rates are to improve in line with comparable countries, we need to employ every advantage. This study demonstrates how the LCNS role may open doors to positive patient outcomes, including treatment. Further research is required to explore patients’ experiences, decision-making and attitudes to treatment. PMID:26685023

  13. Breast cancer statistics, 2015: Convergence of incidence rates between black and white women.

    PubMed

    DeSantis, Carol E; Fedewa, Stacey A; Goding Sauer, Ann; Kramer, Joan L; Smith, Robert A; Jemal, Ahmedin

    2016-01-01

    In this article, the American Cancer Society provides an overview of female breast cancer statistics in the United States, including data on incidence, mortality, survival, and screening. Approximately 231,840 new cases of invasive breast cancer and 40,290 breast cancer deaths are expected to occur among US women in 2015. Breast cancer incidence rates increased among non-Hispanic black (black) and Asian/Pacific Islander women and were stable among non-Hispanic white (white), Hispanic, and American Indian/Alaska Native women from 2008 to 2012. Although white women have historically had higher incidence rates than black women, in 2012, the rates converged. Notably, during 2008 through 2012, incidence rates were significantly higher in black women compared with white women in 7 states, primarily located in the South. From 1989 to 2012, breast cancer death rates decreased by 36%, which translates to 249,000 breast cancer deaths averted in the United States over this period. This decrease in death rates was evident in all racial/ethnic groups except American Indians/Alaska Natives. However, the mortality disparity between black and white women nationwide has continued to widen; and, by 2012, death rates were 42% higher in black women than in white women. During 2003 through 2012, breast cancer death rates declined for white women in all 50 states; but, for black women, declines occurred in 27 of 30 states that had sufficient data to analyze trends. In 3 states (Mississippi, Oklahoma, and Wisconsin), breast cancer death rates in black women were stable during 2003 through 2012. Widening racial disparities in breast cancer mortality are likely to continue, at least in the short term, in view of the increasing trends in breast cancer incidence rates in black women. PMID:26513636

  14. Salivary Immunoglobulin A Secretion Rate Is Negatively Associated with Cancer Mortality: The West of Scotland Twenty-07 Study.

    PubMed

    Phillips, Anna C; Carroll, Douglas; Drayson, Mark T; Der, Geoff

    2015-01-01

    Immunoglobulins are essential for combating infectious disease although very high levels can indicate underlying pathology. The present study examined associations between secretory immunoglobulin A (sIgA) in saliva and mortality rates in the general population. Participants were 639 adults from the eldest cohort of the West of Scotland Twenty-07 Study aged 63 years at the time of saliva sampling in 1995. From unstimulated 2-minute saliva samples, saliva volume and S-IgA concentration were measured, and S-IgA secretion rate determined as their product. Mortality data were tracked for 19 years. Cox proportional hazard models were applied to compute hazard ratios (HR) for all-cause mortality from sIgA secretion rate. Associations were adjusted for gender, assay batch, household occupational group, smoking, medication usage, and self-reported health. There was a negative association between log sIgA secretion rate and all-cause mortality, HR = 0.81, 95%CI = 0.73-0.91, p < .001. Further analysis of specific causes of mortality revealed that the all-cause association was due to an underlying association with cancer mortality and in particular with cancers other than lung cancer. The HR for non-lung cancer was 0.68 (95%CI = 0.54 to 0.85) implying a 32% reduction in mortality risk per standard deviation rise in log sIgA secretion rate. Effects were stronger for men than women. For deaths from respiratory diseases, sIgA secretion had a non-linear relationship with mortality risk whereby only the very lowest levels of secretion were associated with elevated risk. SIgA concentration revealed a similar but weaker pattern of association. In the present study, higher secretion rates of sIgA were associated with a decreased risk of death from cancer, specifically non-lung cancer, as well as from respiratory disease. Thus, it appears that sIgA plays a protective role among older adults, and could serve as a marker of mortality risk, specifically cancer mortality. PMID:26699127

  15. Salivary Immunoglobulin A Secretion Rate Is Negatively Associated with Cancer Mortality: The West of Scotland Twenty-07 Study

    PubMed Central

    Carroll, Douglas; Drayson, Mark T.

    2015-01-01

    Immunoglobulins are essential for combating infectious disease although very high levels can indicate underlying pathology. The present study examined associations between secretory immunoglobulin A (sIgA) in saliva and mortality rates in the general population. Participants were 639 adults from the eldest cohort of the West of Scotland Twenty-07 Study aged 63 years at the time of saliva sampling in 1995. From unstimulated 2-minute saliva samples, saliva volume and S-IgA concentration were measured, and S-IgA secretion rate determined as their product. Mortality data were tracked for 19 years. Cox proportional hazard models were applied to compute hazard ratios (HR) for all-cause mortality from sIgA secretion rate. Associations were adjusted for gender, assay batch, household occupational group, smoking, medication usage, and self-reported health. There was a negative association between log sIgA secretion rate and all-cause mortality, HR = 0.81, 95%CI = 0.73–0.91, p < .001. Further analysis of specific causes of mortality revealed that the all-cause association was due to an underlying association with cancer mortality and in particular with cancers other than lung cancer. The HR for non-lung cancer was 0.68 (95%CI = 0.54 to 0.85) implying a 32% reduction in mortality risk per standard deviation rise in log sIgA secretion rate. Effects were stronger for men than women. For deaths from respiratory diseases, sIgA secretion had a non-linear relationship with mortality risk whereby only the very lowest levels of secretion were associated with elevated risk. SIgA concentration revealed a similar but weaker pattern of association. In the present study, higher secretion rates of sIgA were associated with a decreased risk of death from cancer, specifically non-lung cancer, as well as from respiratory disease. Thus, it appears that sIgA plays a protective role among older adults, and could serve as a marker of mortality risk, specifically cancer mortality. PMID:26699127

  16. Chemotherapy for Late-Stage Cancer Patients: Meta-Analysis of Complete Response Rates

    PubMed Central

    Ashdown, Martin L.; Robinson, Andrew P.; Yatomi-Clarke, Steven L.; Ashdown, M. Luisa; Allison, Andrew; Abbott, Derek; Markovic, Svetomir N.; Coventry, Brendon J.

    2015-01-01

    Complete response (CR) rates reported for cytotoxic chemotherapy for late-stage cancer patients are generally low, with few exceptions, regardless of the solid cancer type or drug regimen. We investigated CR rates reported in the literature for clinical trials using chemotherapy alone, across a wide range of tumour types and chemotherapeutic regimens, to determine an overall CR rate for late-stage cancers. A total of 141 reports were located using the PubMed database. A meta-analysis was performed of reported CR from 68 chemotherapy trials (total 2732 patients) using standard agents across late-stage solid cancers—a binomial model with random effects was adopted. Mean CR rates were compared for different cancer types, and for chemotherapeutic agents with different mechanisms of action, using a logistic regression. Our results showed that the CR rates for chemotherapy treatment of late-stage cancer were generally low at 7.4%, regardless of the cancer type or drug regimen used. We found no evidence that CR rates differed between different chemotherapy drug types, but amongst different cancer types small CR differences were evident, although none exceeded a mean CR rate of 11%. This remarkable concordance of CR rates regardless of cancer or therapy type remains currently unexplained, and motivates further investigation. PMID:26834979

  17. The Mediating Role of Mental Adjustment in the Relationship between Perceived Stress and Depressive Symptoms in Hematological Cancer Patients: A Cross-Sectional Study

    PubMed Central

    Li, Yingchun; Yang, Ying; Zhang, Rong; Yao, Kun; Liu, Zhuogang

    2015-01-01

    Background Depression is a particularly common psychological disorder that affects cancer patients. Diagnosed with hematological malignancies constitute a serious unpredictable and uncontrollable medical stress situation and patients are susceptible to suffer from depressive symptoms. The aims of the study were to explore the correlation between perceived stress and depressive symptoms in patients with hematological malignancies, and assess the mediating role of mental adjustment between these variables. Methods A single center, cross-sectional study was performed by convenience sampling between July 2013 and April 2014 in a hospital of China. The Center for Epidemiologic Studies Depression Scale, Perceived Stress Scale, and Mini-Mental Adjustment Scale, as well as questions about demographic and clinical factors was distributed to 300 hematological cancer patients. Completed questionnaires were received from 227 inpatients. Results The results showed that perceived stress was positively correlated with depressive symptoms. The mental adjustment significantly mediated the relationship between perceived stress and depressive symptoms. Conclusions Among hematological cancer patients perceived stress may be a risk factor for depressive symptoms, whereas positive coping style might be protective against depressive symptoms. Results showed that medical managers could support the development of mental adjustment in the patients to alleviate psychological disorders. PMID:26587991

  18. 75 FR 70744 - Fiscal Year (FY) 2012-2013 Proposed Power Rate Adjustments Public Hearing and Opportunities for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-18

    ...BPA is holding a consolidated rate proceeding, Docket No. BP- 12, to establish power and transmission rates for FY 2012-2013. The purpose of this Federal Register Notice is to provide notice of the proposed power rates and the rates for control area services and certain ancillary services (listed below, Section IV.C.). BPA will issue a separate Federal Register Notice to provide notice of the......

  19. Prostate Cancer in South Africa: Pathology Based National Cancer Registry Data (1986–2006) and Mortality Rates (1997–2009)

    PubMed Central

    Babb, Chantal; Urban, Margaret; Kielkowski, Danuta; Kellett, Patricia

    2014-01-01

    Prostate cancer is one of the most common male cancers globally; however little is known about prostate cancer in Africa. Incidence data for prostate cancer in South Africa (SA) from the pathology based National Cancer Registry (1986–2006) and data on mortality (1997–2009) from Statistics SA were analysed. World standard population denominators were used to calculate age specific incidence and mortality rates (ASIR and ASMR) using the direct method. Prostate cancer was the most common male cancer in all SA population groups (excluding basal cell carcinoma). There are large disparities in the ASIR between black, white, coloured, and Asian/Indian populations: 19, 65, 46, and 19 per 100 000, respectively, and ASMR was 11, 7, 52, and 6 per 100 000, respectively. Prostate cancer was the second leading cause of cancer death, accounting for around 13% of male deaths from a cancer. The average age at diagnosis was 68 years and 74 years at death. For SA the ASIR increased from 16.8 in 1986 to 30.8 in 2006, while the ASMR increased from 12.3 in 1997 to 16.7 in 2009. There has been a steady increase of incidence and mortality from prostate cancer in SA. PMID:24955252

  20. Prostate cancer in South Africa: pathology based national cancer registry data (1986-2006) and mortality rates (1997-2009).

    PubMed

    Babb, Chantal; Urban, Margaret; Kielkowski, Danuta; Kellett, Patricia

    2014-01-01

    Prostate cancer is one of the most common male cancers globally; however little is known about prostate cancer in Africa. Incidence data for prostate cancer in South Africa (SA) from the pathology based National Cancer Registry (1986-2006) and data on mortality (1997-2009) from Statistics SA were analysed. World standard population denominators were used to calculate age specific incidence and mortality rates (ASIR and ASMR) using the direct method. Prostate cancer was the most common male cancer in all SA population groups (excluding basal cell carcinoma). There are large disparities in the ASIR between black, white, coloured, and Asian/Indian populations: 19, 65, 46, and 19 per 100 000, respectively, and ASMR was 11, 7, 52, and 6 per 100 000, respectively. Prostate cancer was the second leading cause of cancer death, accounting for around 13% of male deaths from a cancer. The average age at diagnosis was 68 years and 74 years at death. For SA the ASIR increased from 16.8 in 1986 to 30.8 in 2006, while the ASMR increased from 12.3 in 1997 to 16.7 in 2009. There has been a steady increase of incidence and mortality from prostate cancer in SA. PMID:24955252

  1. QuickStats: Age-Adjusted Suicide Rates* for Females and Males, by Method(†) - National Vital Statistics System, United States, 2000 and 2014.

    PubMed

    2016-01-01

    From 2000 to 2014, the age-adjusted suicide rate increased from 4.0 to 5.8 per 100,000 for females and from 17.7 to 20.7 for males. Suicide rates by specific method (firearm, poisoning, suffocation, or other methods) also increased, with the greatest increase seen for suicides by suffocation. During the 15-year period, the rate of suicide by suffocation more than doubled for females from 0.7 to 1.6 and increased from 3.4 to 5.6 for males. In 2014, among females, suicide by poisoning had the highest rate (1.9), and among males, suicide by firearm had the highest rate (11.4). PMID:27197046

  2. Relation between clinical and mammographic diagnosis of breast problems and the cancer/biopsy rate

    PubMed Central

    Sterns, Ernest E.

    1996-01-01

    Objective To determine the sensitivity of mammographic and clinical assessment of breast problems, independent of one another, on the ratio of cancers found to biopsies performed (cancer/biopsy rate). Design A review of diagnoses from prospectively recorded and independently assessed clinical and mammographic examinations. Setting The breast clinic in a university-affiliated hospital. Patients Patients were considered in two age groups — under 50 years and 50 years and over; 1251 patients underwent breast biopsy between September 1976 and November 1994 after clinical assessment and mammography. Main Outcome Measure The cancer diagnosis rate found on biopsy as a result of clinical and mammographic findings. Results In both age groups, mammography was significantly (p < 0.001) more sensitive than clinical assessment in cancer diagnosis but gave a significantly (p < 0.0001) higher rate of false-positive results. The cancer diagnosis rate was highest when lesions were assessed both clinically and mammographically as malignant but was of diagnostic benefit only to women in the under-50-year age group. The cancer rate was 12% when both assessments indicated a benign process and only 2% in women under age 50 years with clinically benign conditions who did not have mammography. Twenty-one percent of the biopsies were obtained in women with clinically normal breasts because of a mammographic abnormality and 17% of all the cancers found were clinically occult. Conclusions The sensitivity of clinical assessment, particularly in premenopausal women is low and the false-positive mammography rate is high, but the cancer/biopsy rate is sufficiently high to warrant breast biopsy if either diagnostic modality suggests a cancer. When neither modality suggests cancer, the cancer/biopsy rate is 12% in both age groups. PMID:8769923

  3. A poly(glycerol sebacate)-coated mesoporous bioactive glass scaffold with adjustable mechanical strength, degradation rate, controlled-release and cell behavior for bone tissue engineering.

    PubMed

    Lin, Dan; Yang, Kai; Tang, Wei; Liu, Yutong; Yuan, Yuan; Liu, Changsheng

    2015-07-01

    Various requirements in the field of tissue engineering have motivated the development of three-dimensional scaffold with adjustable physicochemical properties and biological functions. A series of multiparameter-adjustable mesoporous bioactive glass (MBG) scaffolds with uncrosslinked poly(glycerol sebacate) (PGS) coating was prepared in this article. MBG scaffold was prepared by a modified F127/PU co-templating process and then PGS was coated by a simple adsorption and lyophilization process. Through controlling macropore parameters and PGS coating amount, the mechanical strength, degradation rate, controlled-release and cell behavior of the composite scaffold could be modulated in a wide range. PGS coating successfully endowed MBG scaffold with improved toughness and adjustable mechanical strength covering the bearing range of trabecular bone (2-12MPa). Multilevel degradation rate of the scaffold and controlled-release rate of protein from mesopore could be achieved, with little impact on the protein activity owing to an "ultralow-solvent" coating and "nano-cavity entrapment" immobilization method. In vitro studies indicated that PGS coating promoted cell attachment and proliferation in a dose-dependent manner, without affecting the osteogenic induction capacity of MBG substrate. These results first provide strong evidence that uncrosslinked PGS might also yield extraordinary achievements in traditional MBG scaffold. With the multiparameter adjustability, the composite MBG/PGS scaffolds would have a hopeful prospect in bone tissue engineering. The design considerations and coating method of this study can also be extended to other ceramic-based artificial scaffolds and are expected to provide new thoughts on development of future tissue engineering materials. PMID:25935647

  4. PIP breast implants: rupture rate and correlation with breast cancer

    PubMed Central

    MOSCHETTA, M.; TELEGRAFO, M.; CORNACCHIA, I.; VINCENTI, L.; RANIERI, V.; CIRILLI, A.; RELLA, L.; IANORA, A.A. STABILE; ANGELELLI, G.

    2014-01-01

    Aim To evaluate the incidence of Poly Implant Prosthése (PIP) rupture as assessed by magnetic resonance imaging (MRI), the prevalence of the detected signs and the potential correlation with breast carcinoma. Patients and methods 67 patients with silicone breast implants and clinical indications for breast MRI were evaluated for a total of 125 implants: 40 (32%) PIP in 21 patients and 85 non-PIP in 46 patients (68%), the latest considered as control group. A 1.5-T MR imaging device was used in order to assess implant integrity with dedicated sequences and in 6 cases a dynamic study was performed for characterizing breast lesions. Two radiologists with more than 5 years’ experience in the field of MRI evaluated in consensus all MR images searching for the presence of clear signs of intra or extra-capsular implant rupture. Results 20/40 (50%) PIP implants presented signs of intra-capsular rupture: linguine sign in 20 cases (100%), tear-drop sign in 6 (30%). In 12/20 cases (60%), MRI signs of extra-capsular rupture were detected. In the control group, an intra-capsular rupture was diagnosed in 12/85 cases (14%) associated with extra-capsular one in 5/12 cases (42%). Among the six cases with suspected breast lesions, in 2/21 patients with PIP implants (10%) a breast carcinoma was diagnosed (mucinous carcinoma, n=1; invasive ductal carcinoma, n=1). In 4/46 patients (9%) with non-PIP implants, an invasive ductal carcinoma was diagnosed. Conclusion The rupture rate of PIP breast implants is significantly higher than non-PIP (50% vs 14%). MRI represents the most accurate imaging tool for evaluating breast prostheses and the linguine sign is the most common MRI sign to be searched. The incidence of breast carcinoma does not significantly differ between the PIP and non-PIP implants and a direct correlation with breast cancer can not been demonstrated. PMID:25644728

  5. Delay Adjusted Incidence Infographic

    Cancer.gov

    This Infographic shows the National Cancer Institute SEER Incidence Trends. The graphs show the Average Annual Percent Change (AAPC) 2002-2011. For Men, Thyroid: 5.3*,Liver & IBD: 3.6*, Melanoma: 2.3*, Kidney: 2.0*, Myeloma: 1.9*, Pancreas: 1.2*, Leukemia: 0.9*, Oral Cavity: 0.5, Non-Hodgkin Lymphoma: 0.3*, Esophagus: -0.1, Brain & ONS: -0.2*, Bladder: -0.6*, All Sites: -1.1*, Stomach: -1.7*, Larynx: -1.9*, Prostate: -2.1*, Lung & Bronchus: -2.4*, and Colon & Rectum: -3/0*. For Women, Thyroid: 5.8*, Liver & IBD: 2.9*, Myeloma: 1.8*, Kidney: 1.6*, Melanoma: 1.5, Corpus & Uterus: 1.3*, Pancreas: 1.1*, Leukemia: 0.6*, Brain & ONS: 0, Non-Hodgkin Lymphoma: -0.1, All Sites: -0.1, Breast: -0.3, Stomach: -0.7*, Oral Cavity: -0.7*, Bladder: -0.9*, Ovary: -0.9*, Lung & Bronchus: -1.0*, Cervix: -2.4*, and Colon & Rectum: -2.7*. * AAPC is significantly different from zero (p<.05). Rates were adjusted for reporting delay in the registry. www.cancer.gov Source: Special section of the Annual Report to the Nation on the Status of Cancer, 1975-2011.

  6. Cultural Influences on Ratings of Behavioral and Emotional Problems, and School Adjustment for Korean, Korean American, and Caucasian American Children.

    ERIC Educational Resources Information Center

    Jung, Woo Sik

    This study investigated the effects of child behavioral ratings on the Behavioral Assessment System for Children (BASC) assessed for elementary-age students residing in Oklahoma, Los Angeles, and Seoul, Korea. The students completed the BASC Self Report of Personality (SRP) to examine the differences in the self-report ratings of behavioral…

  7. Occupational Exposure to Diesel Motor Exhaust and Lung Cancer: A Dose-Response Relationship Hidden by Asbestos Exposure Adjustment? The ICARE Study.

    PubMed

    Matrat, Mireille; Guida, Florence; Cénée, Sylvie; Févotte, Joelle; Carton, Matthieu; Cyr, Diane; Menvielle, Gwenn; Paget-Bailly, Sophie; Radoï, Loredana; Schmaus, Annie; Bara, Simona; Velten, Michel; Luce, Danièle; Stücker, Isabelle; The Icare Study Group

    2015-01-01

    Background. In a French large population-based case-control study we investigated the dose-response relationship between lung cancer and occupational exposure to diesel motor exhaust (DME), taking into account asbestos exposure. Methods. Exposure to DME was assessed by questionnaire. Asbestos was taken into account through a global indicator of exposure to occupational carcinogens or by a specific JEM. Results. We found a crude dose response relationship with most of the indicators of DME exposure, including with the cumulative exposure index. All results were affected by adjustment for asbestos exposure. The dose response relationships between DME and lung cancer were observed among subjects never exposed to asbestos. Conclusions. Exposure to DME and to asbestos is frequently found among the same subjects, which may explain why dose-response relationships in previous studies that adjusted for asbestos exposure were inconsistent. PMID:26425123

  8. Occupational Exposure to Diesel Motor Exhaust and Lung Cancer: A Dose-Response Relationship Hidden by Asbestos Exposure Adjustment? The ICARE Study

    PubMed Central

    Matrat, Mireille; Guida, Florence; Cénée, Sylvie; Févotte, Joelle; Carton, Matthieu; Cyr, Diane; Menvielle, Gwenn; Paget-Bailly, Sophie; Radoï, Loredana; Schmaus, Annie; Bara, Simona; Velten, Michel; Luce, Danièle; Stücker, Isabelle; The Icare Study Group

    2015-01-01

    Background. In a French large population-based case-control study we investigated the dose-response relationship between lung cancer and occupational exposure to diesel motor exhaust (DME), taking into account asbestos exposure. Methods. Exposure to DME was assessed by questionnaire. Asbestos was taken into account through a global indicator of exposure to occupational carcinogens or by a specific JEM. Results. We found a crude dose response relationship with most of the indicators of DME exposure, including with the cumulative exposure index. All results were affected by adjustment for asbestos exposure. The dose response relationships between DME and lung cancer were observed among subjects never exposed to asbestos. Conclusions. Exposure to DME and to asbestos is frequently found among the same subjects, which may explain why dose-response relationships in previous studies that adjusted for asbestos exposure were inconsistent. PMID:26425123

  9. Solid-state YVO4/Nd:YVO4/KTP green laser system for the generation of subnanosecond pulses with adjustable kilohertz repetition rate.

    PubMed

    Zhang, Haijuan; Zhao, Shengzhi; Yang, Kejian; Li, Guiqiu; Li, Dechun; Zhao, Jia; Wang, Yonggang

    2013-09-20

    A solid-state green laser generating subnanosecond pulses with adjustable kilohertz repetition rate is presented. This pulse laser system is composed of a Q-switched and mode-locked YVO(4)/Nd:YVO(4)/KTP laser simultaneously modulated by an electro-optic (EO) modulator and a central semiconductor saturable absorption mirror. Because the repetition rate of the Q-switched envelope in this laser depends on the modulation frequency of the EO modulator, so long as the pulsewidth of the Q-switched envelope is shorter than the cavity roundtrip transmit time, i.e., the time interval of two neighboring mode-locking pulses, only one mode-locking pulse exists underneath a Q-switched envelope, resulting in the generation of subnanosecond pulses with kilohertz repetition rate. The experimental results show that the pulsewidth of subnanosecond pulses decreases with increasing pump power and the shortest pulse generated at 1 kHz was 450 ps with pulse energy as high as 252 μJ, corresponding to a peak power of 560 kW. In addition, this laser was confirmed to have high stability, and the pulse repetition rate could be freely adjusted from 1 to 4 kHz. PMID:24085177

  10. A fast rise-rate, adjustable-mass-bit gas puff valve for energetic pulsed plasma experiments

    SciTech Connect

    Loebner, Keith T. K. Underwood, Thomas C.; Cappelli, Mark A.

    2015-06-15

    A fast rise-rate, variable mass-bit gas puff valve based on the diamagnetic repulsion principle was designed, built, and experimentally characterized. The ability to hold the pressure rise-rate nearly constant while varying the total overall mass bit was achieved via a movable mechanical restrictor that is accessible while the valve is assembled and pressurized. The rise-rates and mass-bits were measured via piezoelectric pressure transducers for plenum pressures between 10 and 40 psig and restrictor positions of 0.02-1.33 cm from the bottom of the linear restrictor travel. The mass-bits were found to vary linearly with the restrictor position at a given plenum pressure, while rise-rates varied linearly with plenum pressure but exhibited low variation over the range of possible restrictor positions. The ability to change the operating regime of a pulsed coaxial plasma deflagration accelerator by means of altering the valve parameters is demonstrated.

  11. A fast rise-rate, adjustable-mass-bit gas puff valve for energetic pulsed plasma experiments

    NASA Astrophysics Data System (ADS)

    Loebner, Keith T. K.; Underwood, Thomas C.; Cappelli, Mark A.

    2015-06-01

    A fast rise-rate, variable mass-bit gas puff valve based on the diamagnetic repulsion principle was designed, built, and experimentally characterized. The ability to hold the pressure rise-rate nearly constant while varying the total overall mass bit was achieved via a movable mechanical restrictor that is accessible while the valve is assembled and pressurized. The rise-rates and mass-bits were measured via piezoelectric pressure transducers for plenum pressures between 10 and 40 psig and restrictor positions of 0.02-1.33 cm from the bottom of the linear restrictor travel. The mass-bits were found to vary linearly with the restrictor position at a given plenum pressure, while rise-rates varied linearly with plenum pressure but exhibited low variation over the range of possible restrictor positions. The ability to change the operating regime of a pulsed coaxial plasma deflagration accelerator by means of altering the valve parameters is demonstrated.

  12. 5 CFR 9701.337 - Treatment of employees whose rate of pay falls below the minimum adjusted rate of their band.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM (DEPARTMENT OF HOMELAND SECURITY-OFFICE OF PERSONNEL MANAGEMENT) DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Locality and Special Rate Supplements § 9701.337 Treatment of employees whose rate of pay...

  13. 5 CFR 9701.337 - Treatment of employees whose rate of pay falls below the minimum adjusted rate of their band.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM (DEPARTMENT OF HOMELAND SECURITY-OFFICE OF PERSONNEL MANAGEMENT) DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Locality and Special Rate Supplements § 9701.337 Treatment of employees whose rate of pay...

  14. 5 CFR 9701.337 - Treatment of employees whose rate of pay falls below the minimum adjusted rate of their band.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM (DEPARTMENT OF HOMELAND SECURITY-OFFICE OF PERSONNEL MANAGEMENT) DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Locality and Special Rate Supplements § 9701.337 Treatment of employees whose rate of pay...

  15. Estimation of an optimal chemotherapy utilisation rate for cancer: setting an evidence-based benchmark for quality cancer care.

    PubMed

    Jacob, S A; Ng, W L; Do, V

    2015-02-01

    There is wide variation in the proportion of newly diagnosed cancer patients who receive chemotherapy, indicating the need for a benchmark rate of chemotherapy utilisation. This study describes an evidence-based model that estimates the proportion of new cancer patients in whom chemotherapy is indicated at least once (defined as the optimal chemotherapy utilisation rate). The optimal chemotherapy utilisation rate can act as a benchmark for measuring and improving the quality of care. Models of optimal chemotherapy utilisation were constructed for each cancer site based on indications for chemotherapy identified from evidence-based treatment guidelines. Data on the proportion of patient- and tumour-related attributes for which chemotherapy was indicated were obtained, using population-based data where possible. Treatment indications and epidemiological data were merged to calculate the optimal chemotherapy utilisation rate. Monte Carlo simulations and sensitivity analyses were used to assess the effect of controversial chemotherapy indications and variations in epidemiological data on our model. Chemotherapy is indicated at least once in 49.1% (95% confidence interval 48.8-49.6%) of all new cancer patients in Australia. The optimal chemotherapy utilisation rates for individual tumour sites ranged from a low of 13% in thyroid cancers to a high of 94% in myeloma. The optimal chemotherapy utilisation rate can serve as a benchmark for planning chemotherapy services on a population basis. The model can be used to evaluate service delivery by comparing the benchmark rate with patterns of care data. The overall estimate for other countries can be obtained by substituting the relevant distribution of cancer types. It can also be used to predict future chemotherapy workload and can be easily modified to take into account future changes in cancer incidence, presentation stage or chemotherapy indications. PMID:25455844

  16. A Social Marketing Approach To Increasing Breast Cancer Screening Rates.

    ERIC Educational Resources Information Center

    Bryant, Carol A.; Forthofer, Melinda S.; McCormack Brown, Kelli; Alfonso, Moya Lynn; Quinn, Gwen

    2000-01-01

    Used social marketing to identify factors influencing women's breast cancer screening behaviors. Data from focus groups and interviews with diverse women highlighted women's attitudes, knowledge, and barriers regarding screening. Results were used to develop a comprehensive social marketing plan to motivate irregular users of breast cancer…

  17. The evolution of HPV-related anogenital cancers reported in Quebec - incidence rates and survival probabilities.

    PubMed

    Louchini, R; Goggin, P; Steben, M

    2008-01-01

    Non-cervical anogenital cancers (i.e. anal, vulvar, vaginal and penile cancers) associated with the human papillomavirus (HPV), for which HPV is known to be the necessary cause of carcinogenesis, are poorly documented due to their relatively low incidence rate. The aim of this study is to describe the incidence rates of these cancers between 1984 and 2001, and their relative survival probabilities, in Quebec (Canada) between 1984 and 1998. The incidence of these cancers is on the rise, particularly anal cancer in women and, more recently (since 1993-95), vulvar cancer. Between 1984-86 and 1993-95, the 5-year relative survival probability for men with anal cancer decreased from 57% to 46%, while that for penile cancer dropped from 75% to 59%. However, during the same period, the 5-year relative survival probability for women with anal cancer rose from 56% to 65%, and remained stable for cervical and vulvar cancers, at 74% and 82%, respectively. PMID:18341764

  18. Cancer detection rates of different prostate biopsy regimens in patients with renal failure.

    PubMed

    Hoşcan, Mustafa Burak; Özorak, Alper; Oksay, Taylan; Perk, Hakkı; Armağan, Abdullah; Soyupek, Sedat; Serel, Tekin Ahmet; Koşar, Alim

    2014-07-01

    We aimed to evaluate the cancer detection rates of 6-, 10-, 12-core biopsy regimens and the optimal biopsy protocol for prostate cancer diagnosis in patients with renal failure. A total of 122 consecutive patients with renal failure underwent biopsy with age-specific prostate-specific antigen (PSA) levels up to 20 ng/mL. The 12-core biopsy technique (sextant biopsy + lateral base, lateral mid-zone, lateral apex, bilaterally) performed to all patients. Pathology results were examined separately for each sextant, 10-core that exclude parasagittal mid-zones from 12-cores (10a), 10-core that exclude apex zones from 12-cores (10b) and 12-core biopsy regimens. Of 122 patients, 37 (30.3%) were positive for prostate cancer. The cancer detection rates for sextant, 10a, 10b and 12 cores were 17.2%, 29%, 23.7% and 30.7%, respectively. Biopsy techniques of 10a, 10b and 12 cores increased the cancer detection rates by 40%, 27.5% and 43.2% among the sextant technique, respectively. Biopsy techniques of 10a and 12 cores increased the cancer detection rates by 17.1% and 21.6% among 10b biopsy technique, respectively. There were no statistical differences between 12 core and 10a core about cancer detection rate. Adding lateral cores to sextant biopsy improves the cancer detection rates. In our study, 12-core biopsy technique increases the cancer detection rate by 5.4% among 10a core but that was not statistically different. On the other hand, 12-core biopsy technique includes all biopsy regimens. We therefore suggest 12-core biopsy or minimum 10-core strategy incorporating six peripheral biopsies with elevated age- specific PSA levels up to 20 ng/mL in patients with renal failure. PMID:24797801

  19. Trend and forecasting rate of cancer deaths at a public university hospital using univariate modeling

    NASA Astrophysics Data System (ADS)

    Ismail, A.; Hassan, Noor I.

    2013-09-01

    Cancer is one of the principal causes of death in Malaysia. This study was performed to determine the pattern of rate of cancer deaths at a public hospital in Malaysia over an 11 year period from year 2001 to 2011, to determine the best fitted model of forecasting the rate of cancer deaths using Univariate Modeling and to forecast the rates for the next two years (2012 to 2013). The medical records of the death of patients with cancer admitted at this Hospital over 11 year's period were reviewed, with a total of 663 cases. The cancers were classified according to 10th Revision International Classification of Diseases (ICD-10). Data collected include socio-demographic background of patients such as registration number, age, gender, ethnicity, ward and diagnosis. Data entry and analysis was accomplished using SPSS 19.0 and Minitab 16.0. The five Univariate Models used were Naïve with Trend Model, Average Percent Change Model (ACPM), Single Exponential Smoothing, Double Exponential Smoothing and Holt's Method. The overall 11 years rate of cancer deaths showed that at this hospital, Malay patients have the highest percentage (88.10%) compared to other ethnic groups with males (51.30%) higher than females. Lung and breast cancer have the most number of cancer deaths among gender. About 29.60% of the patients who died due to cancer were aged 61 years old and above. The best Univariate Model used for forecasting the rate of cancer deaths is Single Exponential Smoothing Technique with alpha of 0.10. The forecast for the rate of cancer deaths shows a horizontally or flat value. The forecasted mortality trend remains at 6.84% from January 2012 to December 2013. All the government and private sectors and non-governmental organizations need to highlight issues on cancer especially lung and breast cancers to the public through campaigns using mass media, media electronics, posters and pamphlets in the attempt to decrease the rate of cancer deaths in Malaysia.

  20. 76 FR 32204 - Adjusted Federal Medical Assistance Percentage (FMAP) Rates for the Second and Third Quarters of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-03

    ... Foster Care, Adoption Assistance and Guardianship Assistance programs. AGENCY: Office of the Secretary... of the ARRA provides for a temporary increase in FMAP rates for Medicaid and title ] IV-E Foster Care... available for expenditures under part E of title IV of the Act (including Foster Care, Adoption...

  1. 25 CFR 175.13 - Procedures for adjusting electric power rates to reflect changes in the cost of purchased power...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... changes in the cost of purchased power or energy. 175.13 Section 175.13 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN ELECTRIC POWER UTILITIES Service Fees, Electric Power Rates... purchased power or energy. Whenever the cost of purchased power or energy changes, the effect of the...

  2. 25 CFR 175.13 - Procedures for adjusting electric power rates to reflect changes in the cost of purchased power...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... changes in the cost of purchased power or energy. 175.13 Section 175.13 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN ELECTRIC POWER UTILITIES Service Fees, Electric Power Rates... purchased power or energy. Whenever the cost of purchased power or energy changes, the effect of the...

  3. 25 CFR 175.13 - Procedures for adjusting electric power rates to reflect changes in the cost of purchased power...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... changes in the cost of purchased power or energy. 175.13 Section 175.13 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN ELECTRIC POWER UTILITIES Service Fees, Electric Power Rates... purchased power or energy. Whenever the cost of purchased power or energy changes, the effect of the...

  4. Regional Variation in Breast Cancer Rates in the United States (Past Initiative)

    Cancer.gov

    Five institutions are being funded to conduct research using epidemiologic and statistical methods for determining whether various factors may account for the geographic differences in breast cancer rates in the United States.

  5. Estimating the Esophagus Cancer Incidence Rate in Ardabil, Iran: A Capture-Recapture Method

    PubMed Central

    Khodadost, Mahmoud; Yavari, Parvin; Khodadost, Behnam; Babaei, Masoud; Sarvi, Fatemeh; Khatibi, Seyed Reza; Barzegari, Saeed

    2016-01-01

    Background: Accurate cancer registry and awareness of cancer incidence rate is essential in order to define strategies for cancer prevention and control programs. Capture-recapture methods have been recommended for reducing bias and increase the accuracy of cancer incidence estimation. Objectives: This study aimed to estimate the esophagus cancer incidence by capture-recapture method based on Ardabil population-based cancer registry data. Patients and Methods: Total new cases of esophagus cancer reported by three sources of pathology reports, medical records, and death certificates to Ardabil province cancer registry center in 2006 and 2008 were enrolled in the study. All duplicated cases between three sources were identified and removed using Excel software. Some characteristics such as name, surname, father’s name, date of birth and ICD codes related to their cancer type were used for data linkage and finding the common cases among three sources. The incidence rate per 100,000 was estimated based on capture-recapture method using the log-linear models. We used BIC, G2 and AIC statistics to select the best-fit model. Results: After removing duplicates, total 471 new cases of esophagus cancer were reported from three sources. The model with linkage between pathology reports, medical record sources and independence with the death certificates source was the best fitted model. The reported incidence rate for the years 2006 and 2008 was 18.77 and 18.51 per 100,000, respectively. In log-linear analysis, the estimated incidence rate for the years 2006 and 2008 was 49.71 and 53.87 per 100,000 populations, respectively. Conclusions: Based on the obtained results, it can be concluded that none of the sources of pathology reports, death certificates and medical records individually or collectively were fully covered the incidence cases of esophagus cancer and need to apply some changes in data abstracting and case finding.

  6. Screening for prostate cancer

    NASA Technical Reports Server (NTRS)

    Weirich, Stephen A.

    1993-01-01

    Despite recent advances in both the survival and cure rates for many forms of cancer, unfortunately the same has not been true for prostate cancer. In fact, the age-adjusted death rate from prostate cancer has not significantly improved since 1949, and prostate cancer remains the most common cancer in American men, causing the second highest cancer mortality rate. Topics discussed include the following: serum testosterone levels; diagnosis; mortality statistics; prostate-sppecific antigen (PSA) tests; and the Occupational Medicine Services policy at LeRC.

  7. Distinct mutation accumulation rates among tissues determine the variation in cancer risk

    PubMed Central

    Hao, Dapeng; Wang, Li; Di, Li-jun

    2016-01-01

    Cancer is believed to be a result of accumulated mutations. However, this concept has not been fully confirmed owing to the impossibility of tracking down the ancestral somatic cell. We sought to verify the concept by exploring the correlation between cancer risk and mutation accumulation among different tissues. We hypothesized that the detected mutations through bulk tumor sequencing are commonly shared in majority, if not all, of tumor cells and are therefore largely a reflection of the mutations accumulated in the ancestral cell that gives rise to tumor. We collected a comprehensive list of mutation frequencies revealed by bulk tumor sequencing, and investigated its correlation with cancer risk to mirror the correlation between mutation accumulation and cancer risk. This revealed an approximate 1:1 relationship between mutation frequency and cancer risk in 41 different cancer types based on the sequencing data of 5,542 patients. The correlation strongly suggests that variation in cancer risk among tissues is mainly attributable to distinct mutation accumulation rates. Moreover, the correlation establishes a baseline to evaluate the effect of non-mutagenic carcinogens on cancer risk. Finally, our mathematic modeling provides a reasonable explanation to reinforce that cancer risk is predominantly determined by the first rate-limiting mutation. PMID:26785814

  8. Distinct mutation accumulation rates among tissues determine the variation in cancer risk.

    PubMed

    Hao, Dapeng; Wang, Li; Di, Li-jun

    2016-01-01

    Cancer is believed to be a result of accumulated mutations. However, this concept has not been fully confirmed owing to the impossibility of tracking down the ancestral somatic cell. We sought to verify the concept by exploring the correlation between cancer risk and mutation accumulation among different tissues. We hypothesized that the detected mutations through bulk tumor sequencing are commonly shared in majority, if not all, of tumor cells and are therefore largely a reflection of the mutations accumulated in the ancestral cell that gives rise to tumor. We collected a comprehensive list of mutation frequencies revealed by bulk tumor sequencing, and investigated its correlation with cancer risk to mirror the correlation between mutation accumulation and cancer risk. This revealed an approximate 1:1 relationship between mutation frequency and cancer risk in 41 different cancer types based on the sequencing data of 5,542 patients. The correlation strongly suggests that variation in cancer risk among tissues is mainly attributable to distinct mutation accumulation rates. Moreover, the correlation establishes a baseline to evaluate the effect of non-mutagenic carcinogens on cancer risk. Finally, our mathematic modeling provides a reasonable explanation to reinforce that cancer risk is predominantly determined by the first rate-limiting mutation. PMID:26785814

  9. Major ethnic group differences in breast cancer screening uptake in Scotland are not extinguished by adjustment for indices of geographical residence, area deprivation, long-term illness and education

    PubMed Central

    Bansal, N; Bhopal, R S; Steiner, M F C; Brewster, D H

    2012-01-01

    Background: Breast cancer screening data generally show lower uptake in minority ethnic groups. We investigated whether such variations occur in Scotland. Methods: Using non-disclosive computerised linkage we combined Scottish breast screening and Census 2001 data. Non-attendance at first breast-screening invitation (2002–2008) was compared between 11 ethnic groups using age-adjusted risk ratios (RR) with 95% confidence intervals (CI), multiplied by 100, using Poisson regression. Results: Compared with the White Scottish (RR=100), non-attendance was similar for Other White British (99.5, 95% CI 96.1–103.2) and Chinese (112.8, 95% CI 96.3–132.2) and higher for Pakistani (181.7, 95% CI 164.9–200.2), African (162.2, 95% CI 130.8–201.1), Other South Asian (151.7, 95% CI 118.9–193.7) and Indian (141.7, 95% CI 121.1–165.7) groups. Adjustment for rural vs urban residence, long-term illness, area deprivation and education, associated with risk of non-attendance, increased the RR for non-attendance except for Pakistani women where it was modestly attenuated (RR=164.9, 149.4–182.1). Conclusion: Our data show important inequality in breast cancer screening uptake, not attenuated by potential confounding factors. Ethnic inequalities in breast screening attendance are of concern especially given evidence that the traditionally lower breast cancer rates in South Asian groups are converging towards the risks in the White UK population. Notwithstanding the forthcoming review of breast cancer screening, these data call for urgent action. PMID:22415231

  10. Autism Linked to Increased Oncogene Mutations but Decreased Cancer Rate

    PubMed Central

    Zimmerman, M. Bridget; Mahajan, Vinit B.; Bassuk, Alexander G.

    2016-01-01

    Autism spectrum disorder (ASD) is one phenotypic aspect of many monogenic, hereditary cancer syndromes. Pleiotropic effects of cancer genes on the autism phenotype could lead to repurposing of oncology medications to treat this increasingly prevalent neurodevelopmental condition for which there is currently no treatment. To explore this hypothesis we sought to discover whether autistic patients more often have rare coding, single-nucleotide variants within tumor suppressor and oncogenes and whether autistic patients are more often diagnosed with neoplasms. Exome-sequencing data from the ARRA Autism Sequencing Collaboration was compared to that of a control cohort from the Exome Variant Server database revealing that rare, coding variants within oncogenes were enriched for in the ARRA ASD cohort (p<1.0x10-8). In contrast, variants were not significantly enriched in tumor suppressor genes. Phenotypically, children and adults with ASD exhibited a protective effect against cancer, with a frequency of 1.3% vs. 3.9% (p<0.001), but the protective effect decreased with age. The odds ratio of neoplasm for those with ASD relative to controls was 0.06 (95% CI: 0.02, 0.19; p<0.0001) in the 0 to 14 age group; 0.35 (95% CI: 0.14, 0.87; p = 0.024) in the 15 to 29 age group; 0.41 (95% CI: 0.15, 1.17; p = 0.095) in the 30 to 54 age group; and 0.49 (95% CI: 0.14, 1.74; p = 0.267) in those 55 and older. Both males and females demonstrated the protective effect. These findings suggest that defects in cellular proliferation, and potentially senescence, might influence both autism and neoplasm, and already approved drugs targeting oncogenic pathways might also have therapeutic value for treating autism. PMID:26934580

  11. HIGH CONSTANT INCIDENCE RATES OF SECOND PRIMARY CANCERS OF THE HEAD AND NECK: A POOLED ANALYSIS OF 13 CANCER REGISTRIES

    PubMed Central

    Bosetti, Cristina; Scelo, Ghislaine; Chuang, Shu-Chun; Tonita, Jon M.; Tamaro, Sharon; Jonasson, Jon G.; Kliewer, Erich V.; Hemminki, Kari; Weiderpass, Elisabete; Pukkala, Eero; Tracey, Elizabeth; Olsen, Jorgen H.; Pompe-Kirn, Vera; Brewster, David H.; Martos, Carmen; Chia, Kee-Seng; Brennan, Paul; Hashibe, Mia; Levi, Fabio; La Vecchia, Carlo; Boffetta, Paolo

    2010-01-01

    Scanty data are available on the incidence (i.e., the absolute risk) of second cancers of the head and neck (HN) and its pattern with age. We investigated this issue using data from a multicentric study of 13 population-based cancer registries from Europe, Canada, Australia and Singapore for the years 1943-2000. A total of 99,257 patients had a first primary HN cancer (15,985 tongue, 22,378 mouth, 20,758 pharyngeal, and 40,190 laryngeal cancer), contributing to 489,855 person-years of follow-up. 1294 of the patients (1.3%) were diagnosed with second HN cancers (342 tongue, 345 mouth, 418 pharynx, and 189 larynx). Male incidence rates of first HN cancer steeply increased from 0.68/100,000 at age 30-34 to 46.2/100,000 at age 70-74, and leveled off at higher age; female incidence increased from 0.50/100,000 at age 30-34 to 16.5/100,000 at age 80-84. However, age-specific incidence of second HN cancers after a first HN cancer in men was around 200-300/100,000 between age 40-44 and age 70-74, and tended to decline at subsequent ages (150/100,000 at age 80-84); in women, incidence of second HN cancers was around 200-300/100,000 between age 45-49 and 80-84. The patterns of age-specific incidence were consistent for different subsites of second HN cancer and sexes; moreover, they were similar for age-specific incidence of first primary HN cancer in patients who subsequently developed a second HN cancer. The incidence of second HN cancers does not increase with age, but remains constant, or if anything, decreases with advancing age. Impact statement While the incidence of first primary cancers of the head and neck increases with advancing age that of second primary cancers is stable between age 40 and 70 and, if anything, declines thereafter. PMID:20824702

  12. Increased microtubule assembly rates influence chromosomal instability in colorectal cancer cells.

    PubMed

    Ertych, Norman; Stolz, Ailine; Stenzinger, Albrecht; Weichert, Wilko; Kaulfuß, Silke; Burfeind, Peter; Aigner, Achim; Wordeman, Linda; Bastians, Holger

    2014-08-01

    Chromosomal instability (CIN) is defined as the perpetual missegregation of whole chromosomes during mitosis and represents a hallmark of human cancer. However, the mechanisms influencing CIN and its consequences on tumour growth are largely unknown. We identified an increase in microtubule plus-end assembly rates as a mechanism influencing CIN in colorectal cancer cells. This phenotype is induced by overexpression of the oncogene AURKA or by loss of the tumour suppressor gene CHK2, a genetic constitution found in 73% of human colorectal cancers. Increased microtubule assembly rates are associated with transient abnormalities in mitotic spindle geometry promoting the generation of lagging chromosomes and influencing CIN. Reconstitution of proper microtubule assembly rates by chemical or genetic means suppresses CIN and thereby, unexpectedly, accelerates tumour growth in vitro and in vivo. Thus, we identify a fundamental mechanism influencing CIN in cancer cells and reveal its adverse consequence on tumour growth. PMID:24976383

  13. Prophylactic Oophorectomy: Reducing the U.S. Death Rate from Epithelial Ovarian Cancer. A Continuing Debate.

    PubMed

    Piver

    1996-01-01

    If instead of the title "Prophylactic Oophorectomy: Reducing the U.S. Death Rate from Epithelial Ovarian Cancer," the title were "Drug X Reducing the U.S. Death Rate from Epithelial Ovarian Cancer," there would be great media and medical attention worldwide to such a report. Correctly so. Regrettably, there probably is no new Drug X in the foreseeable future that will significantly reduce the death rate from ovarian cancer, be it Taxol®, taxotere, topotecan, gemcitabine, or liposomal doxorubicin-although each may result in significant responses and some prolongation of median survival. Epithelial ovarian cancer is a much more complex disease than anyone envisioned, when it was believed that extensive debulking surgery and the newest cytotoxic chemotherapy would radically reduce the death rate from ovarian cancer in the United States. Over 20 years after the first patient was treated with cisplatin for epithelial ovarian cancer, the annual death rate from ovarian cancer continued to increase. Just in the past decade, the number of women in the United States dying from ovarian cancer has increased 18% (Fig. 1) [1]. Although ovarian cancer is estimated to account for 26,700 cases and 14,800 deaths in 1996, it is a low-prevalence disease in comparison with breast cancer, which in 1996 is estimated to account for 185,700 cases and 44,560 deaths. Inexplicably, similar to breast cancer, the lifetime risk for ovarian cancer in the United States continues to increase. The most recent Surveillance, Epidemiology and End Results (SEER) calculations of lifetime risk for ovarian cancer are that 1 in 55 women will develop ovarian cancer over their lifetime, or 1.8%, up from the 1970 figures of 1 in 70, or 1.4% [2]. The 1.8% baseline lifetime risk for the general population is used to estimate the lifetime risk of known ovarian cancer risk factors (Table 1). Even utilizing what are now believed to be two of the most effective cytotoxic drugs against stage III and IV epithelial

  14. High power fiber amplifier with adjustable repetition rate for use in all-fiber supercontinuum light sources

    NASA Astrophysics Data System (ADS)

    Baselt, T.; Taudt, Ch.; Hartmann, P.

    2014-03-01

    In recent years the use of supercontinuum light sources has encouraged the development of various optical measurement techniques, like microscopy and optical coherence-tomography. Some disadvantages of common supercontinuum solutions, in particular the rather poor stability and the absence of modulation abilities limit the application potential of this technique. We present a directly controllable all-fiber laser source with appropriate parameters in order to generate a broad supercontinuum spectrum with the aid of microstructured fibers. Through the application of a laser seed-diode, which is driven by a custom built controller to generate nanosecond pulses with repetition rates in the MHz range in a reproducible manner, a direct control of the laser system is enabled. The seedsignal is amplified to the appropriate power level in a 2-step amplification stage. Wide supercontinuum is finally generated by launching the amplified laser pulses into different microstructured fibers. The system has been optimized in terms of stability, power-output, spectral width and beam-quality by employing different laser pulse parameters and several different microstructured fibers. Finally, the system as a whole has been characterized in reference to common solid state-laser-based supercontinuum light sources

  15. What is the relationship between ultraviolet B and global incidence rates of colorectal cancer?

    PubMed Central

    Cuomo, Raphael E.; Mohr, Sharif B.; Gorham, Edward D.; Garland, Cedric F.

    2013-01-01

    The purpose of this study is to examine the relationship between ultraviolet B and global incidence of colorectal cancer, while controlling for relevant covariates. Linear regression was used to assess the relationship between latitude and incidence rates of colon cancer in 173 countries. Multiple linear regression was employed to investigate the relationship between ultraviolet B dose and colorectal cancer rates while controlling for per capita intake of energy from animal sources, per capita health expenditure, pigmentation, and life expectancy. Data on all variables were available for 139 countries. Incidence of colon cancer was highest in countries distant from the equator (R2 = 0.50, p < 0.0001). UV B dose (p < 0.0001) was independently, inversely associated with incidence rates of colorectal cancer after controlling for intake of energy from animal sources, per capita health expenditure, pigmentation, and life expectancy (R2 for overall model = 0.76, p < 0.0001). Consistent with previous research, UVB was inversely associated with incidence of colon cancer. Further research on vitamin D and prevention of colon cancer in individuals should be conducted, including studies of higher serum 25-hydroxyvitamin D concentrations than have been studied to date. PMID:24494052

  16. High resolution anoscopy may be useful in achieving reductions in anal cancer local disease failure rates.

    PubMed

    Goon, P; Morrison, V; Fearnhead, N; Davies, J; Wilson, C; Jephcott, C; Sterling, J; Crawford, R

    2015-05-01

    Anal cancer is uncommon, with an incidence rate of 0.5-1.0 per 100,000 of the population but incidence rates have been steadily increasing over the last 3 decades. Biological and epidemiological evidence have been mounting and demonstrate that anal cancer has many similarities to cervical cancer, especially in regard to its aetiology. High-resolution anoscopy (HRA) of the anal region – analogous to colposcopy of the cervix, is a technique that is not well-known in the medical and surgical fraternity. Evidence to support the use of HRA for detection and treatment in the surveillance of AIN exists and strongly suggests that it is beneficial, resulting in reduced rates of cancer progression. Pilot data from our study showed a local disease failure rate of 1.73 per 1000 patient-months compared with a published rate of 9.89 per 1000 patient-months. This demonstrates a 5.72-fold reduction in local disease failure rates of patients with T1-T3 tumours; the data therefore suggests that use of HRA for detection and treatment in surveillance of anal cancer patients will help prevent local regional relapse at the anal site. There is an urgent need for a large, randomised controlled clinical trial to definitively test this hypothesis. PMID:24373061

  17. An ecological analysis of PM2.5 concentrations and lung cancer mortality rates in China

    PubMed Central

    Fu, Jingying; Jiang, Dong; Lin, Gang; Liu, Kun; Wang, Qiao

    2015-01-01

    Objective To explore the association between Particulate Matter (PM)2.5 (particles with an aerodynamic diameter less than 2.5 µm) and lung cancer mortality rates and to estimate the potential risk of lung cancer mortality related to exposure to high PM2.5 concentrations. Design Geographically weighted regression was performed to evaluate the relation between PM2.5 concentrations and lung cancer mortality for males, females and for both sexes combined, in 2008, based on newly available long-term data. Lung cancer fatalities from long-term exposure to PM2.5 were calculated according to studies by Pope III et al and the WHO air quality guidelines (AQGs). Setting 31 provinces in China. Results PM2.5 was associated with the lung cancer mortality of males, females and both sexes combined, in China, although there were exceptions in several regions, for males and females. The number of lung cancer fatalities calculated by the WHO AQGs ranged from 531 036 to 532 004, whereas the number calculated by the American Cancer Society (ACS) reached 614 860 after long-term (approximately 3–4 years) exposure to PM2.5 concentrations since 2008. Conclusions There is a positive correlation between PM2.5 and lung cancer mortality rate, and the relationship between them varies across the entire country of China. The number of lung cancer fatalities estimated by ACS was closer to the actual data than those of the WHO AQGs. Therefore, the ACS estimate of increased risk of lung cancer mortality from long-term exposure to PM2.5 might be more applicable for evaluating lung cancer fatalities in China than the WHO estimate. PMID:26603253

  18. The incidence rates of endometrial hyperplasia and endometrial cancer: a four-year population-based study

    PubMed Central

    2016-01-01

    Introduction The aim of this study was to determine the incidence rates of endometrial hyperplasia (EH) and endometrial cancer (EC) in the Republic of Korea using national insurance claim data generated from 2009 to 2012. Materials and Methods Data that were generated from 2009 to 2012 were sourced from the Korean Health Insurance Review and Assessment Service-National Inpatients Sample database. The data from women who were assigned diagnosis codes representing EH or EC within 1 month of being assigned codes that corresponded to procedures that included endometrial biopsies and several types of gynecologic surgeries to obtain endometrial pathology samples, were selected for analysis. Results Data from 2,477,424 women were entered into the database between 2009 and 2012, and the data from 1,868 women with EH and 868 women with EC were extracted for analysis. The mean ages of the patients were 44.1 ± 0.4 years for those with EH and 52.7 ± 0.6 years for those with EC. The EH and EC incidence rates were 37 per 100,000 woman-years and 8 per 100,000 woman-years, respectively. The EH and EC incidence rates peaked when the women were in their late forties and fifties, respectively. Conclusions The EH and EC incidence rates determined in this study were somewhat lower than those determined from previous studies. Further studies are required that adjust the data for race, menopausal hormone therapy, and obesity.

  19. Moderate stem-cell telomere shortening rate postpones cancer onset in a stochastic model

    NASA Astrophysics Data System (ADS)

    Holbek, Simon; Bendtsen, Kristian Moss; Juul, Jeppe

    2013-10-01

    Mammalian cells are restricted from proliferating indefinitely. Telomeres at the end of each chromosome are shortened at cell division and when they reach a critical length, the cell will enter permanent cell cycle arrest—a state known as senescence. This mechanism is thought to be tumor suppressing, as it helps prevent precancerous cells from dividing uncontrollably. Stem cells express the enzyme telomerase, which elongates the telomeres, thereby postponing senescence. However, unlike germ cells and most types of cancer cells, stem cells only express telomerase at levels insufficient to fully maintain the length of their telomeres, leading to a slow decline in proliferation potential. It is not yet fully understood how this decline influences the risk of cancer and the longevity of the organism. We here develop a stochastic model to explore the role of telomere dynamics in relation to both senescence and cancer. The model describes the accumulation of cancerous mutations in a multicellular organism and creates a coherent theoretical framework for interpreting the results of several recent experiments on telomerase regulation. We demonstrate that the longest average cancer-free lifespan before cancer onset is obtained when stem cells start with relatively long telomeres that are shortened at a steady rate at cell division. Furthermore, the risk of cancer early in life can be reduced by having a short initial telomere length. Finally, our model suggests that evolution will favor a shorter than optimal average cancer-free lifespan in order to postpone cancer onset until late in life.

  20. Facets of Spirituality as Predictors of Adjustment to Cancer: Relative Contributions of Having Faith and Finding Meaning

    ERIC Educational Resources Information Center

    Yanez, Betina; Edmondson, Donald; Stanton, Annette L.; Park, Crystal L.; Kwan, Lorna; Ganz, Patricia A.; Blank, Thomas O.

    2009-01-01

    Spirituality is a multidimensional construct, and little is known about how its distinct dimensions jointly affect well-being. In longitudinal studies (Study 1, n = 418 breast cancer patients; Study 2, n = 165 cancer survivors), the authors examined 2 components of spiritual well-being (i.e., meaning/peace and faith) and their interaction, as well…

  1. United We Stand? The Effects of a Couple-Coping Intervention on Adjustment to Early Stage Breast or Gynecological Cancer

    ERIC Educational Resources Information Center

    Scott, Jennifer L.; Halford, W. Kim; Ward, Bruce G.

    2004-01-01

    Cancer diagnosis affects the psychological well-being of both patients and their partners, and effective coping has been suggested to be a conjoint process of mutual support. Ninety-four married women with early stage cancer and their partners were randomly assigned to couples-based coping training (CanCOPE), individual coping training for the…

  2. Brain cancer mortality rates increase with Toxoplasma gondii seroprevalence in France

    USGS Publications Warehouse

    Vittecoq, Marion; Elguero, Eric; Lafferty, Kevin D.; Roche, Benjamin; Brodeur, Jacques; Gauthier-Clerc, Michel; Missé, Dorothée; Thomas, Frédéric

    2012-01-01

    The incidence of adult brain cancer was previously shown to be higher in countries where the parasite Toxoplasma gondii is common, suggesting that this brain protozoan could potentially increase the risk of tumor formation. Using countries as replicates has, however, several potential confounding factors, particularly because detection rates vary with country wealth. Using an independent dataset entirely within France, we further establish the significance of the association between T. gondii and brain cancer and find additional demographic resolution. In adult age classes 55 years and older, regional mortality rates due to brain cancer correlated positively with the local seroprevalence of T. gondii. This effect was particularly strong for men. While this novel evidence of a significant statistical association between T. gondii infection and brain cancer does not demonstrate causation, these results suggest that investigations at the scale of the individual are merited.

  3. An ecologic study of cancer mortality rates in Spain with respect to indices of solar UVB irradiance and smoking.

    PubMed

    Grant, William B

    2007-03-01

    There is increasing evidence that vitamin D reduces the risk of many types of cancer. Geographic variations in cancer mortality rates in Spain are apparently linked to variations in solar ultraviolet (UV) irradiances and other factors. Cancer mortality rates for 48 continental Spanish provinces for 1978-1992 were used in linear regression analyses with respect to mortality rates for latitude (an index of solar UVB levels), skin cancer (an index of high cumulative UVB irradiance), melanoma (an index related to solar UV irradiance and several other factors) and lung cancer (an index of cumulative effects of smoking). The 9 cancers with mortality rates significantly correlated with latitude for 1 or both sexes were brain, gastric, melanoma, nonmelanoma skin cancer (NMSC), non-Hodgkin's lymphoma (NHL), pancreatic, pleural, rectal and thyroid cancer. Inverse correlations with latitude were found for laryngeal, lung and uterine corpus cancer. The 17 cancers inversely correlated with NMSC are bladder, brain, breast, colon, esophageal, gallbladder, Hodgkin's lymphoma, lung, melanoma, multiple myeloma, NHL, ovarian, pancreatic, pleural, rectal, thyroid and uterine corpus cancer. The 16 correlated with melanoma are bladder, brain, breast, colon, gallbladder, leukemia, lung, multiple myeloma, NHL, ovarian, pancreatic, pleural, prostate, rectal, renal and uterine corpus cancer. The results for lung cancer were in accordance with the literature. These results provide more support for the UVB/vitamin D/cancer hypothesis and indicate a new way to investigate the role of solar UV irradiance on cancer risk. They also provide more evidence that melanoma and NMSC have different etiologies. PMID:17149699

  4. Significantly Increased Medical Expenditure on Breast Cancer Failing to Bring Down Its Mortality and Incidence Rate

    PubMed Central

    Ho, Ming-Lin; Liaw, Yung-Po; Lai, Chien-Hsu; Chen, Yen-Yu; Tsai, Horng-Der; Chou, Ming-Chih; Hsiao, Yi-Hsuan

    2013-01-01

    Background: The direct impact of medical expenses on breast cancer incidence and mortality rate has not been sufficiently addressed. The purpose of this study is to investigate the potential correlation between the incidence and mortality rate of breast cancer and the medical expenses in Taiwan. Materials and Methods: Breast cancer cases were identified from the National Health Insurance Research Database (NHIRD) with corresponding to International Classification of Diseases, and the Ninth Revision (ICD-9) code 174, 1740-1749, 175, 1750 and 1759 from January 1999 to December 2006. Age-specific incidences were estimated by population data obtained from the Department of Statistics, Ministry of the Interior. Medical expenses, including outpatient and inpatient services, were also retrieved from the NHIRD. Results: The incidence increased from 20.06 per 100,000 in 1999 to 30.34 per 100,000 in 2006; the total expenses increased from 1,449,333,521 in 1999 to 4,350,400,592 Taiwan dollars in 2006. The age-standardized mortality rate for female breast cancer remained essentially unchanged, while the age-standardized incidence increased steadily (except 2002-2003). Among the top 20 coexisting ICD-9 codes for expenses, four are directly on cancers, while 16 are on other diseases or symptoms, which are not necessarily caused by breast cancer. Conclusions: Significantly increased medical expenditure on breast cancer failed to bring down its mortality and incidence rate. The finding has implications for healthcare policy planners in proposing strategies for breast cancer control and allocating the resources. PMID:23983817

  5. Experimental investigation and theoretical analysis of pulse repetition rate adjustable deep ultraviolet picosecond radiation by second harmonic generation in KBe2BO3F2

    NASA Astrophysics Data System (ADS)

    Xu, Zhi; Zhang, Fengfeng; Zhang, Shenjin; Wang, Zhimin; Yang, Feng; Xu, Fengliang; Peng, Qinjun; Cui, Dafu; Zhang, Jingyuan; Wang, Xiaoyang; Chen, Chuangtian; Xu, Zuyan

    2014-06-01

    We reported on an experimental investigation and theoretical analysis of pulse repetition rate (PRR) adjustable deep ultraviolet (DUV) picosecond (ps) radiation by second harmonic generation (SHG) in KBe2BO3F2 (KBBF) crystal. Third harmonic radiation at 355 nm of a ps Nd:YVO4 laser output with PRR of 200 kHz-1 MHz was employed as the pump source. The dependence of the 177.3 nm output power on the 355 nm pump power was measured at different PRRs, and the maximum 177.3 nm average output power of 695 μW was obtained at the PRR of 200 kHz. The measured data agreed well with the results of the ps KBBF SHG theoretical simulations. Using simulations, the pulse width and the spectral bandwidth of the generated radiation at 177.3 nm were estimated to be 5.88 ps and 7.84 pm, respectively.

  6. Adaptive upstream rate adjustment by RSOA-ONU depending on different injection power of seeding light in standard-reach and long-reach PON systems

    NASA Astrophysics Data System (ADS)

    Yeh, C. H.; Chow, C. W.; Shih, F. Y.; Pan, C. L.

    2012-08-01

    The wavelength division multiplexing-time division multiplexing (WDM-TDM) passive optical network (PON) using reflective semiconductor optical amplifier (RSOA)-based colorless optical networking units (ONUs) is considered as a promising candidate for the realization of fiber-to-the-home (FTTH). And this architecture is actively considered by Industrial Technology Research Institute (ITRI) for the realization of FTTH in Taiwan. However, different fiber distances and optical components would introduce different power budgets to different ONUs in the PON. Besides, due to the aging of optical transmitter (Tx), the power decay of the distributed optical carrier from the central office (CO) could also reduce the injection power into each ONU. The situation will be more severe in the long-reach (LR) PON, which is considered as an option for the future access. In this work, we investigate a WDM-TDM PON using RSOA-based ONU for upstream data rate adjustment depending on different continuous wave (CW) injection powers. Both standard-reach (25 km) and LR (100 km) transmissions are evaluated. Moreover, a detail analysis of the upstream signal bit-error rate (BER) performances at different injection powers, upstream data rates, PON split-ratios under stand-reach and long-reach is presented.

  7. The Central Role of Meaning in Adjustment to the Loss of a Child to Cancer: Implications for the Development of Meaning-Centered Grief Therapy

    PubMed Central

    Lichtenthal, Wendy G.; Breitbart, William

    2015-01-01

    Purpose of review This review describes research on meaning and meaning-making in parents who lost a child to cancer, suggesting the need for a meaning-centered therapeutic approach to improve their sense of meaning, purpose, and identity and to help with management of prolonged grief symptoms. Recent findings Several studies have demonstrated that parents bereaved by cancer experience unique meaning related challenges associated with the caregiving and illness experience, including struggles with making sense of their loss, benefit-finding, their sense of identity and purpose, disconnection from sources of meaning, and sustaining a sense of meaning in their child’s life. Meaning-Centered Grief Therapy, adapted from Meaning-Centered Psychotherapy, directly addresses these issues, highlighting the choices parents have in how they face their pain, how they honor their child and his/her living legacy, the story they create, and how they live their lives. Summary Given the important role that meaning plays in adjustment to the loss of a child to cancer, a meaning-focused approach such as Meaning-Centered Grief Therapy, may help improve parents’ sense of meaning and grief symptoms. It seems particularly appropriate for parents who lost a child to cancer because it does not pathologize their struggles and directly targets issues they frequently face. PMID:25588204

  8. Screening for cervical cancer in French Guiana: screening rates from 2006 to 2011.

    PubMed

    Douine, M; Roué, T; Lelarge, C; Adenis, A; Thomas, N; Nacher, M

    2015-12-01

    In French Guiana, the age-standardized incidence rate of cervical cancer is four times higher than in France and the mortality rate 5.5 times higher. A survival study revealed that stage at diagnosis was the main factor influencing the prognosis, showing that early detection is crucial to increase cervical cancer survival. The present study aimed at evaluating the cervical cancer screening rate between 2006 and 2011 by age and for a 3-year period in French Guiana. All pap smears realised in French Guiana were analysed in two laboratories allowing exhaustive review of screening data. The screening rate was estimated at about 54% from 2006 to 2011, with a statistical difference between coastal and rural area (56.3% versus 18.7%). Although the methodological difference did not allow comparisons with metropolitan France, these results could be used to evaluate the impact of organised cervical cancer screening by the French Guiana Association for Organized Screening of Cancers which has been implemented in French Guiana since 2012. PMID:26608273

  9. Trends in corrected lung cancer mortality rates in Brazil and regions

    PubMed Central

    Malta, Deborah Carvalho; de Abreu, Daisy Maria Xavier; de Moura, Lenildo; Lana, Gustavo C; Azevedo, Gulnar; França, Elisabeth

    2016-01-01

    ABSTRACT OBJECTIVE To describe the trend in cancer mortality rates in Brazil and regions before and after correction for underreporting of deaths and redistribution of ill-defined and nonspecific causes. METHODS The study used data of deaths from lung cancer among the population aged from 30 to 69 years, notified to the Mortality Information System between 1996 and 2011, corrected for underreporting of deaths, non-registered sex and age , and causes with ill-defined or garbage codes according to sex, age, and region. Standardized rates were calculated by age for raw and corrected data. An analysis of time trend in lung cancer mortality was carried out using the regression model with autoregressive errors. RESULTS Lung cancer in Brazil presented higher rates among men compared to women, and the South region showed the highest death risk in 1996 and 2011. Mortality showed a trend of reduction for males and increase for women. CONCLUSIONS Lung cancer in Brazil presented different distribution patterns according to sex, with higher rates among men and a reduction in the mortality trend for men and increase for women. PMID:27355467

  10. The End of the Hysterectomy Epidemic and Endometrial Cancer Incidence: What Are the Unintended Consequences of Declining Hysterectomy Rates?

    PubMed Central

    Temkin, Sarah M.; Minasian, Lori; Noone, Anne-Michelle

    2016-01-01

    Population-level cancer incidence rates are one measure to estimate the cancer burden. The goal is to provide information on trends to measure progress against cancer at the population level and identify emerging patterns signifying increased risk for additional research and intervention. Endometrial cancer is the most common of the gynecologic malignancies but capturing the incidence of disease among women at risk (i.e., women with a uterus) is challenging and not routinely published. Decreasing rates of hysterectomy increase the number of women at risk for disease, which should be reflected in the denominator of the incidence rate calculation. Furthermore, hysterectomy rates vary within the United States by multiple factors including geographic location, race, and ethnicity. Changing rates of hysterectomy are important to consider when looking at endometrial cancer trends. By correcting for hysterectomy when calculating incidence rates of cancers of the uterine corpus, many of the disparities that have been assumed for this disease are diminished. PMID:27148481

  11. Improving teacher-child relationship quality and teacher-rated behavioral adjustment amongst externalizing preschoolers: effects of a two-component intervention.

    PubMed

    Vancraeyveldt, Caroline; Verschueren, Karine; Wouters, Sofie; Van Craeyevelt, Sanne; Van den Noortgate, Wim; Colpin, Hilde

    2015-02-01

    The school-based Playing-2-gether is a 12-week intervention with two components aimed at decreasing child externalizing behavior through improving teacher-child interactions. The first component is rooted in attachment theory and aimed at enhancing teacher-child relationship quality, and the second is based on learning theory and aimed at improving teachers' behavior management. In this three-wave randomized study, effects of Playing-2-gether on the teacher-child relationship quality and on teacher-rated child behavioral adjustment were investigated. To this aim, 175 dyads consisting of male preschoolers with relatively high levels of externalizing problem behavior and their teachers were randomly assigned to Playing-2-gether (n = 89) or an education-as-usual control condition (n = 86). Teacher-rated questionnaires were collected at pre-test, after the first intervention component, and at post-test. At post-test, the intervention group showed a larger decrease in teacher-child conflict, child conduct problems, and child hyperactivity/inattention. Supplementary analyses showed that all positive effects were already visible after the first intervention component and that teacher-child conflict, child conduct problems and hyperactivity/inattention did not further reduce during the second component. In addition, an increase in closeness was found following the first component, but subsequently disappeared at post-test. PMID:25028283

  12. Local control rates with five-fraction stereotactic body radiotherapy for oligometastatic cancer to the lung

    PubMed Central

    Chen, Yuhchyau; Hare, Mary Z.; Usuki, Kenneth Y.; Zhang, Hong; Lundquist, Thomas; Joyce, Neil; Schell, Michael C.; Milano, Michael T.

    2014-01-01

    Objective To report our institutional experience with five fractions of daily 8-12 Gy stereotactic body radiotherapy (SBRT) for the treatment of oligometastatic cancer to the lung. Methods Thirty-four consecutive patients with oligometastatic cancers to the lung were treated with image-guided SBRT between 2008 and 2011. Patient age ranged from 38 to 81 years. There were 17 males and 17 females. Lung metastases were from the following primary cancer types: colon cancer (n=13 patients), head and neck cancer (n=6), breast cancer (n=4), melanoma (n=4), sarcoma (n=4) and renal cell carcinoma (n=3). The median prescription dose was 50 Gy in five fractions (range, 40-60 Gy) to the isocenter, with the 80% isodose line encompassing the planning target volume (PTV) [defined as gross tumor volume (GTV) + 7-11 mm volumetric expansion]. The follow-up interval ranged from 2.4-54 months, with a median of 16.7 months. Results The 1-, 2-, and 3-year patient local control (LC) rates for all patients were 93%, 88%, and 80% respectively. The 1-, 2-, and 3-year overall survival (OS) rates were 62%, 44%, and 23% respectively. The 1- and 2-year patient LC rates were 95% and 88% for tumor size 1-2 cm (n=25), and 86% for tumor size 2-3 cm (n=7). The majority (n=4) of local failures occurred within 12 months. No patient experienced local failure after 12 months except for one patient with colon cancer whose tumors progressed locally at 26 months. All five patients with local recurrences had colorectal cancer. Statistical analyses showed that age, gender, previous chemotherapy, previous surgery or radiation had no significant effect on LC rates. No patient was reported to have any symptomatic pneumonitis at any time point. Conclusions SBRT for oligometastatic disease to the lung using 8-12 Gy daily fractions over five treatments resulted in excellent 1- and 2-year LC rates. Most local failures occurred within the first 12 months, with five local failures associated with colorectal cancer

  13. The Clinicopathologic Characteristics and 5-year Survival Rate of Epithelial Ovarian Cancer in Yazd, Iran

    PubMed Central

    Karimi-Zarchi, Mojgan; Mortazavizadeh, Seyed Mohammad Reza; Bashardust, Nasrollah; Zakerian, Neda; Zaidabadi, Mahbube; Yazdian-Anari, Pouria; Teimoori, Soraya

    2015-01-01

    Introduction Ovarian cancer is the second most common malignancy in women, the most common cause of gynecologic cancer deaths, and most patients have advanced stage disease at the time of diagnosis. The purpose of this study was to estimate the 5-year survival of patients with epithelial ovarian cancer based on age, tumor histology, stage of disease, and type of treatment. Methods This study was conducted on 120 patients with epithelial ovarian cancer referred to Shahid Sadoughi hospital and Shah Vali oncology clinic of Yazd from 2006 to 2012. Demographic data and patient records were studied to evaluate the treatment outcome, pathology of the tumor, and stage of disease. Finally, the overall survival rate and tumor-free survival of patients was assessed. Results The mean patient age was 53.87± 14.11 years. Most participants had stage I (36.7%) or stage II (35%) disease. Serous adenocarcinoma (57.6%) was the most common pathology found in patients with epithelial ovarian cancer. The overall survival of patients in this study was significantly associated with the histological tumor type (p = 0.000) and disease stage (p = 0.0377). Stage I (84.18%) and serous adenocarcinoma (72.81%) demonstrated the best survival. The tumor-free survival rates were not associated with histology types (p = 0.079), surgical procedure (p = 0.18), or chemotherapy (p = 0.18). Conclusion The survival of patients with epithelial ovarian cancer was significantly associated with disease stage. Serous adenocarcinoma also had the best prognosis among the pathologies studied. Therefore, early detection of ovarian cancer can substantially increase the survival rate. PMID:26516450

  14. Semen cryopreservation and usage rate for assisted reproductive technology in 898 men with cancer.

    PubMed

    Muller, Iris; Oude Ophuis, Ralph J A; Broekmans, Frank J M; Lock, Tycho M T W

    2016-02-01

    An undesired side effect of cancer treatment is potential subfertility or infertility. Timely cryopreservation of semen is the best modality to ensure fertility. This retrospective data analysis established the usage rate of cryopreserved semen from cancer patients. Pubertal and post-pubertal patients who could become infertile as a result of cancer (treatment) were offered the option to cryopreserve semen prior to treatment. Of the 898 patients who cryopreserved their semen in our hospital, 96 (10.7%) used this for assisted reproductive technology. The live birth rates for intrauterine insemination, in-vitro fertilization, intracytoplasmic sperm injection and cryopreserved embryo transfer were 13%, 29%, 32% and 17%, respectively. Of all couples involved, 77% achieved parenthood, i.e. 60 of the 78 patients (with complete follow-up) fathered at least one child. PMID:26687904

  15. Improving Psychological Adjustment among Late-Stage Ovarian Cancer Patients: Examining the Role of Avoidance in Treatment

    ERIC Educational Resources Information Center

    Rost, Ann D.; Wilson, Kelly; Buchanan, Erin; Hildebrandt, Mikaela J.; Mutch, David

    2012-01-01

    Data suggest that individuals dealing with a cancer diagnosis are less likely to suffer from depression, anxiety, and psychological distress when they cope with their condition from a stance of emotional and cognitive acceptance (e.g. Dunkel, et al., 1992; Stanton, et al., 2000). Although traditional CBT often includes some acceptance-oriented…

  16. Adjustment disorder

    MedlinePlus

    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, Va: American Psychiatric Publishing. 2013. Powell AD. Grief, bereavement, and adjustment disorders. In: Stern TA, Rosenbaum ...

  17. 'In Vivo' Dosimetry in High Dose Rate Brachytherapy for Cervical Cancer Treatments

    SciTech Connect

    Gonzalez-Azcorra, S. A.; Ruiz-Trejo, C.; Buenfil, A. E.; Mota-Garcia, A.; Poitevin-Chacon, M. A.; Santamaria-Torruco, B. J.; Rodriguez-Ponce, M.; Herrera-Martinez, F. P.; Gamboa de Buen, I.

    2008-08-11

    In this prospective study, rectal dose was measured 'in vivo' using TLD-100 crystals (3x3x1 mm{sup 3}), and it has been compared to the prescribed dose. Measurements were performed in patients with cervical cancer classified in FIGO stages IB-IIIB and treated with high dose rate brachytherapy (HDR BT) at the Instituto Nacional de Cancerologia (INCan)

  18. Detection rates of high-grade prostate cancer during subsequent screening visits. Results of the European Randomized Screening Study for Prostate Cancer.

    PubMed

    van der Kwast, Theodorus H; Ciatto, Stefano; Martikainen, Paula M; Hoedemaeker, Robert; Laurila, Marita; Pihl, Carl-Gustaph; Hugosson, Jonas; Neetens, Ingrid; Nelen, Vera; Di Lollo, Simonetta; Roobol, Monique J; Määtänen, Liisa; Santonja, Carlos; Moss, Sue; Schröder, Fritz H

    2006-05-15

    Screening for prostate cancer using prostate-specific antigen (PSA) tests has led to a stage and grade shift as compared to the pre-PSA era. Effectiveness of screening for prostate cancer should be manifested by a reduction in detection rate of aggressive cancers during subsequent screening. In 6 centers of the European Randomized Screening study for Prostate Cancer, a total of 58,710 men were tested for prostate cancer. Screening centers differed with regard to age-range, screening interval and biopsy indications. During the 2nd visit, the proportion of Gleason score 6 cancers increased from 62.5 to 75%, mainly at the expense of Gleason score 7 cancers. High-grade (Gleason score 8-10) cancer detection rates varied per screening center during the 1st visit from 5.1 to 41.1, and during the 2nd visit from 6.4 to 29.3/10,000 men. The overall detection rate of high-grade cancers showed a reduction during the 2nd visit from 26 to 12/10,000 men, an effect mainly attributable to the screening center with the highest cancer detection rate (i.e. 507/10,000 men). Variations in detection rates among screening centers related among others to biopsy compliance and age range. PMID:16353141

  19. Major lessons learned from a nationally-based community-academic partnership: addressing sibling adjustment to childhood cancer.

    PubMed

    Long, Kristin A; Goldish, Melanie; Lown, E Anne; Ostrowski, Nancy L; Alderfer, Melissa A; Marsland, Anna L; Ring, Sandra; Skala, Suzanne; Ewing, Linda J

    2015-03-01

    Prolonged, intensive treatment protocols for childhood cancer disrupt family routines and daily functioning, with effects extending to all family members. Despite their unique needs, siblings of children with cancer receive limited attention from community organizations and researchers. Community-academic partnerships may foster research that effectively assesses and addresses siblings' unmet needs. In this article, "community" refers to siblings of children with cancer who participate in SuperSibs!, a national nonprofit organization for siblings of children with cancer. This article (a) describes a replicable model for successful community-academic partnerships: the Sibling Research Advisory Board (SRAB) and (b) articulates "lessons learned" from this partnership, including documenting the ability to recruit a representative sample through a community organization. Lessons emerged from an iterative process of discussion and revision that involved all SRAB members. This case study describes approaches to overcoming practical obstacles in community-partnered research planning and implementation. To meet the common goals of identifying and addressing unmet sibling needs, SRAB partners learned to establish a common language, identify each team member's unique expertise, and acknowledge differences in approach (e.g., methodology, pace of accomplishment) between research and community service. SRAB's ability to recruit a representative sample was achieved through close collaboration with SuperSibs! and implementation of active recruitment strategies to overcome barriers to research participation. Protection of community member privacy was emphasized alongside methodological rigor. Community-academic partnerships enable research with high-need, hard-to-access populations. Proactively identifying and addressing common pitfalls of community-academic partnerships promotes community engagement and acceptability and facilitates high-quality research. PMID:25581558

  20. Why are lung cancer rate trends so different in the United States and United kingdom?

    PubMed

    Lee, Peter N; Forey, Barbara A

    2003-08-01

    Over the period 1951-1995, lung cancer rates in men aged 35-74 yr more than doubled in the United States but declined slightly in the United Kingdom. In women, rates rose about sevenfold in the United States but only about threefold in the United Kingdom. To investigate whether these very different trends in lung cancer risk could be explained by smoking habits, trends in smoking were compared in the two countries and a multistage model was used to predict lung cancer rates from detailed data on age of starting and stopping smoking, amount smoked per smoker, and sales-weighted average tar levels. In both countries, there was a similar switch to filter cigarettes, reduction in tar levels and the average age of starting to smoke, and decline in prevalence of smoking in women aged under 50 yr and in men. Although some differences were evident, most notably in older women where prevalence of smoking and consumption per adult has increased more in the United States, these trends do not appear to explain the markedly different trends in lung cancer, evident in both sexes and all age groups. The multistage analyses confirmed these tentative conclusions-the differing trends in smoking in the two countries could not explain the markedly differing trends in lung cancer. Lung cancer trends in the United Kingdom were found to be clearly more favorable than expected on the basis of smoking trends, while trends in the United States were less favorable. In sensitivity analyses, these conclusions were found not to be materially dependent on the precise methods used, including whether tar reduction was or was not assumed to be beneficial. The explanation for these findings must lie in changes over time, differing in the two countries, in aspects of smoking not considered in these analyses and/or in exposure to other risk factors. Evidence relating to a number of possible such smoking variables (including type of tobacco, curing, use of pesticides and additives, and butt length) or

  1. Estimating quality adjusted progression free survival of first-line treatments for EGFR mutation positive non small cell lung cancer patients in The Netherlands

    PubMed Central

    2012-01-01

    Background Gefitinib, a tyrosine kinase inhibitor, is an effective treatment in advanced non-small cell lung cancer (NSCLC) patients with an activating mutation in the epidermal growth factor receptor (EGFR). Randomised clinical trials showed a benefit in progression free survival for gefitinib versus doublet chemotherapy regimens in patients with an activated EGFR mutation (EGFR M+). From a patient perspective, progression free survival is important, but so is health-related quality of life. Therefore, this analysis evaluates the Quality Adjusted progression free survival of gefitinib versus three relevant doublet chemotherapies (gemcitabine/cisplatin (Gem/Cis); pemetrexed/cisplatin (Pem/Cis); paclitaxel/carboplatin (Pac/Carb)) in a Dutch health care setting in patients with EGFR M+ stage IIIB/IV NSCLC. This study uses progression free survival rather than overall survival for its time frame in order to better compare the treatments and to account for the influence that subsequent treatment lines would have on overall survival analysis. Methods Mean progression free survival for Pac/Carb was obtained by extrapolating the median progression free survival as reported in the Iressa-Pan-Asia Study (IPASS). Data from a network meta-analysis was used to estimate the mean progression free survival for therapies of interest relative to Pac/Carb. Adjustment for health-related quality of life was done by incorporating utilities for the Dutch population, obtained by converting FACT-L data (from IPASS) to utility values and multiplying these with the mean progression free survival for each treatment arm to determine the Quality Adjusted progression free survival. Probabilistic sensitivity analysis was carried out to determine 95% credibility intervals. Results The Quality Adjusted progression free survival (PFS) (mean, (95% credibility interval)) was 5.2 months (4.5; 5.8) for Gem/Cis, 5.3 months (4.6; 6.1) for Pem/Cis; 4.9 months (4.4; 5.5) for Pac/Carb and 8.3 (7.0; 9.9) for

  2. Modeling of influential predictors of gastric cancer incidence rates in Golestan province, North Iran.

    PubMed

    Behnampour, Nasser; Hajizadeh, Ebrahim; Zayeri, Farid; Semnani, Shahriar

    2014-01-01

    Golestan province has a reputation for relatively high incidence rates of gastric cancer in Iran. Along with dietary, lifestyle and environmental influential factors, soil selenium and high levels of pesticide used may exert influence in this region. The present study was designed for modeling the influential predictors on incidence of gastric cancer in Golestan. All registered cases of gastric cancer from March 2009 to March 2010 (49 females and 107 males) were investigated. Data were gathered by both check list and researcher made questionnaire (demographic, clinical and lifestyle characteristics) and analysed using logistic regression. Mean (±SD) age at diagnosis was 62.9±13.8 years. CIR and ASR of gastric cancer showed 9.16 and 13.9 per 100,000 people, respectively. Based on univariate logistic regression, a history of smoking (OR= 2.076), unwashed hands after defecation (OR= 2.612), history of cancer in relatives (OR= 2.473), history of gastric cancer in first-degree relatives (OR= 2.278), numbers of gastric cancers in first-degree relatives (OR= 2.078), history of X-ray and dye exposure (OR= 2.395), history of CT scan encounter (OR= 2.915), improper food habits (OR= 3.320), specific eating behavior (OR= 0.740), consumption of probable high risk foods (OR= 2.942), charred flesh (OR= 1.945), and animal fat (OR= 2.716) were confirmed as a risk factors. Changes in lifestyle may be expected to increase gastric cancer incidence dramatically in the near future. Therefore, appropriate educational interventions should be designed and implemented by competent authorities. PMID:24606427

  3. Image-guided high-dose-rate brachytherapy in inoperable endometrial cancer

    PubMed Central

    Petsuksiri, J; Chansilpa, Y; Hoskin, P J

    2014-01-01

    Inoperable endometrial cancer may be treated with curative aim using radical radiotherapy alone. The radiation techniques are external beam radiotherapy (EBRT) alone, EBRT plus brachytherapy and brachytherapy alone. Recently, high-dose-rate brachytherapy has been used instead of low-dose-rate brachytherapy. Image-guided brachytherapy enables sufficient coverage of tumour and reduction of dose to the organs at risk, thus increasing the therapeutic ratio of treatment. Local control rates with three-dimensional brachytherapy appear better than with conventional techniques (about 90–100% and 70–90%, respectively). PMID:24807067

  4. Ten-Year Recurrence Rates in Young Women With Breast Cancer by Locoregional Treatment Approach

    SciTech Connect

    Beadle, Beth M.; Woodward, Wendy A. Tucker, Susan L.; Outlaw, Elesyia D.; Allen, Pamela K.; Oh, Julia L.; Strom, Eric A.; Perkins, George H.; Tereffe, Welela; Yu, T.-K.; Meric-Bernstam, Funda; Litton, Jennifer K.; Buchholz, Thomas A.

    2009-03-01

    Purpose: Young women with breast cancer have higher locoregional recurrence (LRR) rates than older patients. The goal of this study is to determine the impact of locoregional treatment strategy, breast-conserving therapy (BCT), mastectomy alone (M), or mastectomy with adjuvant radiation (MXRT), on LRR for patients 35 years or younger. Methods and Materials: Data for 668 breast cancers in 652 young patients with breast cancer were retrospectively reviewed; 197 patients were treated with BCT, 237 with M, and 234 with MXRT. Results: Median follow-up for all living patients was 114 months. In the entire cohort, 10-year actuarial LRR rates varied by locoregional treatment: 19.8% for BCT, 24.1% for M, and 15.1% for MXRT (p = 0.05). In patients with Stage II disease, 10-year actuarial LRR rates by locoregional treatment strategy were 17.7% for BCT, 22.8% for M, and 5.7% for MXRT (p = 0.02). On multivariate analysis, M (hazard ratio, 4.45) and Grade III disease (hazard ratio, 2.24) predicted for increased LRR. In patients with Stage I disease, there was no difference in LRR rates based on locoregional treatment (18.0% for BCT, 19.8% for M; p = 0.56), but chemotherapy use had a statistically significant LRR benefit (13.5% for chemotherapy, 27.9% for none; p = 0.04). Conclusions: Young women have high rates of LRR after breast cancer treatment. For patients with Stage II disease, the best locoregional control rates were achieved with MXRT. For patients with Stage I disease, similar outcomes were achieved with BCT and mastectomy; however, chemotherapy provided a significant benefit to either approach.

  5. The rate and pattern of bed incision and bank adjustment on the Colorado River in Glen Canyon downstream from Glen Canyon Dam, 1956-2000

    USGS Publications Warehouse

    Grams, P.E.; Schmidt, J.C.; Topping, D.J.

    2007-01-01

    Closure of Glen Canyon Dam in 1963 transformed the Colorado River by reducing the magnitude and duration of spring floods, increasing the magnitude of base flows, and trapping fine sediment delivered from the upper watershed. These changes caused the channel downstream in Glen Canyon to incise, armor, and narrow. This study synthesizes over 45 yr of channel-change measurements and demonstrates that the rate and style of channel adjustment are directly related to both natural processes associated with sediment deficit and human decisions about dam operations. Although bed lowering in lower Glen Canyon began when the first cofferdam was installed in 1959, most incision occurred in 1965 in conjunction with 14 pulsed high flows that scoured an average of 2.6 m of sediment from the center of the channel. The average grain size of bed material has increased from 0.25 mm in 1956 to over 20 mm in 1999. The magnitude of incision at riffles decreases with distance downstream from the dam, while the magnitude of sediment evacuation from pools is spatially variable and extends farther downstream. Analysis of bed-material mobility indicates that the increase in bed-material grain size and reduction in reach-average gradient are consistent with the transformation of an adjustable-bed alluvial river to a channel with a stable bed that is rarely mobilized. Decreased magnitude of peak discharges in the post-dam regime coupled with channel incision and the associated downward shifts of stage-discharge relations have caused sandbar and terrace erosion and the transformation of previously active sandbars and gravel bars to abandoned deposits that are no longer inundated. Erosion has been concentrated in a few pre-dam terraces that eroded rapidly for brief periods and have since stabilized. The abundance of abandoned deposits decreases downstream in conjunction with decreasing magnitude of shift in the stage-discharge relations. In the downstream part of the study area where riffles

  6. The Effect of Administrative Boundaries and Geocoding Error on Cancer Rates in California

    PubMed Central

    Goldberg, Daniel W.; Cockburn, Myles G.

    2012-01-01

    Geocoding is often used to produce maps of disease rates from the diagnosis addresses of incident cases to assist with disease surveillance, prevention, and control. In this process, diagnosis addresses are converted into latitude/longitude pairs which are then aggregated to produce rates at varying geographic scales such as Census tracts, neighborhoods, cities, counties, and states. The specific techniques used within geocoding systems have an impact on where the output geocode is located and can therefore have an effect on the derivation of disease rates at different geographic aggregations. This paper investigates how county-level cancer rates are affected by the choice of interpolation method when case data are geocoded to the ZIP code level. Four commonly used areal unit interpolation techniques are applied and the output of each is used to compute crude county-level five-year incidence rates of all cancers in California. We found that the rates observed for 44 out of the 58 counties in California vary based on which interpolation method is used, with rates in some counties increasing by nearly 400% between interpolation methods. PMID:22469490

  7. Does absorption of ultraviolet B by stratospheric ozone and urban aerosols influence colon and breast cancer mortality rates? Contributions from NASA and NOAA data

    NASA Astrophysics Data System (ADS)

    Gorham, Edward D.; Garland, Frank C.; Mohr, Sharif B.; Grant, William B.; Garland, Cedric F.

    2005-08-01

    Although most ultraviolet B (UVB) radiation is absorbed by stratospheric ozone, dense anthropogenic sulfate aerosols in the troposphere may further attenuate UVB in some regions. Mortality rates from colon and breast cancer tend to be much higher in areas with low levels of UVB radiation. These high rates may be due in part to inadequate cutaneous photosynthesis of vitamin D. Satellite data on atmospheric aerosols, stratospheric ozone, and cloud cover were obtained from the National Aeronautics and Space Administration (NASA) and the National Oceanic and Atmospheric Administration (NOAA). These data were combined with age-adjusted mortality rates from 175 countries reporting to the World Health Organization. Regression was used to assess the relationship of stratospheric ozone thickness, aerosol optical depth, cloud cover, solar UVB irradiance at the top of the atmosphere, average skin exposure, and a dietary factor with colon and breast cancer mortality rates. Solar UVB irradiance at the top of the atmosphere, total cloud cover, and atmospheric aerosols had the strongest associations with mortality rates, apart from a strong influence of diet. Since 95% of circulating vitamin D is derived from current or stored products of photosynthesis, which may be nonexistent or minimal much of the year above 37°N or below 37°S, attenuation of UVB by atmospheric aerosols and clouds may have a greater than expected adverse effect on human health.

  8. Comparison of time-tradeoff utilities and rating scale values of cancer patients and their relatives: evidence for a possible plateau relationship.

    PubMed

    O'Leary, J F; Fairclough, D L; Jankowski, M K; Weeks, J C

    1995-01-01

    Because they are easy to administer, rating scales are often used as proxies for utility measures. The authors investigated the relationship between time-tradeoff utilities and rating scale values in two populations: 124 cancer patients asked to evaluate their current states of health and 102 relatives and close friends of cancer patients asked to evaluate health-state scenarios. None of the models tested effectively described the relationship between individual patients' rating scale values and time-tradeoff utilities for their current states of health. In contrast, both a plateau and a power-function model explained the variability in the responses of the relatives reasonably well (R2 = 0.56 and R2 = 0.58, respectively). Given that many respondents who were unwilling to trade off any time assigned rating scale values of well below 100, a plateau model may represent the best approach to adjusting rating scale values for health-state scenarios when it is not feasible to elicit time-tradeoff utilities. PMID:7783573

  9. A systematic review of patient-rated measures of radiodermatitis in breast cancer radiotherapy

    PubMed Central

    Schnur, Julie B.; Love, Bianca; Scheckner, Bari L.; Green, Sheryl; Wernicke, A. Gabriella; Montgomery, Guy H.

    2013-01-01

    During breast cancer radiotherapy, nearly all patients will experience radiodermatitis. Study objectives were to: 1) systematically review the literature on radiodermatitis and breast cancer; 2) summarize and describe patient-rated radiodermatitis measures; 3) determine whether consensus exists regarding subjective radiodermatitis measurement; and 4) provide recommendations for future research. PubMed and CINAHL were searched from their inception through August 2009. Study inclusion/exclusion criteria were: full abstract available; manuscript in English; focused on radiodermatitis resulting from breast cancer radiotherapy, and described a patient-rated empirical assessment of radiodermatitis. Three reviewers examined abstracts, and decisions about inclusion were reached by consensus. 22/237 mutually identified studies met selection criteria. Using a standardized abstraction form, three authors independently extracted relevant information. Results indicated that: 1) only 9% of the studies reviewed included a patient-rated measure; 2) generally, extant scales are very brief and focus almost exclusively on physical reactions, and 3) there is no “gold standard” measure of patient-rated radiodermatitis at this time. We conclude that significantly more research is needed to determine the best (most valid, reliable, sensitive, comprehensive) measure(s) to evaluate the experience of radiodermatitis from the patient’s perspective, and that further scale development efforts are needed. PMID:20838323

  10. Geostatistical Analysis of County-Level Lung Cancer Mortality Rates in the Southeastern United States

    PubMed Central

    Goovaerts, Pierre

    2009-01-01

    The analysis of health data and putative covariates, such as environmental, socioeconomic, demographic, behavioral, or occupational factors, is a promising application for geostatistics. Transferring methods originally developed for the analysis of earth properties to health science, however, presents several methodological and technical challenges. These arise because health data are typically aggregated over irregular spatial supports (e.g., counties) and consist of a numerator and a denominator (i.e., rates). This article provides an overview of geostatistical methods tailored specifically to the characteristics of areal health data, with an application to lung cancer mortality rates in 688 U.S. counties of the southeast (1970–1994). Factorial Poisson kriging can filter short-scale variation and noise, which can be large in sparsely populated counties, to reveal similar regional patterns for male and female cancer mortality that correlate well with proximity to shipyards. Rate uncertainty was transferred through local cluster analysis using stochastic simulation, allowing the computation of the likelihood of clusters of low or high cancer mortality. Accounting for population size and rate uncertainty led to the detection of new clusters of high mortality around Oak Ridge National Laboratory for both sexes, in counties with high concentrations of pig farms and paper mill industries for males (occupational exposure) and in the vicinity of Atlanta for females. PMID:20445829

  11. Interstitial high-dose-rate brachytherapy in locally advanced and recurrent vulvar cancer

    PubMed Central

    Białas, Brygida; Fijałkowski, Marek; Wojcieszek, Piotr; Szlag, Marta; Cholewka, Agnieszka; Ślęczka, Maciej; Kołosza, Zofia

    2016-01-01

    Purpose The aim of the study was to report our experience with high-dose-rate interstitial brachytherapy (HDR-ISBT) in locally advanced and recurrent vulvar cancer. Material and methods Between 2004 and 2014, fourteen women with locally advanced or recurrent vulvar cancer were treated using HDR-ISBT in our Centre. High-dose-rate interstitial brachytherapy was performed as a separate treatment or in combination with external beam radiotherapy (EBRT) (given prior to brachytherapy). Results Patients were divided into: group I (n = 6) with locally advanced tumors, stages III-IVA after an incisional biopsy only, and group II (n = 8) with recurrent vulvar cancer after previous radical surgery. In group I, median follow up was 12 months (range 7-18 months); 1-year overall survival (OS) was 83%. Transient arrest of cancer growth or tumor regression was noticed in all patients but 4/6 developed relapse. Median time to failure was 6.3 months (range 3-11 months). The 1-year progression-free survival (PFS) was 33%. In group II, median follow up was 28 months (range 13-90 months). The 1-year and 3-year OS was 100% and 80%, respectively. The arrest of cancer growth or tumor regression was achieved in all patients. In 4/8 patients neither clinical nor histological symptoms of relapse were observed but 4/8 women experienced relapse. Median time to failure was 31 months (range 13-76 months). The 1-year and 3-year PFS was 100% and 62.5%, respectively. Two patients (14.3%) in group II had severe late toxicity (G3). Conclusions High-dose-rate interstitial brachytherapy is a well-tolerated treatment option in selected patients with advanced or recurrent vulvar cancer. It is a safe and effective treatment modality for advanced and recurrent vulvar cancer, yielding good local control with acceptable late treatment related side effects. In our study, patients with recurrent vulvar cancer had better results in HDR-ISBT treatment, probably because of the smaller tumor volume. This

  12. Development and pilot testing of an online intervention to support young couples' coping and adjustment to breast cancer.

    PubMed

    Fergus, K D; McLeod, D; Carter, W; Warner, E; Gardner, S L; Granek, L; Cullen, K I

    2014-07-01

    Couplelinks is an original, professionally facilitated online intervention tailored to the unique challenges facing young women with breast cancer and their male partners. The purpose of this evaluation was to determine the feasibility and acceptability of the intervention and areas for improvement. Sixteen couples were sequentially enrolled over an 18-month period. Couples provided feedback via a treatment satisfaction survey, and post-treatment interviews with a sub-group of participants. Qualitative information was analysed for themes relevant to the program's acceptability, perceived benefits and limitations, and directions for improvement. Of the 16 couples who enrolled, six completed four modules or less, and 10 completed the entire program. Completers reported satisfaction with the program overall, as well as with the website useability and professional facilitation. Reported benefits were: enhanced communication and self-other knowledge; creation of opportunities for meaningful, cancer-related discussion; affirmation of relationship strengths; and a greater sense of closeness between partners. The main reported limitation was how program participation disrupted the couple's usual routine. Themes related to non-completion suggest that partners with particularly elevated relational or illness-related distress, or with differential levels of motivation, are less likely to finish. These findings have led to targeted improvements to the website and intervention protocol. PMID:24472013

  13. Regulating the Rate of Molecular Self-Assembly for Targeting Cancer Cells.

    PubMed

    Zhou, Jie; Du, Xuewen; Xu, Bing

    2016-05-01

    Besides tight and specific ligand-receptor interactions, the rate regulation of the formation of molecular assemblies is one of fundamental features of cells. But the latter receives little exploration for developing anticancer therapeutics. Here we show that a simple molecular design of the substrates of phosphatases-tailoring the number of phosphates on peptidic substrates-is able to regulate the rate of molecular self-assembly of the enzyme reaction product. Such a rate regulation allows selective inhibition of osteosarcoma cells over hepatocytes, which promises to target cancer cells in a specific organ. Moreover, our result reveals that the direct measurement of the rate of the self-assembly in a cell-based assay provides precise assessment of the cell targeting capability of self-assembly. This work, as the first report establishing rate regulation of a multiple-step process to inhibit cells selectively, illustrates a fundamentally new approach for controlling the fate of cells. PMID:27062481

  14. Adjustable microforceps.

    PubMed

    Bao, J Y

    1991-04-01

    The commonly used microforceps have a much greater opening distance and spring resistance than needed. A piece of plastic ring or rubber band can be used to adjust the opening distance and reduce most of the spring resistance, making the user feel more comfortable and less fatigued. PMID:2051437

  15. Disparities in Cervical Cancer Mortality Rates as Determined by the Longitudinal Hyperbolastic Mixed-Effects Type II Model

    PubMed Central

    Tabatabai, Mohammad A.; Kengwoung-Keumo, Jean-Jacques; Eby, Wayne M.; Bae, Sejong; Guemmegne, Juliette T.; Manne, Upender; Fouad, Mona; Partridge, Edward E.; Singh, Karan P.

    2014-01-01

    Background The main purpose of this study was to model and analyze the dynamics of cervical cancer mortality rates for African American (Black) and White women residing in 13 states located in the eastern half of the United States of America from 1975 through 2010. Methods The cervical cancer mortality rates of the Surveillance, Epidemiology, and End Results (SEER) were used to model and analyze the dynamics of cervical cancer mortality. A longitudinal hyperbolastic mixed-effects type II model was used to model the cervical cancer mortality data and SAS PROC NLMIXED and Mathematica were utilized to perform the computations. Results Despite decreasing trends in cervical cancer mortality rates for both races, racial disparities in mortality rates still exist. In all 13 states, Black women had higher mortality rates at all times. The degree of disparities and pace of decline in mortality rates over time differed among these states. Determining the paces of decline over 36 years showed that Tennessee had the most rapid decline in cervical cancer mortality for Black women, and Mississippi had the most rapid decline for White Women. In contrast, slow declines in cervical cancer mortality were noted for Black women in Florida and for White women in Maryland. Conclusions In all 13 states, cervical cancer mortality rates for both racial groups have fallen. Disparities in the pace of decline in mortality rates in these states may be due to differences in the rates of screening for cervical cancers. Of note, the gap in cervical cancer mortality rates between Black women and White women is narrowing. PMID:25226583

  16. Depression and anxiety in ovarian cancer: a systematic review and meta-analysis of prevalence rates

    PubMed Central

    Watts, Sam; Prescott, Philip; Mason, Jessica; McLeod, Natalie; Lewith, George

    2015-01-01

    Objectives To systematically review the literature pertaining to the prevalence of depression and anxiety in patients with ovarian cancer as a function of treatment stage. Design Systematic review and meta-analysis. Participants 3623 patients with ovarian cancer from primary research investigations. Primary outcome measure The prevalence of depression and anxiety in patients with ovarian cancer as a function of treatment stage. Results We identified 24 full journal articles that met the inclusion criteria for entry into the meta-analysis resulting in a pooled sample size of 3623 patients. The meta-analysis of prevalence rates identified pretreatment, on-treatment and post-treatment depression prevalences of 25.34% (CI 22.79% to 28.07%), 22.99% (CI 19.85% to 26.46%) and 12.71% (CI 10.14% to 15.79%), respectively. Pretreatment, on-treatment and post-treatment anxiety prevalences were 19.12% (CI 17.11% to 21.30%), 26.23% (CI 22.30% to 30.56%) and 27.09% (CI 23.10% to 31.49%). Conclusions Our findings suggest that the prevalence of depression and anxiety in women with ovarian cancer, across the treatment spectrum, is significantly greater than in the healthy female population. With the growing emphasis on improving the management of survivorship and quality of life, we conclude that further research is warranted to ensure psychological distress in ovarian cancer is not underdiagnosed and undertreated. PMID:26621509

  17. Adherence to Vaginal Dilation Following High Dose Rate Brachytherapy for Endometrial Cancer

    SciTech Connect

    Friedman, Lois C.; Abdallah, Rita; Schluchter, Mark; Panneerselvam, Ashok; Kunos, Charles A.

    2011-07-01

    Purpose: We report demographic, clinical, and psychosocial factors associated with adherence to vaginal dilation and describe the sexual and marital or nonmarital dyadic functioning of women following high dose rate (HDR) brachytherapy for endometrial cancer. Methods and Materials: We retrospectively evaluated women aged 18 years or older in whom early-stage endometrial (IAgr3-IIB) cancers were treated by HDR intravaginal brachytherapy within the past 3.5 years. Women with or without a sexual partner were eligible. Patients completed questionnaires by mail or by telephone assessing demographic and clinical variables, adherence to vaginal dilation, dyadic satisfaction, sexual functioning, and health beliefs. Results: Seventy-eight of 89 (88%) eligible women with early-stage endometrial cancer treated with HDR brachytherapy completed questionnaires. Only 33% of patients were adherers, based on reporting having used a dilator more than two times per week in the first month following radiation. Nonadherers who reported a perceived change in vaginal dimension following radiation reported that their vaginas were subjectively smaller after brachytherapy (p = 0.013). Adherers reported more worry about their sex lives or lack thereof than nonadherers (p = 0.047). Patients reported considerable sexual dysfunction following completion of HDR brachytherapy. Conclusions: Adherence to recommendations for vaginal dilator use following HDR brachytherapy for endometrial cancer is poor. Interventions designed to educate women about dilator use benefit may increase adherence. Although sexual functioning was compromised, it is likely that this existed before having cancer for many women in our study.

  18. Towards enabling ultrasound guidance in cervical cancer high-dose-rate brachytherapy

    NASA Astrophysics Data System (ADS)

    Wong, Adrian; Sojoudia, Samira; Gaudet, Marc; Yap, Wan Wan; Chang, Silvia D.; Abolmaesumi, Purang; Aquino-Parsons, Christina; Moradi, Mehdi

    2014-03-01

    MRI and Computed Tomography (CT) are used in image-based solutions for guiding High Dose Rate (HDR) brachytherapy treatment of cervical cancer. MRI is costly and CT exposes the patients to ionizing radiation. Ultrasound, on the other hand, is affordable and safe. The long-term goal of our work is to enable the use of multiparametric ultrasound imaging in image-guided HDR for cervical cancer. In this paper, we report the development of enabling technology for ultrasound guidance and tissue typing. We report a system to obtain the 3D freehand transabdominal ultrasound RF signals and B-mode images of the uterus, and a method for registration of ultrasound to MRI. MRI and 3D ultrasound images of the female pelvis were registered by contouring the uterus in the two modalities, creating a surface model, followed by rigid and B-spline deformable registration. The resulting transformation was used to map the location of the tumor from the T2-weighted MRI to ultrasound images and to determine cancerous and normal areas in ultrasound. B-mode images show a contrast for cancer vs. normal tissue. Our study shows the potential and the challenges of ultrasound imaging in guiding cervical cancer treatments.

  19. The thickness history of the northern sector of the Laurentide Ice Sheet: an assessment of glacial isostatic adjustment models, sea-level measurements, and vertical land motion rates

    NASA Astrophysics Data System (ADS)

    Simon, K. M.; James, T. S.; Henton, J. A.; Dyke, A.

    2014-12-01

    The fit of glacial isostatic adjustment (GIA) model predictions to 24 relative sea-level histories and an additional 18 present-day GPS-measured vertical land motion rates constrains the thickness and volume history of the central and northern Laurentide Ice Sheet. The predictions of the best-fit GIA model indicate respective peak ice thicknesses west and east of Hudson Bay of 3.4-3.6 km and approximately 4 km. These values represent, respectively, a large decrease, and a moderate increase, to the load thickness compared to ICE-5G. This result is generally consistent with other GIA studies focussing on space-geodetic constraints. The large reduction to the ice load west of Hudson Bay also reduces the vertical mantle response along the margins of the load centre, which improves the fit to relative sea-level data from the southern Canadian Arctic Archipelago. The fit of GIA model predictions to relative sea-level data from the Baffin Sector of the Laurentide Ice Sheet indicate peak ice thicknesses there of 1.2-1.3 km, a modest reduction compared to ICE-5G. On Baffin Island, the modelled elastic crustal response of the Earth to present-day ice mass changes is large. Accounting for this effect improves the agreement between GPS measurements of vertical crustal motion and the GIA model predictions. However, work is needed to incorporate more detailed observations and modelling of present-day changes to glaciers and ice caps. Overall, the fit to the data is most strongly improved in the region west of Hudson Bay (the χ2 RSL misfit is reduced by a factor of ~4) although the entire revised reconstruction for the central and northern Laurentide Ice Sheet provides an improved fit to both the regional RSL data (the cumulative χ2 misfit is reduced by a factor of >2) and the GPS data (the RMS misfit is reduced by a factor of 9).

  20. The effect of lead selection on traditional and heart rate-adjusted ST segment analysis in the detection of coronary artery disease during exercise testing.

    PubMed

    Viik, J; Lehtinen, R; Turjanmaa, V; Niemelä, K; Malmivuo, J

    1997-09-01

    Several methods of heart rate-adjusted ST segment (ST/HR) analysis have been suggested to improve the diagnostic accuracy of exercise electrocardiography in the identification of coronary artery disease compared with traditional ST segment analysis. However, no comprehensive comparison of these methods on a lead-by-lead basis in all 12 electrocardiographic leads has been reported. This article compares the diagnostic performances of ST/HR hysteresis, ST/HR index, ST segment depression 3 minutes after recovery from exercise, and ST segment depression at peak exercise in a study population of 128 patients with angiographically proved coronary artery disease and 189 patients with a low likelihood of the disease. The methods were determined in each lead of the Mason-Likar modification of the standard 12-lead exercise electrocardiogram for each patient. The ST/HR hysteresis, ST/HR index, ST segment depression 3 minutes after recovery from exercise, and ST segment depression at peak exercise achieved more than 85% area under the receiver-operating characteristic curve in nine, none, three, and one of the 12 standard leads, respectively. The diagnostic performance of ST/HR hysteresis was significantly superior in each lead, with the exception of leads a VL and V1. Examination of individual leads in each study method revealed the high diagnostic performance of leads I and -aVR, indicating that the importance of these leads has been undervalued. In conclusion, the results indicate that when traditional ST segment analysis is used for the detection of coronary artery disease, more attention should be paid to the leads chosen for analysis, and lead-specific cut points should be applied. On the other hand, ST/HR hysteresis, which integrates the ST/HR depression of the exercise and recovery phases, seems to be relatively insensitive to the lead selection and significantly increases the diagnostic performance of exercise electrocardiography in the detection of coronary artery

  1. Salvage high-dose-rate interstitial brachytherapy for locally recurrent rectal cancer*

    PubMed Central

    Pellizzon, Antônio Cássio Assis

    2016-01-01

    For tumors of the lower third of the rectum, the only safe surgical procedure is abdominal-perineal resection. High-dose-rate interstitial brachytherapy is a promising treatment for local recurrence of previously irradiated lower rectal cancer, due to the extremely high concentrated dose delivered to the tumor and the sparing of normal tissue, when compared with a course of external beam radiation therapy. PMID:27403021

  2. Definitive radiotherapy for primary vaginal cancer: correlation between treatment patterns and recurrence rate

    PubMed Central

    Kanayama, Naoyuki; Isohashi, Fumiaki; Yoshioka, Yasuo; Baek, Sungjae; Chatani, Masashi; Kotsuma, Tadayuki; Tanaka, Eiichi; Yoshida, Ken; Seo, Yuji; Suzuki, Osamu; Mabuchi, Seiji; Shiki, Yasuhiko; Tatsumi, Keiji; Kimura, Tadashi; Teshima, Teruki; Ogawa, Kazuhiko

    2015-01-01

    The purpose of this study was to determine the outcomes and optimal practice patterns of definitive radiotherapy for primary vaginal cancer. Between 1993 and 2012, 49 patients were treated with definitive radiotherapy for primary vaginal cancer in three hospitals. Of these, 15 patients (31%) had clinically positive regional lymph node metastasis. A total of 34 patients (70%) received external beam radiotherapy with high-dose-rate brachytherapy (interstitial or intracavitary), and 8 (16%) (with small superficial Stage I tumors) were treated with local radiotherapy. The median follow-up was 33 months (range: 1–169 months). The 3-year overall survival (OS), disease-free survival (DFS), and loco-regional control (LRC) rates were 83%, 59% and 71%, respectively. In multivariate analysis, the histological type (P = 0.044) was significant risk factors for LRC. In Federation of Gynecology and Obstetrics (FIGO) Stage I cases, 3 of 8 patients (38%) who did not undergo prophylactic lymph node irradiation had lymph node recurrence, compared with 2 of 12 patients (17%) who underwent prophylactic pelvic irradiation. For Stage III–IV tumors, the local recurrence rate was 50% and the lymph node recurrence rate was 40%. Patients with FIGO Stage I/II or clinical Stage N1 had a higher recurrence rate with treatment using a single modality compared with the recurrence rate using combined modalities. In conclusion, our treatment outcomes for vaginal cancer were acceptable, but external beam radiotherapy with brachytherapy (interstitial or intracavitary) was needed regardless of FIGO stage. Improvement of treatment outcomes in cases of FIGO Stage III or IV remains a significant challenge. PMID:25614068

  3. Measures of racial/ethnic health disparities in cancer mortality rates and the influence of socioeconomic status.

    PubMed Central

    Chu, Kenneth C.; Miller, Barry A.; Springfield, Sanya A.

    2007-01-01

    OBJECTIVES: In the 1990s, U.S. cancer mortality rates declined due to reductions in tobacco use among men and beneficial cancer interventions, such as mammography and Pap smears. We examined the cancer rates by racial/ethnic group, socioeconomic status and time period to identify disparities underlying the overall mortality trend. METHODS: We examined racial/ethnic disparities by measuring excess cancer burden [rate ratio (RR) and ratio differences (RD)] and trends in their cancer rates for nine cancer sites. The trend (T) is calculated as a ratio of the average annual cancer mortality rate for 1995-2000 relative to the rate for 1990-1994 for three levels of poverty (counties with <10% living below the poverty level, 10% - <20% and > or =20%) for the major racial/ethnic populations. We also compared the trend for each racial/ethnic SES group to the trend for lowest SES white group (TD). RESULTS: Blacks have RR disparities relative to whites for each cancer site examined, except for female lung cancer, while the other minorities had RR disparities for cervical cancer (RR>1). There are increases in RR disparities from 1990-1994 to 1995-2000 (RD>0) for colorectal cancer, prostate cancer and breast cancer for each racial/ethnic minority. Whites and blacks had declining trends for every SES group (T<1) and positive high SES gradients (the highest SES group had the best trend and the lowest SES group had the worst trend) at each cancer site, except female lung cancer (T>1). In contrast, American Indians/Alaska natives, Hispanics and Asians/ Pacific Islanders had increasing trends for some of their cancer sites, and their trends did not have the SES gradients. CONCLUSIONS: Increases in racial/ethnic disparities (RD>0) for colorectal, breast and prostate cancer were largest in the lowest SES groups. At some cancer sites, the highest SES group for minorities had worse trend results than the trends for the lowest SES white group (TD>0). PMID:17987912

  4. Feasibility study of volumetric modulated arc therapy with constant dose rate for endometrial cancer

    SciTech Connect

    Yang, Ruijie; Wang, Junjie; Xu, Feng; Li, Hua; Zhang, Xile

    2013-10-01

    To investigate the feasibility, efficiency, and delivery accuracy of volumetric modulated arc therapy with constant dose rate (VMAT-CDR) for whole-pelvic radiotherapy (WPRT) of endometrial cancer. The nine-field intensity-modulated radiotherapy (IMRT), VMAT with variable dose-rate (VMAT-VDR), and VMAT-CDR plans were created for 9 patients with endometrial cancer undergoing WPRT. The dose distribution of planning target volume (PTV), organs at risk (OARs), and normal tissue (NT) were compared. The monitor units (MUs) and treatment delivery time were also evaluated. For each VMAT-CDR plan, a dry run was performed to assess the dosimetric accuracy with MatriXX from IBA. Compared with IMRT, the VMAT-CDR plans delivered a slightly greater V{sub 20} of the bowel, bladder, pelvis bone, and NT, but significantly decreased the dose to the high-dose region of the rectum and pelvis bone. The MUs decreased from 1105 with IMRT to 628 with VMAT-CDR. The delivery time also decreased from 9.5 to 3.2 minutes. The average gamma pass rate was 95.6% at the 3%/3 mm criteria with MatriXX pretreatment verification for 9 patients. VMAT-CDR can achieve comparable plan quality with significant shorter delivery time and smaller number of MUs compared with IMRT for patients with endometrial cancer undergoing WPRT. It can be accurately delivered and be an alternative to IMRT on the linear accelerator without VDR capability.

  5. Feasibility study of volumetric modulated arc therapy with constant dose rate for endometrial cancer.

    PubMed

    Yang, Ruijie; Wang, Junjie; Xu, Feng; Li, Hua; Zhang, Xile

    2013-01-01

    To investigate the feasibility, efficiency, and delivery accuracy of volumetric modulated arc therapy with constant dose rate (VMAT-CDR) for whole-pelvic radiotherapy (WPRT) of endometrial cancer. The nine-field intensity-modulated radiotherapy (IMRT), VMAT with variable dose-rate (VMAT-VDR), and VMAT-CDR plans were created for 9 patients with endometrial cancer undergoing WPRT. The dose distribution of planning target volume (PTV), organs at risk (OARs), and normal tissue (NT) were compared. The monitor units (MUs) and treatment delivery time were also evaluated. For each VMAT-CDR plan, a dry run was performed to assess the dosimetric accuracy with MatriXX from IBA. Compared with IMRT, the VMAT-CDR plans delivered a slightly greater V20 of the bowel, bladder, pelvis bone, and NT, but significantly decreased the dose to the high-dose region of the rectum and pelvis bone. The MUs decreased from 1105 with IMRT to 628 with VMAT-CDR. The delivery time also decreased from 9.5 to 3.2 minutes. The average gamma pass rate was 95.6% at the 3%/3mm criteria with MatriXX pretreatment verification for 9 patients. VMAT-CDR can achieve comparable plan quality with significant shorter delivery time and smaller number of MUs compared with IMRT for patients with endometrial cancer undergoing WPRT. It can be accurately delivered and be an alternative to IMRT on the linear accelerator without VDR capability. PMID:23669454

  6. Shaft adjuster

    DOEpatents

    Harry, Herbert H.

    1989-01-01

    Apparatus and method for the adjustment and alignment of shafts in high power devices. A plurality of adjacent rotatable angled cylinders are positioned between a base and the shaft to be aligned which when rotated introduce an axial offset. The apparatus is electrically conductive and constructed of a structurally rigid material. The angled cylinders allow the shaft such as the center conductor in a pulse line machine to be offset in any desired alignment position within the range of the apparatus.

  7. High-Dose-Rate Monotherapy: Safe and Effective Brachytherapy for Patients With Localized Prostate Cancer

    SciTech Connect

    Demanes, D. Jeffrey; Martinez, Alvaro A.; Ghilezan, Michel; Hill, Dennis R.; Schour, Lionel; Brandt, David; Gustafson, Gary

    2011-12-01

    Purpose: High-dose-rate (HDR) brachytherapy used as the only treatment (monotherapy) for early prostate cancer is consistent with current concepts in prostate radiobiology, and the dose is reliably delivered in a prospectively defined anatomic distribution that meets all the requirements for safe and effective therapy. We report the disease control and toxicity of HDR monotherapy from California Endocurietherapy (CET) and William Beaumont Hospital (WBH) in low- and intermediate-risk prostate cancer patients. Methods and Materials: There were 298 patients with localized prostate cancer treated with HDR monotherapy between 1996 and 2005. Two biologically equivalent hypofractionation protocols were used. At CET the dose was 42 Gy in six fractions (two implantations 1 week apart) delivered to a computed tomography-defined planning treatment volume. At WBH the dose was 38 Gy in four fractions (one implantation) based on intraoperative transrectal ultrasound real-time treatment planning. The bladder, urethral, and rectal dose constraints were similar. Toxicity was scored with the National Cancer Institute Common Toxicity Criteria for Adverse Events version 3. Results: The median follow-up time was 5.2 years. The median age of the patients was 63 years, and the median value of the pretreatment prostate-specific antigen was 6.0 ng/mL. The 8-year results were 99% local control, 97% biochemical control (nadir +2), 99% distant metastasis-free survival, 99% cause-specific survival, and 95% overall survival. Toxicity was scored per event, meaning that an individual patient with more than one symptom was represented repeatedly in the morbidity data table. Genitourinary toxicity consisted of 10% transient Grade 2 urinary frequency or urgency and 3% Grade 3 episode of urinary retention. Gastrointestinal toxicity was <1%. Conclusions: High disease control rates and low morbidity demonstrate that HDR monotherapy is safe and effective for patients with localized prostate cancer.

  8. Depression and anxiety in prostate cancer: a systematic review and meta-analysis of prevalence rates

    PubMed Central

    Watts, Sam; Leydon, Geraldine; Birch, Brian; Prescott, Philip; Lai, Lily; Eardley, Susan; Lewith, George

    2014-01-01

    Objectives To systematically review the literature pertaining to the prevalence of depression and anxiety in patients with prostate cancer as a function of treatment stage. Design Systematic review and meta-analysis. Participants 4494 patients with prostate cancer from primary research investigations. Primary outcome measure The prevalence of clinical depression and anxiety in patients with prostate cancer as a function of treatment stage. Results We identified 27 full journal articles that met the inclusion criteria for entry into the meta-analysis resulting in a pooled sample size of 4494 patients. The meta-analysis of prevalence rates identified pretreatment, on-treatment and post-treatment depression prevalences of 17.27% (95% CI 15.06% to 19.72%), 14.70% (95% CI 11.92% to 17.99%) and 18.44% (95% CI 15.18% to 22.22%), respectively. Pretreatment, on-treatment and post-treatment anxiety prevalences were 27.04% (95% CI 24.26% to 30.01%), 15.09% (95% CI 12.15% to 18.60%) and 18.49% (95% CI 13.81% to 24.31%), respectively. Conclusions Our findings suggest that the prevalence of depression and anxiety in men with prostate cancer, across the treatment spectrum, is relatively high. In light of the growing emphasis placed on cancer survivorship, we consider that further research within this area is warranted to ensure that psychological distress in patients with prostate cancer is not underdiagnosed and undertreated. PMID:24625637

  9. Ethnic variation in cancer patients’ ratings of information provision, communication and overall care

    PubMed Central

    Trenchard, Lorna; Mc Grath-Lone, Louise; Ward, Helen

    2016-01-01

    ABSTRACT Objective. Ethnic inequalities in cancer patient experience exist but variation within broad ethnic categories is under-explored. This study aimed to describe variation by ethnic sub-category in experiences of information provision and communication (key domains of patient experience) using National Cancer Patient Experience Survey (NCPES) data. Design. The NCPES 2012–2013 contained responses from 68,737 cancer patients treated at 155 NHS Trusts in England. Multivariate logistic regression was used to investigate associations between ethnicity and patients’ ratings of overall care, information provision and communication. Results. Variation by and within broad ethnic categories was evident. Non-White patients (particularly Asian patients (ORadj:0.78; 95%CI:0.67-0.90, p=0.001)) were less likely than White patients to receive an understandable explanation of treatment side effects. Among Asian patients, those of Bangladeshi ethnicity were least likely to receive an understandable explanation. Conclusions. Effective communication and information provision are important to ensure patients are well informed, receive the best possible care and have a positive patient experience. However, ethnic inequalities exist in cancer patients’ experiences of information provision and communication with variation evident both between and within broad ethnic categories. Further work to understand the causes of this variation is required to address ethnic inequalities at practice and policy level. PMID:26853061

  10. [Study of the Response Rate and Neutrophil Lymphocyte Ratio in Breast Cancer Patients Undergoing Neoadjuvant Chemotherapy].

    PubMed

    Adachi, Keita; Sakurai, Kenichi; Suzuki, Shuhei; Hara, Yukiko; Nagashima, Saki; Hirano, Tomohiro; Enomoto, Katsuhisa; Amano, Sadao

    2015-10-01

    The neutrophil lymphocyte ratio (NLR) is associated with the outcomes of some cancer patients such as those with digestive cancer. Herein, we examined the relationship between the response rate following neoadjuvant chemotherapy and NLR in breast cancer patients. We recruited 19 primary breast cancer patients who were administered neoadjuvant chemotherapy. We evaluated the effects of this treatment and classified the patients into responder (CR and PR) and non-responder (SD and PD) groups. We measured the value of NLR before or at the start of nab-PTX treatment, and 7 days after nab-PTX (1-1) and nab-PTX (4-3) treatment. The average age was 58.6 years. The responder and non-responder groups comprised 14 and 5 cases, respectively. The average values of NLR before or at the start of the nab-PTX phase were 4.33 and 5.05 in the responder and non-responder groups, respectively. The average NLR values 7 days after nab-PTX (1-1) were 6.72 and 5.60 in the responder and non-responder groups, respectively. The NLR values 7 days after nab-PTX (4-3) were 2.40 and 2.65 for the responder and non-responder groups, respectively. There were no significant differences between the responder and non-responder groups for each treatment phase. PMID:26489573

  11. Contralateral prophylactic mastectomy rate stable at major Canadian breast cancer center

    PubMed Central

    Roberts, Amanda; Sandhu, Lakhbir; Cil, Tulin D; Hofer, Stefan O P; Zhong, Toni

    2016-01-01

    AIM: To examine trends of contralateral prophylactic mastectomy (CPM) rates at a Canadian academic breast cancer center. METHODS: A single-institution retrospective cohort study was completed. Women of any age who underwent at least a unilateral mastectomy (UM) for primary unilateral breast carcinoma between January 1, 2004 and December 31, 2010 were included. Patients who underwent CPM on the same day as UM were isolated to create two distinct cohorts. Patient and procedure characteristics were compared across groups using R software (version 3.1.0). The percentage of CPMs per year was determined. The Cochrane-Armitage test was used to assess the trend of CPMs over time. A P value of < 0.05 was considered significant. RESULTS: A total of 811 women met the inclusions/exclusion criteria; 759 (93.6%) underwent UM alone and 52 (6.4%) underwent UM with immediate CPM. The absolute number of procedures (UM and UM + CPM) increased over time, from 83 in 2004 to 147 in 2010 reflecting an increase in mastectomy volume. Annual CPM rates did not increase over time (P = 0.7) and varied between 2.6% to 10.7%. Family history of breast cancer [OR 3.6 (1.8-7.3)] and immediate reconstruction [10.0 (5.2-19.3)] were both significantly associated with CPM. Women who underwent CPM were younger (median age CPM 49 years vs UM 52 years, P < 0.0001) but age less than 50 years was not statistically associated with increased rates of CPM. CONCLUSION: CPM rates from 2004 to 2010 at a high-volume Canadian breast cancer center did not increase over time, in contrast to trends observed in the United States. PMID:27298770

  12. Quality assurance and its impact on ovarian visualization rates in the multicenter United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS)

    PubMed Central

    Sharma, A.; Burnell, M.; Gentry‐Maharaj, A.; Campbell, S.; Amso, N. N.; Seif, M. W.; Fletcher, G.; Brunell, C.; Turner, G.; Rangar, R.; Ryan, A.; Jacobs, I.

    2016-01-01

    ABSTRACT Objective To describe the quality assurance (QA) processes and their impact on visualization of postmenopausal ovaries in the ultrasound arm of a multicenter screening trial for ovarian cancer. Methods In the United Kingdom Collaborative Trial of Ovarian Cancer Screening, 50 639 women aged 50–74 years were randomized to the ultrasound arm and underwent annual transvaginal ultrasound (TVS) examinations. QA processes were developed during the course of the trial and included regular monitoring of the visualization rate (VR) of the right ovary. Non‐subjective factors identified previously as impacting on VR of the right ovary were included in a generalized estimating equation model for binary outcomes to enable comparison of observed vs adjusted VR between individual sonographers who had undertaken > 1000 scans during the trial and comparison between centers. Observed and adjusted VRs of sonographers and centers were ranked according to the highest VR. Analysis of annual VRs of sonographers and those of the included centers was undertaken. Results Between June 2001 and December 2010, 48 230 of 50 639 women attended one of 13 centers for a total of 270 035 annual TVS scans. One or both ovaries were seen in 228 145 (84.5%) TVS scans. The right ovary was seen on 196 426 (72.7%) of the scans. For the 78 sonographers included in the model, the median difference between observed and adjusted VR was −0.7% (range, −7.9 to 5.9%) and the median change in VR rank after adjustment was 3 (range, 0–18). For the 13 centers, the median difference between observed and adjusted VR was −0.5% (range, −2.2 to 1%), with no change in ranking after adjustment. The median adjusted VR was 73% (interquartile range (IQR), 65–82%) for sonographers and 74.7% (IQR, 67.1–79.0%) for centers. Despite the increasing age of the women being scanned, there was a steady decrease in the number of sonographers with VR < 60% (21.4% in 2002 vs 2.0% in 2010) and an increase in

  13. Is there an Ideal Breast Conservation Rate for the Treatment of Breast Cancer?

    PubMed

    Tan, M P

    2016-09-01

    Since the results of randomised controlled trials in the last quarter of the twentieth century were reported, it has been conventionally accepted that breast conservation treatment (BCT) provides equivalent survival to mastectomy for early breast cancer. As expected, there was an initial fall in the use of mastectomy. The first decade of the twenty-first century, however, witnessed a trend of increasing mastectomy rates in some regions. This perplexing circumstance served as an impetus for a relook at survival outcomes with each surgical modality. Recent studies have demonstrated higher survival rates and improved local control associated with BCT. Such findings warrant a re-evaluation of treatment strategies, beginning with whether there is an optimum BCT rate. PMID:27177489

  14. Mutational Biases Drive Elevated Rates of Substitution at Regulatory Sites across Cancer Types.

    PubMed

    Kaiser, Vera B; Taylor, Martin S; Semple, Colin A

    2016-08-01

    Disruption of gene regulation is known to play major roles in carcinogenesis and tumour progression. Here, we comprehensively characterize the mutational profiles of diverse transcription factor binding sites (TFBSs) across 1,574 completely sequenced cancer genomes encompassing 11 tumour types. We assess the relative rates and impact of the mutational burden at the binding sites of 81 transcription factors (TFs), by comparing the abundance and patterns of single base substitutions within putatively functional binding sites to control sites with matched sequence composition. There is a strong (1.43-fold) and significant excess of mutations at functional binding sites across TFs, and the mutations that accumulate in cancers are typically more disruptive than variants tolerated in extant human populations at the same sites. CTCF binding sites suffer an exceptionally high mutational load in cancer (3.31-fold excess) relative to control sites, and we demonstrate for the first time that this effect is seen in essentially all cancer types with sufficient data. The sub-set of CTCF sites involved in higher order chromatin structures has the highest mutational burden, suggesting a widespread breakdown of chromatin organization. However, we find no evidence for selection driving these distinctive patterns of mutation. The mutational load at CTCF-binding sites is substantially determined by replication timing and the mutational signature of the tumor in question, suggesting that selectively neutral processes underlie the unusual mutation patterns. Pervasive hyper-mutation within transcription factor binding sites rewires the regulatory landscape of the cancer genome, but it is dominated by mutational processes rather than selection. PMID:27490693

  15. Mutational Biases Drive Elevated Rates of Substitution at Regulatory Sites across Cancer Types

    PubMed Central

    Semple, Colin A.

    2016-01-01

    Disruption of gene regulation is known to play major roles in carcinogenesis and tumour progression. Here, we comprehensively characterize the mutational profiles of diverse transcription factor binding sites (TFBSs) across 1,574 completely sequenced cancer genomes encompassing 11 tumour types. We assess the relative rates and impact of the mutational burden at the binding sites of 81 transcription factors (TFs), by comparing the abundance and patterns of single base substitutions within putatively functional binding sites to control sites with matched sequence composition. There is a strong (1.43-fold) and significant excess of mutations at functional binding sites across TFs, and the mutations that accumulate in cancers are typically more disruptive than variants tolerated in extant human populations at the same sites. CTCF binding sites suffer an exceptionally high mutational load in cancer (3.31-fold excess) relative to control sites, and we demonstrate for the first time that this effect is seen in essentially all cancer types with sufficient data. The sub-set of CTCF sites involved in higher order chromatin structures has the highest mutational burden, suggesting a widespread breakdown of chromatin organization. However, we find no evidence for selection driving these distinctive patterns of mutation. The mutational load at CTCF-binding sites is substantially determined by replication timing and the mutational signature of the tumor in question, suggesting that selectively neutral processes underlie the unusual mutation patterns. Pervasive hyper-mutation within transcription factor binding sites rewires the regulatory landscape of the cancer genome, but it is dominated by mutational processes rather than selection. PMID:27490693

  16. Changes in Age-Adjusted Mortality Rates and Disparities for Rural Physician Shortage Areas Staffed by the National Health Service Corps: 1984-1998

    ERIC Educational Resources Information Center

    Pathman, Donald E.; Fryer, George E.; Green, Larry A.; Phillips, Robert L.

    2005-01-01

    Objective: This study assesses whether the National Health Service Corps's legislated goals to see health improve and health disparities lessen are being met in rural health professional shortage areas for a key population health indicator: age-adjusted mortality. Methods: In a descriptive study using a pre-post design with comparison groups, the…

  17. Changes in Age-Adjusted Mortality Rates and Disparities for Rural Physician Shortage Areas Staffed by the National Health Service Corps: 1984-1998

    ERIC Educational Resources Information Center

    Pathman, Donald E.; Fryer, George E.; Green, Larry A.; Phillips, Robert L.

    2005-01-01

    This study assesses whether the National Health Service Corps's legislated goals to see health improve and health disparities lessen are being met in rural health professional shortage areas for a key population health indicator: age-adjusted mortality. In a descriptive study using a pre-post design with comparison groups, the authors calculated…

  18. Long-term results of breast cancer irradiation treatment with low-dose-rate external irradiation

    SciTech Connect

    Pierquin, Bernard; Tubiana, Maurice . E-mail: maurice.tubiana@biomedicale.univ-paris5.fr; Pan, Camille; Lagrange, Jean-Leon; Calitchi, Elie; Otmezguine, Yves

    2007-01-01

    Purpose: The aim of this study was to assess beam therapy with low-dose-rate (LDR) external irradiation in a group of patients with breast cancer. Methods and Materials: This trial compared, from 1986 to 1989, patients with advanced breast cancer treated either by conventional fractionation or low-dose-rate (LDR) external radiotherapy (dose-rate 15 mGy/min, 5 sessions of 9 Gy delivered on 5 consecutive days). Results: A total of 21 patients were included in the fractionated therapy arm. At follow-up 15 years after treatment, 7 local recurrences had occurred, 3 patients had died of cancer, 18 patients were alive, 10 were without evidence of disease, and 6 had evidence of disease. A total of 22 patients had been included in the LDR arm of the study. Of these, 11 had received a dose of 45 Gy; thereafter, in view of severe local reactions, the dose was reduced to 35 Gy. There was no local recurrence in patients who had received 45 Gy, although there were 2 local recurrences among the 11 patients after 35 Gy. The sequelae were severe in patients who received 45 Gy but were comparable to those observed in patients treated by fractionated radiotherapy who received 35 Gy. The higher efficacy of tumor control in patients treated by LDR irradiation as well as the lower tolerance of normal tissue are probably related to the lack of repopulation. Conclusion: Although the patient numbers in this study are limited, based on our study results we conclude that the data for LDR irradiation are encouraging and that further investigation is warranted.

  19. UGT1A1 genotype-dependent dose adjustment of belinostat in patients with advanced cancers using population pharmacokinetic modeling and simulation.

    PubMed

    Peer, Cody J; Goey, Andrew K L; Sissung, Tristan M; Erlich, Sheryl; Lee, Min-Jung; Tomita, Yusuke; Trepel, Jane B; Piekarz, Richard; Balasubramaniam, Sanjeeve; Bates, Susan E; Figg, William D

    2016-04-01

    Belinostat is a second-generation zinc-binding histone deacetylase inhibitor that is approved for peripheral T-cell lymphoma and is currently being studied in small cell lung cancer and other advanced carcinomas as a 48-hour continuous intravenous infusion. Belinostat is predominantly metabolized by UGT1A1, which is polymorphic. Preliminary analyses revealed a difference in belinostat clearance based on UGT1A1 genotype. A 2-compartment population pharmacokinetic (PK) model was developed and validated that incorporated the UGT1A1 genotype, albumin, and creatinine clearance on the clearance parameter; body weight was a significant covariate on volume. Simulated doses of 600 and 400 mg/m(2) /24 h given to patients considered extensive or impaired metabolizers, respectively, provided equivalent AUCs. This model and subsequent simulations supported additional PK/toxicity and pharmacogenomics/toxicity analyses to suggest a UGT1A1 genotype-based dose adjustment to normalize belinostat exposure and allow for more tolerable therapy. In addition, global protein lysine acetylation was modeled with PK and demonstrated a reversible belinostat exposure/response relationship, consistent with previous reports. PMID:26637161

  20. Predicting cancer rates in astronauts from animal carcinogenesis studies and cellular markers

    NASA Technical Reports Server (NTRS)

    Williams, J. R.; Zhang, Y.; Zhou, H.; Osman, M.; Cha, D.; Kavet, R.; Cuccinotta, F.; Dicello, J. F.; Dillehay, L. E.

    1999-01-01

    The radiation space environment includes particles such as protons and multiple species of heavy ions, with much of the exposure to these radiations occurring at extremely low average dose-rates. Limitations in databases needed to predict cancer hazards in human beings from such radiations are significant and currently do not provide confidence that such predictions are acceptably precise or accurate. In this article, we outline the need for animal carcinogenesis data based on a more sophisticated understanding of the dose-response relationship for induction of cancer and correlative cellular endpoints by representative space radiations. We stress the need for a model that can interrelate human and animal carcinogenesis data with cellular mechanisms. Using a broad model for dose-response patterns which we term the "subalpha-alpha-omega (SAO) model", we explore examples in the literature for radiation-induced cancer and for radiation-induced cellular events to illustrate the need for data that define the dose-response patterns more precisely over specific dose ranges, with special attention to low dose, low dose-rate exposure. We present data for multiple endpoints in cells, which vary in their radiosensitivity, that also support the proposed model. We have measured induction of complex chromosome aberrations in multiple cell types by two space radiations, Fe-ions and protons, and compared these to photons delivered at high dose-rate or low dose-rate. Our data demonstrate that at least three factors modulate the relative efficacy of Fe-ions compared to photons: (i) intrinsic radiosensitivity of irradiated cells; (ii) dose-rate; and (iii) another unspecified effect perhaps related to reparability of DNA lesions. These factors can produce respectively up to at least 7-, 6- and 3-fold variability. These data demonstrate the need to understand better the role of intrinsic radiosensitivity and dose-rate effects in mammalian cell response to ionizing radiation. Such

  1. Premenopausal Obesity and Breast Cancer Growth Rates in a Rodent Model

    PubMed Central

    Matthews, Shawna B.; McGinley, John N.; Neil, Elizabeth S.; Thompson, Henry J.

    2016-01-01

    Obese premenopausal women with breast cancer have poorer prognosis for long term survival, in part because their tumors are larger at the time of diagnosis than are found in normal weight women. Whether larger tumor mass is due to obesity-related barriers to detection or to effects on tumor biology is not known. This study used polygenic models for obesity and breast cancer to deconstruct this question with the objective of determining whether cell autonomous mechanisms contribute to the link between obesity and breast cancer burden. Assessment of the growth rates of 259 chemically induced mammary carcinomas from rats sensitive to dietary induced obesity (DS) and of 143 carcinomas from rats resistant (DR) to dietary induced obesity revealed that tumors in DS rats grew 1.8 times faster than in DR rats. This difference may be attributed to alterations in cell cycle machinery that permit more rapid tumor cell accumulation. DS tumors displayed protein expression patterns consistent with reduced G1/S checkpoint inhibition and a higher threshold of factors required for execution of the apoptotic cell death pathway. These mechanistic insights identify regulatory targets for life style modifications or pharmacological interventions designed to disrupt the linkage between obesity and tumor burden. PMID:27077880

  2. Premenopausal Obesity and Breast Cancer Growth Rates in a Rodent Model.

    PubMed

    Matthews, Shawna B; McGinley, John N; Neil, Elizabeth S; Thompson, Henry J

    2016-01-01

    Obese premenopausal women with breast cancer have poorer prognosis for long term survival, in part because their tumors are larger at the time of diagnosis than are found in normal weight women. Whether larger tumor mass is due to obesity-related barriers to detection or to effects on tumor biology is not known. This study used polygenic models for obesity and breast cancer to deconstruct this question with the objective of determining whether cell autonomous mechanisms contribute to the link between obesity and breast cancer burden. Assessment of the growth rates of 259 chemically induced mammary carcinomas from rats sensitive to dietary induced obesity (DS) and of 143 carcinomas from rats resistant (DR) to dietary induced obesity revealed that tumors in DS rats grew 1.8 times faster than in DR rats. This difference may be attributed to alterations in cell cycle machinery that permit more rapid tumor cell accumulation. DS tumors displayed protein expression patterns consistent with reduced G1/S checkpoint inhibition and a higher threshold of factors required for execution of the apoptotic cell death pathway. These mechanistic insights identify regulatory targets for life style modifications or pharmacological interventions designed to disrupt the linkage between obesity and tumor burden. PMID:27077880

  3. Incidence and mortality rate of esophageal cancer has decreased during past 40 years in Hebei Province, China

    PubMed Central

    He, Yutong; Wu, Yan; Song, Guohui; Li, Yongwei; Liang, Di; Jin, Jing; Wen, Denggui

    2015-01-01

    Background Hebei province is located in North of China with of approximately 6% of whole national population. It is known as a high-risk area for esophageal cancer in China and worldwide. The aim of our study was to estimate the esophageal cancer burden and trend in Hebei Province. Methods Eight cancer registries in Hebei Province submitted cancer registry data to the Hebei Provincial Cancer Registry Center. All data were qualified and compiled for cancer statistics in 2011. The pooled data were stratified by gender and age group (0, 1-4, 5-9, 10-14…80+). Incidence and mortality rates were age-standardized to World Segi’s population standard and expressed per 100,000 persons. In addition, proportions and cumulative incidence/mortality rates for esophageal cancer were calculated. Esophageal cancer mortality data during the periods 1973-1975, 1990-1992, and 2004-2005 were extracted from the national death surveys. Mortality and incidence rate data from Cixian and Shexian were obtained from population-based cancer registries in each county. Results The estimated number of newly diagnosed esophageal cancer cases and deaths in 2011 in Hebei Province was 24,318 and 18,226, respectively. The crude incidence rate of esophageal cancer was 33.37/100,000 (males, 42.18/100,000 and females, 24.31/100,000). The age-standardized rate by world standard population (ASRW) was 28.09/100,000, ranking third among all cancers. The esophageal cancer mortality rate was 25.01/100,000 (males, 31.40/100,000 and females, 18.45/100,000), ranking third in deaths among all cancers. The mortality rates of esophageal cancer displayed a significant decreasing trend in Hebei Province from 1973-1975 (ASRW =48.69/100,000) to 2004-2005 (ASRW =28.02/100,000), with a decreased rate of 42.45%. In Cixian, the incidence of esophageal cancer decreased from 250.76/100,000 to 106.74/100,000 in males and from 153.86/100,000 to 75.41/100,000 in females, with annual percentage changes (APC) of 2.13 and 2

  4. [New Combination Therapy to Improve the Functional Preservation Rate of the Larynx in Laryngeal, Oropharyngeal, and Hypopharyngeal Cancers].

    PubMed

    Furusaka, Tohru

    2015-10-01

    A new combination therapy has been developed to achieve high overall survival and functional laryngeal preservation rates in head and neck cancers, which require laryngectomy. In order to treat the primary site without resection, superselective intra-arterial infusions with DCF anterogradely and 60 mg/m2 of DOC and 60 mg/m2 of CDDP via the femoral artery on day 1 were administered, followed by continuous intravenous instillation of 750 mg/m2/day of 5-FU for 5 days from day 2. The 5- year survival rate was 70.4% in laryngeal cancer, 72.8% in oropharyngeal cancer, and 68.5% in hypopharyngeal cancer. The 5-year functional laryngeal preservation rate was 71.0% in laryngeal cancer, 63.4% in oropharyngeal cancer, and 65.2% in hypopharyngeal cancer. In addition to regional lymph node control, a thorough neck dissection was performed. Good overall survival and functional laryngeal preservation rates were achieved. PMID:26489542

  5. Association of soil arsenic and nickel exposure with cancer mortality rates, a town-scale ecological study in Suzhou, China.

    PubMed

    Chen, Kai; Liao, Qi Lin; Ma, Zong Wei; Jin, Yang; Hua, Ming; Bi, Jun; Huang, Lei

    2015-04-01

    Heavy metals and arsenic are well-known carcinogens. However, few studies have examined whether soil heavy metals and arsenic concentrations associate with cancer in the general population. In this ecological study, we aimed to evaluate the association of heavy metals and arsenic in soil with cancer mortality rates during 2005-2010 in Suzhou, China, after controlling for education and smoking prevalence. In 2005, a total of 1683 soil samples with a sampling density of one sample every 4 km(2) were analyzed. Generalized linear model with a quasi-Poisson regression was applied to evaluate the association between town-scale cancer mortality rates and soil heavy metal concentrations. Results showed that soil arsenic exposure had a significant relationship with colon, gastric, kidney, lung, and nasopharyngeal cancer mortality rates and soil nickel exposure was significantly associated with liver and lung cancer. The associations of soil arsenic and nickel exposure with colon, gastric, kidney, and liver cancer in male were higher than those in female. The observed associations of soil arsenic and nickel with cancer mortality rates were less sensitive to alternative exposure metrics. Our findings would contribute to the understanding of the carcinogenic effect of soil arsenic and nickel exposure in general population. PMID:25410308

  6. Do Cervical Cancer Screening Rates Increase in Association with an Intervention Designed to Increase Mammography Usage?

    PubMed Central

    KATZ, MIRA L.; TATUM, CATHY M.; DEGRAFFINREID, CECILIA R.; DICKINSON, STEPHANIE; PASKETT, ELECTRA D.

    2015-01-01

    Objectives To assess cervical cancer screening behaviors among underserved women participating in an intervention designed to increase mammography use. Methods This was a randomized trial of 897 women from three racial groups (white, African American, Native American) living in a rural county in North Carolina. Baseline and follow-up surveys were completed by 815 women; 775 women provided data to be included in these analyses. The intervention group received an educational program focused on mammography delivered by a lay health advisor, and the control group received a physician letter/brochure focusing on Pap tests. Results Women in both the intervention (OR 1.70; 1.31, 2.21, p < 0.001) and control groups (OR 1.38; 1.04, 1.82, p = 0.025) significantly increased cervical cancer screening rates within risk appropriate guidelines. No differences by racial group were documented. Women categorized in the high-risk group for developing cervical cancer (>2 sexual partners, age <18 years at first sexual intercourse, smoker; treated for sexually transmitted disease [STD] or partner with treated STD) significantly (OR 1.88; 1.54, 2.28, p < 0.001) increased Pap test completion. However, a nonsignificant increase (OR 1.25; 0.87, 1.79, p = 0.221) in Pap test completion was demonstrated in women categorized as low risk for cervical cancer. Conclusions This study suggests that women in an intensive behavioral intervention designed to increase mammography use may also increase Pap test completion, similar to a minimal intervention focused only on increasing Pap test completion. These results have implications for the design and evaluation of behavioral intervention studies. PMID:17324094

  7. Quality of Life of Oral Cancer Patients After Low-Dose-Rate Interstitial Brachytherapy

    SciTech Connect

    Yoshimura, Ryo-ichi Shibuya, Hitoshi; Miura, Masahiko; Watanabe, Hiroshi; Ayukawa, Fumio; Hayashi, Keiji; Toda, Kazuma

    2009-03-01

    Purpose: To assess the quality of life (QOL) of oral cancer patients treated with low-dose-rate interstitial brachytherapy (LDR-BT) alone. Methods and Materials: Between June 2005 and July 2006, a total of 56 patients with oral cancer were enrolled in this prospective study. QOL was assessed by means of the core questionnaire and head and neck questionnaire module of the European Organization for Research and Treatment of Cancer (EORTC Quality of Life Questionnaire-Core 30 [QLQ-C30] and QLQ Head and Neck 35 [H and N35]). The questionnaires were distributed to the patients before the start of treatment and 3 months, 6 months, and 12 months after the start of LDR-BT. Results: It was possible to analyze the results for 20 of the initial 56 patients because they did not experience metastasis or recurrence during this study. No functions or symptoms asked about in the QLQ-C30 deteriorated during the first year. The emotional function score steadily and significantly increased. No symptoms in the QLQ-H and N35 significantly deteriorated. The scores for pain, trouble with social eating, and weight loss on the QLQ-H and N35 steadily and significantly decreased. Age, gender, and LDR-BT source had no effect on the change in QOL during the first year, but T-stage significantly affected the change in global health status, tumor site affected the changes in swallowing, sensory problems, sticky saliva, and complications affected the changes in pain, swallowing, and mouth opening. Conclusions: QOL of oral cancer patients treated with LDR-BT is high. However, tumor stage, tumor site, and complications affected the changes in a few functions and symptoms during the first year.

  8. Rationale of the BREAst cancer e-healTH [BREATH] multicentre randomised controlled trial: An Internet-based self-management intervention to foster adjustment after curative breast cancer by decreasing distress and increasing empowerment

    PubMed Central

    2012-01-01

    Background After completion of curative breast cancer treatment, patients go through a transition from patient to survivor. During this re-entry phase, patients are faced with a broad range of re-entry topics, concerning physical and emotional recovery, returning to work and fear of recurrence. Standard and easy-accessible care to facilitate this transition is lacking. In order to facilitate adjustment for all breast cancer patients after primary treatment, the BREATH intervention is aimed at 1) decreasing psychological distress, and 2) increasing empowerment, defined as patients’ intra- and interpersonal strengths. Methods/design The non-guided Internet-based self-management intervention is based on cognitive behavioural therapy techniques and covers four phases of recovery after breast cancer (Looking back; Emotional processing; Strengthening; Looking ahead). Each phase of the fully automated intervention has a fixed structure that targets consecutively psychoeducation, problems in everyday life, social environment, and empowerment. Working ingredients include Information (25 scripts), Assignment (48 tasks), Assessment (10 tests) and Video (39 clips extracted from recorded interviews). A non-blinded, multicentre randomised controlled, parallel-group, superiority trial will be conducted to evaluate the effectiveness of the BREATH intervention. In six hospitals in the Netherlands, a consecutive sample of 170 will be recruited of women who completed primary curative treatment for breast cancer within 4 months. Participants will be randomly allocated to receive either usual care or usual care plus access to the online BREATH intervention (1:1). Changes in self-report questionnaires from baseline to 4 (post-intervention), 6 and 10 months will be measured. Discussion The BREATH intervention provides a psychological self-management approach to the disease management of breast cancer survivors. Innovative is the use of patients’ own strengths as an explicit

  9. Salvage high-dose-rate (HDR) brachytherapy for recurrent head-and-neck cancer

    SciTech Connect

    Hepel, Jaroslaw T.; Syed, A.M. Nisar . E-mail: bvigil@memnet.org; Puthawala, Ajmel; Sharma, Anil; Frankel, Paul

    2005-08-01

    Background: A significant portion of head-and-neck cancer patients will develop persistent or recurrent disease after definitive treatment. Radiation therapy is often used as definitive therapy or as an adjunct to surgery. Recurrent cancer of the head and neck in the previously irradiated field is, thus, a common occurrence and poses a therapeutic challenge. Some studies have evaluated low-dose-rate (LDR) brachytherapy as a therapeutic option, including a large case series with long-term follow-up by our own institution. High-dose-rate (HDR) brachytherapy offers therapeutic advantages over LDR brachytherapy. This study evaluates the local control and outcomes of patients with previously irradiated recurrent head-and-neck cancer treated with HDR interstitial brachytherapy. Methods and Materials: Between 1997 and 2002, 30 patients who received prior radiation therapy for primary tumors of the head and neck were treated for biopsy-proven recurrent disease. All patients received previous radiation as definitive therapy alone or as adjunct to surgery. All patients were inoperable, refused surgery, or had gross residual disease after salvage surgery for their recurrent disease. Thirty-six sites on the 30 patients were implanted by application of high-dose-rate interstitial brachytherapy techniques with mean tumor dose of 34 Gy (18-48 Gy) in twice daily fractions of 300 to 400cGy per fraction. Results: At a minimum follow-up of 12 months, local tumor control was achieved in 69% of implanted sites. Disease-specific survival at 1 and 2 years was 54% and 45%, respectively. Overall survival at 1 and 2 years was 56% and 37%, respectively. Grade 3/4 late complications occurred in 16% of the patients. No fatal complications occurred. Conclusion: HDR brachytherapy can play an important role in the salvage treatment of previously irradiated recurrent head-and-neck cancer. This study shows that comparable results are obtained by HDR brachytherapy with fewer late complications than

  10. Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

    SciTech Connect

    Shah, Chirag; Vicini, Frank A.

    2011-11-15

    As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer-related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2-65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

  11. Reirradiation of recurrent head and neck cancer using high-dose-rate brachytherapy.

    PubMed

    Rudzianskas, V; Inciura, A; Juozaityte, E; Rudzianskiene, M; Kubilius, R; Vaitkus, S; Kaseta, M; Adliene, D

    2012-10-01

    The aim of the present study was to evaluate the results of hypofractionated accelerated CT-guided interstitial HDR-BRT using 2.5 Gy per fraction. From December 2008 to March 2010, 30 patients were treated for recurrence of previously-irradiated head and neck cancer. Thirteen patients underwent surgical resection followed by HDR-BRT to the tumour bed. Seventeen patients were treated with HDR-BRT only. All patients received 2.5 Gy twice per day for a total dosage of 30 Gy. The overall survival rate (OS) for the entire group at 1 and 2-years was 63% and 47%, while local control (LC) was 73% and 67%, and disease-free survival (DFS) was 60% and 53%, respectively. Patients treated with surgical resection and HDR-BRT showed an improvement in both 2-year LC (77% vs. 47%, p = 0.013) and 2-year OS (62% vs. 35%, p = 0.035) compared to patients treated with HDR-BRT only. Median OS for pre-treatment tumour volumes ≤ 36 cm3 was 22 months and 9.2 months for those > 36 cm3 (p = 0.038). Grade III and IV late complications occurred in 3% of patients. There were no grade V complications. The interstitial HDR brachytherapy regimen using 2.5 Gy twice daily fractions at a total dose of 30 Gy offers an effective treatment option for patients with recurrent previously-irradiated head and neck cancer with a low rate of late high grade toxicity. Surgical resection had a positive effect on survival and local control in management of patients with recurrent head and neck cancer. PMID:23326008

  12. Influence of Preoperative Radiation Field on Postoperative Leak Rates in Esophageal Cancer Patients after Trimodality Therapy

    PubMed Central

    Juloori, Aditya; Tucker, Susan L.; Komaki, Ritsuko; Liao, Zhongxing; Correa, Arlene M.; Swisher, Stephen G.; Hofstetter, Wayne L.; Lin, Steven H.

    2014-01-01

    Introduction Postoperative morbidities, such as anastomotic leaks, are common after trimodality therapy (chemoradiation followed by surgery) for esophageal cancer. We investigated for factors associated with an increased incidence of anastomotic leaks. Methods Data from 285 esophageal cancer patients treated from 2000–2011 with trimodality therapy was analyzed. Anastomotic location relative to preoperative radiation field was assessed using postoperative computed tomographic imaging. Logistic regression was used to evaluate for factors associated with any or clinically relevant (CR) (≥ grade 2) leaks. Results Overall anastomotic leak rate was 11% (31/285), and CR leak rate was 6% (17/285). Multivariable analysis identified body mass index (BMI) (OR 1.09, 95%CI 1.00–1.17; OR 1.11, 95%CI 1.01–1.22), three-field surgery (OR 10.01, 95%CI 3.83–26.21; OR 4.83, 95%CI 1.39–16.71), and within radiation field (“in-field”) anastomosis (OR 5.37, 95%CI 2.21–13.04; OR 8.63, 95%CI 2.90–25.65) as independent predictors of both all grade and CR leaks, respectively. While patients with distal esophageal tumors and Ivor-Lewis surgery had the lowest incidence of all grade (6.5%) and CR leaks (4.2%), most of the leaks were associated with the anastomosis constructed within the field of radiation (in-field: 39% and 30% versus out-of-field: 2.6% and 1.0%, respectively, for total and CR leaks, p<0.0001, Fisher’s Exact test). Conclusions Esophagogastric anastomosis placed within the preoperative radiation field was a very strong predictor for anastomotic leaks in esophageal cancer patients treated with trimodality therapy, among other factors. Surgical planning should include a critical evaluation of the preoperative radiation fields to ensure proper anastomotic placement after chemoradiation therapy. PMID:24736077

  13. Factors affecting surgical site infection rate after elective gastric cancer surgery

    PubMed Central

    Özmen, Tolga; Javadov, Mirkhalig; Yeğen, Cumhur S.

    2016-01-01

    Objective Surgical site infection (SSI) is a common complication after surgery and is an indicator of quality of care. Risk factors for SSI are studied thoroughly for most types of gastrointestinal surgeries and especially colorectal surgeries, but accumulated data is still lacking for gastric surgeries. We studied the parameters affecting SSI rate after gastric cancer surgery. Material and Methods Consecutive patients, who underwent elective gastric cancer surgery between June and December 2013, were included. Descriptive parameters, laboratory values and past medical histories were recorded prospectively. All patients were followed for 1 month. Recorded parameters were compared between the SSI (+) and SSI (−) groups. Results Fifty-two patients (mean age: 58.87±9.25 [31–80]; 67% male) were included. SSI incidence was 19%. ASA score ≥3 (p<0.001), postoperative weight gain (p<0.001), smoking (p=0.014) and body mass index (BMI) ≥30 (p=0.025) were related with a higher SSI incidence. Also patients in the SSI (+) group had a higher preoperative serum C-reactive protein level (p=0.014). Conclusion We assume that decreasing BMI to <30, stopping smoking at least 3 weeks before the operation, and preventing postoperative weight gain by avoiding excessive intravenous hydration will all help decrease SSI rate after gastric surgery. PMID:27528811

  14. Indoor air exposure to coal and wood combustion emissions associated with a high lung cancer rate in Xuan Wei, China

    SciTech Connect

    Mumford, J.L.; Chapman, R.S.; Harris, D.B.; He, X.Z.; Cac, S.R.

    1989-01-01

    Residents of Xuan Wei County in China have unusually high lung cancer mortality that cannot be attributed to tobacco use or occupational exposure. They are exposed to smoke from unvented, open pit coal or wood fires (often used for cooking and heating). The variation in lung cancer rates among communes within the county suggests that indoor combustion of smoky coal may be the prime determinant of lung cancer. To characterize the air in Xuan Wei homes, samples of the air particles and semivolatile organic compounds were collected from homes located in two communes; one commune has a high rate of lung cancer, and the other has a low rate. Samples collected in the commune where the lung cancer rate is high and where smoky coal is the predominant fuel contained high concentrations of small particles with high organic content; organic extracts of these samples were mutagenic. Samples from homes in the wood-burning commune, which has a low rate of lung cancer, consisted mostly of larger particles of lower organic content and mutagenicity. The smoky coal sample was a mouse skin carcinogen and was a more potent initiator of skin tumors in comparison to the wood or smokeless coal sample.

  15. Indoor air exposure to coal and wood combustion emissions associated with a high lung cancer rate in Xuan Wei, China

    SciTech Connect

    Mumford, J.L.; Chapman, R.S.; Harris, D.B. ); He, X.Z.; Cao, S.R.; Xian, Y.L.; Li, X.M. )

    1989-01-01

    Residents of Xuan Wei County in China have unusually high lung cancer mortality that cannot be attributed to tobacco use or occupational exposure. They are exposed to smoke from unvented, open pit coal or wood fires (often used for cooking and heating). The variation in lung cancer rates among communes within the county suggests that indoor combustion of smoky coal may be the prime determinant of lung cancer. To characterize the air in Xuan Wei homes, samples of air particles and semivolatile organic compounds were collected from homes located in two communes; one commune has a high rate of lung cancer, and the other has a low rate. Samples collected in the commune where the lung cancer rate is high and where smoky coal is the predominant fuel contained high concentrations of small particles with high organic content; organic extracts of these samples were mutagenic. Samples from homes in the wood-burning commune, which has a low rate of lung cancer, consisted mostly of larger particles of lower organic content and mutagenicity. The smoky coal sample was a mouse skin carcinogen and was a more potent initiator of skin tumors in comparison to the wood or smokeless coal sample.

  16. Cost-Effectiveness of Different Cervical Screening Strategies in Islamic Republic of Iran: A Middle-Income Country with a Low Incidence Rate of Cervical Cancer

    PubMed Central

    Nahvijou, Azin; Daroudi, Rajabali; Tahmasebi, Mamak; Amouzegar Hashemi, Farnaz; Rezaei Hemami, Mohsen; Akbari Sari, Ali; Barati Marenani, Ahmad; Zendehdel, Kazem

    2016-01-01

    Objective Invasive cervical cancer (ICC) is the fourth most common cancer among women worldwide. Cervical screening programs have reduced the incidence and mortality rates of ICC. We studied the cost-effectiveness of different cervical screening strategies in the Islamic Republic of Iran, a Muslim country with a low incidence rate of ICC. Methods We constructed an 11-state Markov model, in which the parameters included regression and progression probabilities, test characteristics, costs, and utilities; these were extracted from primary data and the literature. Our strategies included Pap smear screening and human papillomavirus (HPV) DNA testing plus Pap smear triaging with different starting ages and screening intervals. Model outcomes included lifetime costs, life years gained, quality-adjusted life years (QALY), and incremental cost-effectiveness ratios (ICERs). One-way sensitivity analysis was performed to examine the stability of the results. Results We found that the prevented mortalities for the 11 strategies compared with no screening varied from 26% to 64%. The most cost-effective strategy was HPV screening, starting at age 35 years and repeated every 10 years. The ICER of this strategy was $8,875 per QALY compared with no screening. We found that screening at 5-year intervals was also cost-effective based on GDP per capita in Iran. Conclusion We recommend organized cervical screening with HPV DNA testing for women in Iran, beginning at age 35 and repeated every 10 or 5 years. The results of this study could be generalized to other countries with low incidence rates of cervical cancer. PMID:27276093

  17. No increase in brain cancer rates during period of expanding cell phone use

    Cancer.gov

    In a new examination of United States cancer incidence data, investigators at the National Cancer Institute (NCI) reported that incidence trends have remained roughly constant for glioma, the main type of brain cancer hypothesized to be related to cell ph

  18. Cancer

    MedlinePlus

    ... Leukemia Liver cancer Non-Hodgkin lymphoma Ovarian cancer Pancreatic cancer Testicular cancer Thyroid cancer Uterine cancer ... have any symptoms. In certain cancers, such as pancreatic cancer, symptoms often do not start until the disease ...

  19. Retrievable Inferior Vena Cava Filters in Patients with Cancer: Complications and Retrieval Success Rate

    PubMed Central

    Casanegra, Ana I.; Landrum, Lisa M.; Tafur, Alfonso J.

    2016-01-01

    Active cancer (ACa) is strongly associated with venous thromboembolism and bleeding. Retrievable inferior vena cava filters (RIVCF) are frequently placed in these patients when anticoagulation cannot be continued. Objectives. To describe the complications and retrieval rate of inferior vena cava filters in patients with ACa. Methods. Retrospective review of 251 consecutive patients with RIVCF in a single institution. Results. We included 251 patients with RIVCF with a mean age of 58.1 years and a median follow-up of 5.4 months (164 days, IQR: 34–385). Of these patients 32% had ACa. There were no differences in recurrence rate of DVT between patients with ACa and those without ACa (13% versus 17%, p = ns). Also, there were no differences in major filter complications (11% ACa versus 7% no ACa, p = ns). The filter retrieval was not different between groups (log-rank = 0.16). Retrieval rate at 6 months was 49% in ACa patients versus 64% in patients without ACa (p = ns). Filter retrieval was less frequent in ACa patients with metastatic disease (p < 0.01) or a nonsurgical indication for filter placement (p = 0.04). Conclusions. No differences were noted in retrieval rate, recurrent DVT, or filter complications between the two groups. ACa should not preclude the use of RIVCF. PMID:26904290

  20. DRINKING WATER AND CANCER INCIDENCE IN IOWA. 3. ASSOCIATION OF CANCER WITH INDICES OF CONTAMINATION

    EPA Science Inventory

    With data from the Iowa Cancer Registry, age-adjusted sex-specific cancer incidence rates for the years 1969-1981 were determined for towns with a population of 1,000-10,000 and a public water supply from a single stable ground source. These rates were related to levels of volati...

  1. Concordance of parent-, teacher- and self-report ratings on the Conners 3 in adolescent survivors of cancer.

    PubMed

    Willard, Victoria W; Conklin, Heather M; Huang, Lu; Zhang, Hui; Kahalley, Lisa S

    2016-09-01

    Survivors of childhood cancer are at risk for attention problems. The objectives of this study were to assess concordance between parent-, teacher-, and self-report ratings on a measure of attention (Conners Rating Scales, 3rd ed.; Conners, 2008) in adolescent survivors of childhood cancer and to examine associations with a performance-based task. The was completed by 80 survivors of pediatric cancer (39 brain tumor, 41 acute lymphoblastic leukemia; ages 12-17; at least 1 year posttreatment; 51.3% male) as well as their parents and 1 teacher. In addition, survivors completed a continuous performance test. Parents and teachers demonstrated moderate agreement on most subscales; however, agreement was weaker than would be expected based on the normative sample. Agreement between self- and proxy ratings was more variable. The strongest associations for all raters were observed on the Learning Problems subscale. There were significant mean differences between parent and teacher ratings, with parents reporting more problems across subscales. Only self-ratings of Inattention were significantly associated with the continuous performance test (omission errors). Agreement across raters in assessment of attentional functioning in adolescent survivors of childhood cancer is modest. Findings support the need to obtain multiple ratings of behavior, including both proxy- and self-report, when assessing youth with cancer, particularly adolescents. (PsycINFO Database Record PMID:27537005

  2. Role of solar UVB irradiance and smoking in cancer as inferred from cancer incidence rates by occupation in Nordic countries

    PubMed Central

    2012-01-01

    A large body of evidence indicates that solar ultraviolet-B (UVB) irradiance and vitamin D reduce the risk of incidence and death for many types of cancer. However, most of that evidence comes from midlatitude regions, where solar UVB doses are generally high in summer. Data on cancer standardized incidence ratios (SIRs) by sex and 54 occupation categories based on 1.4 million male and 1.36 million female cancer cases for 1961–2005 in the five Nordic countries provide the basis for an ecological study of the role of solar UVB in the risk of many types of cancer at high latitudes. Lip cancer SIRs less lung cancer SIRs for men was the best index of solar UVB dose, which was weakly inversely correlated with both melanoma and nonmelanoma skin cancer (NMSC) SIRs. Lung cancer SIRs were used as the index of the effects of smoking. For men, the UVB index was significantly inversely correlated with 14 types of internal cancer—bladder, breast, colon, gallbladder, kidney, laryngeal, liver, lung, oral, pancreatic, pharyngeal, prostate, rectal and small intestine cancer. For women, the same UVB index was inversely correlated with bladder, breast and colon cancer. These results generally agree with findings from other studies. These results provide more support for the UVB-vitamin D-cancer hypothesis and suggest that widespread fear of chronic solar ultraviolet (UV) irradiance may be misplaced. PMID:22928078

  3. Chemical characterization of indoor air of homes from communes in Xuan Wei, China, with high lung cancer mortality rates

    EPA Science Inventory

    In a rural county, Xuan Wei, China, the lung cancer mortality rate is among China's highest, especially in women. This mortality rate is more associated with indoor air burning of smoky coal, as opposed to smokeless coal or wood, for cooking and heating under unvented conditions....

  4. Inverse Planned High-Dose-Rate Brachytherapy for Locoregionally Advanced Cervical Cancer: 4-Year Outcomes

    SciTech Connect

    Tinkle, Christopher L.; Weinberg, Vivian; Chen, Lee-May; Littell, Ramey; Cunha, J. Adam M.; Sethi, Rajni A.; Chan, John K.; Hsu, I-Chow

    2015-08-01

    Purpose: Evaluate the efficacy and toxicity of image guided brachytherapy using inverse planning simulated annealing (IPSA) high-dose-rate brachytherapy (HDRB) boost for locoregionally advanced cervical cancer. Methods and Materials: From December 2003 through September 2009, 111 patients with primary cervical cancer were treated definitively with IPSA-planned HDRB boost (28 Gy in 4 fractions) after external radiation at our institution. We performed a retrospective review of our experience using image guided brachytherapy. Of the patients, 70% had a tumor size >4 cm, 38% had regional nodal disease, and 15% had clinically evident distant metastasis, including nonregional nodal disease, at the time of diagnosis. Surgical staging involving pelvic lymph node dissection was performed in 15% of patients, and 93% received concurrent cisplatin-based chemotherapy. Toxicities are reported according to the Common Terminology Criteria for Adverse Events version 4.0 guidelines. Results: With a median follow-up time of 42 months (range, 3-84 months), no acute or late toxicities of grade 4 or higher were observed, and grade 3 toxicities (both acute and late) developed in 8 patients (1 constitutional, 1 hematologic, 2 genitourinary, 4 gastrointestinal). The 4-year Kaplan-Meier estimate of late grade 3 toxicity was 8%. Local recurrence developed in 5 patients (4 to 9 months after HDRB), regional recurrence in 3 (6, 16, and 72 months after HDRB), and locoregional recurrence in 1 (4 months after HDR boost). The 4-year estimates of local, locoregional, and distant control of disease were 94.0%, 91.9%, and 69.1%, respectively. The overall and disease-free survival rates at 4 years were 64.3% (95% confidence interval [CI] of 54%-73%) and 61.0% (95% CI, 51%-70%), respectively. Conclusions: Definitive radiation by use of inverse planned HDRB boost for locoregionally advanced cervical cancer is well tolerated and achieves excellent local control of disease. However, overall

  5. Concomitant cervical and transperineal parametrial high-dose-rate brachytherapy boost for locally advanced cervical cancer

    PubMed Central

    Bailleux, Caroline; Falk, Alexander Tuan; Chand-Fouche, Marie-Eve; Gautier, Mathieu; Barranger, Emmanuel

    2016-01-01

    Purpose There is no consensus for parametrial boost technic while both transvaginal and transperineal approaches are discussed. A prototype was developed consisting of a perineal template, allowing transperineal needle insertion. This study analyzed acute toxicity of concomitant cervical and transperineal parametrial high-dose-rate brachytherapy (HDRB) boost for locally advanced cervical cancer. Material and methods From 01.2011 to 12.2014, 33 patients (pts) presenting a locally advanced cervical cancer with parametrial invasion were treated. After the first course of external beam radiation therapy with cisplatinum, HDRB was performed combining endocavitary and interstitial technique for cervical and parametrial disease. Post-operative delineation (CTV, bladder, rectum, sigmoid) and planification were based on CT-scan/MRI. HDRB was delivered in 3-5 fractions over 2-3 consecutive days. Acute toxicities occurring within 6 months after HDRB were retrospectively reviewed. Results Median age was 56.4 years (27-79). Clinical stages were: T2b = 23 pts (69.7%), T3a = 1 pt (3%), T3b = 6 pts (18.2%), and T4a = 3 pts (9.1%). Median HDRB prescribed dose was 21 Gy (21-27). Median CTVCT (16 pts) and HR-CTVMRI (17 pts) were 52.6 cc (28.5-74.3), 31.9 cc (17.1-58), respectively. Median EQD2αβ10 for D90CTV and D90HR-CTV were 82.9 Gy (78.2-96.5), 84.8 Gy (80.6-91.4), respectively. Median EQD2αβ3 (CT/MRI) for D2cc bladder, rectum and sigmoid were 75.5 Gy (66.6-90.9), 64.4 Gy (51.9-77.4), and 60.4 Gy (50.9-81.1), respectively. Median follow-up was 14 months (ranged 6-51). Among the 24 pts with MFU = 24 months, 2-year LRFS rate, RRFS, and OS were 86.8%, 88.8%, and 94.1%, respectively. The rates of acute genitourinary and gastrointestinal toxicities were 36% (G1 dysuria = 8 pts, G2 infection = 2 pts, G3 infection = 2 pts), and 27% (G1 diarrhea = 9 pts), respectively. One patient presented vaginal bleeding at the time of applicator withdrawal (G3-blood transfusion); no bleeding was

  6. Understanding why aspirin prevents cancer and why consuming very hot beverages and foods increases esophageal cancer risk. Controlling the division rates of stem cells is an important strategy to prevent cancer

    PubMed Central

    López-Lázaro, Miguel

    2015-01-01

    Cancer is, in essence, a stem cell disease. The main biological cause of cancer is that stem cells acquire DNA alterations during cell division. The more stem cell divisions a tissue accumulates over a lifetime, the higher is the risk of cancer in that tissue. This explains why cancer is diagnosed millions of times more often in some tissues than in others, and why cancer incidence increases so dramatically with age. It may also explain why taking a daily low-dose aspirin for several years reduces the risk of developing and dying from cancer. Since aspirin use reduces PGE2 levels and PGE2 fuels stem cell proliferation, aspirin may prevent cancer by restricting the division rates of stem cells. The stem cell division model of cancer may also explain why regular consumption of very hot foods and beverages increases the risk of developing esophageal cancer. Given that tissue injury activates stem cell division for repair, the thermal injury associated with this dietary habit will increase esophageal cancer risk by inducing the accumulation of stem cell divisions in the esophagus. Using these two examples, here I propose that controlling the division rates of stem cells is an essential approach to preventing cancer. PMID:26682276

  7. Understanding why aspirin prevents cancer and why consuming very hot beverages and foods increases esophageal cancer risk. Controlling the division rates of stem cells is an important strategy to prevent cancer.

    PubMed

    López-Lázaro, Miguel

    2015-01-01

    Cancer is, in essence, a stem cell disease. The main biological cause of cancer is that stem cells acquire DNA alterations during cell division. The more stem cell divisions a tissue accumulates over a lifetime, the higher is the risk of cancer in that tissue. This explains why cancer is diagnosed millions of times more often in some tissues than in others, and why cancer incidence increases so dramatically with age. It may also explain why taking a daily low-dose aspirin for several years reduces the risk of developing and dying from cancer. Since aspirin use reduces PGE2 levels and PGE2 fuels stem cell proliferation, aspirin may prevent cancer by restricting the division rates of stem cells. The stem cell division model of cancer may also explain why regular consumption of very hot foods and beverages increases the risk of developing esophageal cancer. Given that tissue injury activates stem cell division for repair, the thermal injury associated with this dietary habit will increase esophageal cancer risk by inducing the accumulation of stem cell divisions in the esophagus. Using these two examples, here I propose that controlling the division rates of stem cells is an essential approach to preventing cancer. PMID:26682276

  8. Recent trends in hormone therapy utilization and breast cancer incidence rates in the high incidence population of Marin County, California

    PubMed Central

    2010-01-01

    Background Recent declines in invasive breast cancer have been reported in the US, with many studies linking these declines to reductions in the use of combination estrogen/progestin hormone therapy (EPHT). We evaluated the changing use of postmenopausal hormone therapy, mammography screening rates, and the decline in breast cancer incidence specifically for Marin County, California, a population with historically elevated breast cancer incidence rates. Methods The Marin Women's Study (MWS) is a community-based, prospective cohort study launched in 2006 to monitor changes in breast cancer, breast density, and personal and biologic risk factors among women living in Marin County. The MWS enrolled 1,833 women following routine screening mammography between October 2006 and July 2007. Participants completed a self-administered questionnaire that included items regarding historical hormone therapy regimen (estrogen only, progesterone only, EPHT), age of first and last use, total years of use, and reason(s) for stopping, as well as information regarding complementary hormone use. Questionnaire items were analyzed for 1,083 non-Hispanic white participants ages 50 and over. Breast cancer incidence rates were assessed overall and by tumor histology and estrogen receptor (ER) status for the years 1990-2007 using data from the Northern California Surveillance, Epidemiology and End Results (SEER) cancer registry. Results Prevalence of EPHT use among non-Hispanic white women ages 50 and over declined sharply from 21.2% in 1998 to 6.7% by 2006-07. Estrogen only use declined from 26.9% in 1998 to 22.4% by 2006-07. Invasive breast cancer incidence rates declined 33.4% between 2001 and 2004, with drops most pronounced for ER+ cancers. These rate reductions corresponded to declines of about 50 cases per year, consistent with population attributable fraction estimates for EPHT-related breast cancer. Self-reported screening mammography rates did not change during this period. Use of

  9. Temporal Trends in Incidence and Mortality Rates for Colorectal Cancer by Tumor Location: 1975–2007

    PubMed Central

    Scoggins, John; Rossing, Mary Anne; Li, Christopher I.; Newcomb, Polly A.

    2012-01-01

    Objectives. We evaluated changes in colorectal cancer (CRC) incidence and mortality by anatomic site to assess the possible impact of CRC screening. Methods. Using data from 9 Surveillance, Epidemiology, and End Results cancer registries, we estimated trends in 1975–2007 CRC incidence and 1985–2007 incidence-based mortality. We evaluated trends separately for proximal and distal CRC, overall and by stage, tumor site, and race. Results. Between 1975 and 2007, 323 237 adults in the study area were diagnosed with CRC. For most tumor and population subgroups, incidence rates increased between 1975 and 1985 and subsequently declined markedly. Declines were most rapid between 1999 and 2007 and were greater for distal than proximal CRC. Declines in incidence were greater for White than Black adults and greatest for regional-stage disease. There was little difference in trends across subsites within the proximal and distal colorectum. Declines in incidence-based mortality mirrored those for incidence. Conclusions. Recent declines in CRC incidence and mortality are greater for distal than proximal CRC. Differing trends across populations may reflect variations in screening prevalence; distinct trends by tumor characteristics likely reflect differences in screening efficacy. PMID:22873481

  10. High-Dose-Rate Intraoperative Radiation Therapy for Recurrent Head-and-Neck Cancer

    SciTech Connect

    Perry, David J.; Chan, Kelvin; Wolden, Suzanne; Zelefsky, Michael J.; Chiu, Johnny; Cohen, Gilad; Zaider, Marco; Kraus, Dennis; Shah, Jatin; Lee, Nancy

    2010-03-15

    Purpose: To report the use of high-dose-rate intraoperative radiation therapy (HDR-IORT) for recurrent head-and-neck cancer (HNC) at a single institution. Methods and Materials: Between July 1998 and February 2007, 34 patients with recurrent HNC received 38 HDR-IORT treatments using a Harrison-Anderson-Mick applicator with Iridium-192. A single fraction (median, 15 Gy; range, 10-20 Gy) was delivered intraoperatively after surgical resection to the region considered at risk for close or positive margins. In all patients, the target region was previously treated with external beam radiation therapy (median dose, 63 Gy; range, 24-74 Gy). The 1- and 2-year estimates for in-field local progression-free survival (LPFS), locoregional progression-free survival (LRPFS), distant metastases-free survival (DMFS), and overall survival (OS) were calculated. Results: With a median follow-up for surviving patients of 23 months (range, 6-54 months), 8 patients (24%) are alive and without evidence of disease. The 1- and 2-year LPFS rates are 66% and 56%, respectively, with 13 (34%) in-field recurrences. The 1- and 2-year DMFS rates are 81% and 62%, respectively, with 10 patients (29%) developing distant failure. The 1- and 2-year OS rates are 73% and 55%, respectively, with a median time to OS of 24 months. Severe complications included cellulitis (5 patients), fistula or wound complications (3 patients), osteoradionecrosis (1 patient), and radiation-induced trigeminal neuralgia (1 patient). Conclusions: HDR-IORT has shown encouraging local control outcomes in patients with recurrent HNC with acceptable rates of treatment-related morbidity. Longer follow-up with a larger cohort of patients is needed to fully assess the benefit of this procedure.

  11. Changes in heart-rate variability of survivors of nasopharyngeal cancer during Tai Chi Qigong practice.

    PubMed

    Fong, Shirley S M; Wong, Janet Y H; Chung, Louisa M Y; Yam, Timothy T T; Chung, Joanne W Y; Lee, Y M; Chow, Lina P Y; Luk, W S; Ng, Shamay S M

    2015-05-01

    [Purpose] To explore the changes in heart-rate variability (HRV) of survivors of nasopharyngeal cancer (NPC) before, during, and after a Tai Chi (TC) Qigong exercise. [Subjects and Methods] Eleven survivors of NPC participated voluntarily in the study. The heart rate of each participant was measured continuously for 1 minute before the TC Qigong intervention, during the 5-minute TC Qigong intervention, and for 1 minute after the intervention, using a Polar heart-rate monitor. Spectral HRV was expressed in terms of normalised low frequency (LF) power, normalised high frequency (HF) power, and the low frequency/high frequency (LF/HF) power ratio. [Results] Both the LF-power and the HF-power components had significant time effects. However, the time effect of the LF/HF power ratio was not significant. Post hoc contrast analysis revealed a significant decrease in LF power and a concomitant increase in HF power during the 4th minute and 5th minute of the TC Qigong exercise. [Conclusion] Five minutes of TC Qigong exercise was found to improve HRV by increasing HF power and decreasing LF power, but these effects were transient. TC Qigong might be an appropriate exercise for improving the ANS function and psychological and cardiac health of survivors of NPC. PMID:26157266

  12. Rectal cancer. Treatment advances that reduce recurrence rates and lengthen survival.

    PubMed

    Sexe, R; Miedema, B W

    1993-07-01

    The risk of malignant disease arising in rectal mucosa is high. Surgery is the most effective form of treatment but results in cure in only 50% of patients. Adjuvant preoperative radiation therapy reduces the likelihood of local recurrence but does not improve survival rates. Fluorouracil is the most effective agent for adjuvant chemotherapy and slightly improves survival when given after surgery. Combining radiation therapy with chemotherapy appears to have a synergistic effect, and recent studies show that providing this combination after surgery improves survival. Future trends in the treatment of rectal cancer are expected to include expanded use of local excision to preserve anal sphincter function, preoperative use of a combination of radiation therapy and chemotherapy, perioperative use of chemotherapy combined with immunostimulating therapy, and use of tumor antibodies for diagnostic and therapeutic purposes. PMID:8321771

  13. Oestrogen-receptor status and endocrine therapy of breast cancer: response rates and status stability.

    PubMed Central

    Leake, R. E.; Laing, L.; Calman, K. C.; Macbeth, F. R.; Crawford, D.; Smith, D. C.

    1981-01-01

    The concentration of cellular oestrogen receptor (RE) was measured in both the soluble and nuclear-pellet fractions of biopsies from 1,000 breast cancers. Data suggest that functional steroid RE is always in equilibrium between the soluble and nuclear fractions. However, biopsies from only one-third of patients contained detectable amounts of high-affinity RE in both fractions. Thirty patients out of 42 (71%) whose biopsies contained RE in both fractions, showed objective remission after receiving some form of hormonal manipulation as sole treatment. Response rates in the other categories ranged from 9% for those whose biopsies contained no detectable RE to 24% for those who displayed soluble RE alone. The presence of RE in both fractions of primary disease, whereas RE-negativity was maintained during progression from primary to secondary disease. Other aspects of RE status in relation to stage of disease are analysed. PMID:7459239

  14. Time trends (1998-2007) in brain cancer incidence rates in relation to mobile phone use in England.

    PubMed

    de Vocht, Frank; Burstyn, Igor; Cherrie, John W

    2011-07-01

    Mobile phone use in the United Kingdom and other countries has risen steeply since the early 1990's when the first digital mobile phones were introduced. There is an ongoing controversy about whether radio frequency (RF) exposure from mobile phones increases the risk of brain cancer. However, given the widespread use and nearly two decades elapsing since mobile phones were introduced, an association should have produced a noticeable increase in the incidence of brain cancer by now. Trends in rates of newly diagnosed brain cancer cases in England between 1998 and 2007 were examined. There were no time trends in overall incidence of brain cancers for either gender, or any specific age group. Systematic increases in rates for cancers of the temporal lobe in men (0.04 new cases/year) and women (0.02/year) were observed, along with decreases in the rates of cancers of the parietal lobe (-0.03/year), cerebrum (-0.02/year) and cerebellum (-0.01/year) in men only. The increased use of mobile phones between 1985 and 2003 has not led to a noticeable change in the incidence of brain cancer in England between 1998 and 2007. The observed increase in the rate of cancers in the temporal lobe, if caused by mobile phone use, would constitute <1 additional case per 100,000 people in that period. These data do not indicate a pressing need to implement a precautionary principle by means of population-wide interventions to reduce RF exposure from mobile phones. PMID:21280060

  15. Incidence rate of ovarian cancer cases in Saudi Arabia: an observational descriptive epidemiological analysis of data from Saudi Cancer Registry 2001–2008

    PubMed Central

    Alghamdi, Ibrahim G; Hussain, Issam I; Alghamdi, Mohamed S; Alghamdi, Mansour M; Dohal, Ahlam A; El-Sheemy, Mohammed A

    2014-01-01

    Purpose This study provides descriptive epidemiological data, such as the percentage of cases diagnosed, crude incidence rate (CIR), and age-standardized incidence rate (ASIR) of ovarian cancer in Saudi Arabia from 2001–2008. Patients and methods A retrospective descriptive epidemiological analysis of all ovarian cancer cases recorded in the Saudi Cancer Registry (SCR) from January 2001–December 2008 was performed. The data were analyzed using descriptive statistics, analysis of variance tests, Poisson regression, and simple linear modeling. Results A total of 991 ovarian cancer cases were recorded in the SCR from January 2001–December 2008. The region of Riyadh had the highest overall ASIR at 3.3 cases per 100,000 women, followed by the Jouf and Asir regions at 3.13 and 2.96 cases per 100,000 women. However, Hail and Jazan had the lowest rates at 1.4 and 0.6 cases per 100,000 women, respectively. Compared to Jazan, the incidence rate ratio for the number of ovarian cancer cases was significantly higher (P<0.001) in the Makkah region at 6.4 (95% confidence interval [CI]: 4.13–9.83), followed by Riyadh at 6.3 (95% CI: 4.10–9.82), and the eastern region of Saudi Arabia at 4.52 (95% CI: 2.93–6.98). The predicted annual CIR and ASIR for ovarian cancer in Saudi Arabia could be defined by the equations 0.9 + (0.07× years) and 1.71 + (0.09× years), respectively. Conclusion We observed a slight increase in the CIRs and ASIRs for ovarian cancer in Saudi Arabia from 2001–2008. Riyadh, Jouf, and Asir had the highest overall ASIR, while Jazan and Hail had the lowest rates. Makkah, Riyadh, and the eastern region of Saudi Arabia had the highest incidence rate ratio for the number of ovarian cancer cases. Further analytical studies are required to determine the potential risk factors of ovarian cancer among Saudi women. PMID:25028565

  16. Implementation of High-Dose-Rate Brachytherapy and Androgen Deprivation in Patients With Prostate Cancer

    SciTech Connect

    Lilleby, Wolfgang; Tafjord, Gunnar; Raabe, Nils K.

    2012-07-01

    Purpose: To evaluate outcome (overall survival [OS], the actuarial 5-year cancer-specific survival [CSS], disease-free survival [DFS], biochemical failure-free survival [BFS]), complications and morbidity in patients treated with high-dose-rate brachytherapy (HDR-BT) boost and hormonal treatment with curative aims. Methods: Between 2004 and 2009, 275 prospectively followed pN0/N0M0 patients were included: 19 patients (7%) with T2, Gleason score 7 and prostate-specific antigen (PSA) <10 and 256 patients (93%) with T3 or Gleason score 8-10 or PSA >20 received multimodal treatment with conformal four-field radiotherapy (prostate/vesiculae 2 Gy Multiplication-Sign 25) combined with HDR-BT (iridium 192; prostate 10 Gy Multiplication-Sign 2) with long-term androgen deprivation therapy (ADT). Results: After a median observation time of 44.2 months (range, 10.4-90.5 months) 12 patients had relapsed clinically and/or biochemically and 10 patients were dead, of which 2 patients died from prostate cancer. Five-year estimates of BFS, CSS, DFS, and OS rates were 98.5%, 99.3%, 95.6%, and 96.3%, respectively. None of the patients with either Gleason score <8 or with intermediate risk profile had relapsed. The number of HDR-BT treatments was not related to outcome. Despite of age (median, 65.7 years; range, 45.7-77 years) and considerable pretreatment comorbidity in 39 of 275 patients, Genitourinary treatment-related morbidity was moderate with long-lasting Radiation Therapy Oncology Group Grade 2 voiding problems in 26 patients (9.5%) and occasionally mucous discharge in 20 patients (7%), none with Grade >2 for gastrointestinal at follow-up. Complications during implantations were related to pubic arch interference (4 patients) and lithotomy time, causing 2 patients to develop compartment syndrome. Conclusion: Despite still preliminary observations, our 5-year outcome estimates favor the implementation of high-dose-rate brachytherapy in high-risk patients combined with conformal

  17. 42 CFR 419.43 - Adjustments to national program payment and beneficiary copayment amounts.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...) Payment adjustment for certain cancer hospitals.—(1) General rule. CMS provides for a payment adjustment... (PCR) before the cancer hospital payment adjustment (as determined by the Secretary at cost report...-cost ratio (PCR) before the cancer hospital payment adjustment (as determined by the Secretary at...

  18. 42 CFR 419.43 - Adjustments to national program payment and beneficiary copayment amounts.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...) Payment adjustment for certain cancer hospitals—(1) General rule. CMS provides for a payment adjustment... (PCR) before the cancer hospital payment adjustment (as determined by the Secretary at cost report...-cost ratio (PCR) before the cancer hospital payment adjustment (as determined by the Secretary at...

  19. 42 CFR 419.43 - Adjustments to national program payment and beneficiary copayment amounts.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...) Payment adjustment for certain cancer hospitals.—(1) General rule. CMS provides for a payment adjustment... (PCR) before the cancer hospital payment adjustment (as determined by the Secretary at cost report...-cost ratio (PCR) before the cancer hospital payment adjustment (as determined by the Secretary at...

  20. PET-Adjusted Intensity Modulated Radiation Therapy and Combination Chemotherapy in Treating Patients With Stage II-IV Non-small Cell Lung Cancer

    ClinicalTrials.gov

    2016-01-10

    Metastatic Malignant Neoplasm in the Brain; Recurrent Non-Small Cell Lung Carcinoma; Stage IIA Non-Small Cell Lung Carcinoma; Stage IIB Non-Small Cell Lung Carcinoma; Stage IIIA Non-Small Cell Lung Cancer; Stage IIIB Non-Small Cell Lung Cancer; Stage IV Non-Small Cell Lung Cancer

  1. Rates of Cancers and Opportunistic Infections in Patients With Psoriatic Arthritis Compared With Patients Without Psoriatic Arthritis

    PubMed Central

    Hagberg, Katrina Wilcox; Li, Lin; Peng, Michael; Paris, Maria; Shah, Kamal; Jick, Susan S.

    2016-01-01

    Objectives This study aimed to estimate rates of cancer or opportunistic infection in patients with psoriatic arthritis (PsA) compared with patients without PsA. Methods Using the Clinical Practice Research Datalink, we conducted a cohort study of patients with a PsA diagnosis and patients without such diagnosis, matched on age, sex, general practice, and calendar time, to assess the incidence of cancers (solid, hematologic, and nonmelanoma skin cancer) and opportunistic infections. We estimated incidence rates (IRs) and IR ratios (IRRs) with 95% confidence intervals (CIs) for each outcome and stratified results in the PsA cohort by receipt of systemic PsA drugs. Results The rate of hematologic cancer was slightly higher in the PsA cohort compared with the non-PsA cohort (IRR, 1.52; 95% CI, 1.10–2.10), whereas the rates of solid cancer and of nonmelanoma skin cancer were similar between the PsA and non-PsA cohorts (IRR, 1.01; 95% CI, 0.90–1.13; and IRR, 0.97; 95% CI, 0.82–1.14, respectively). Incidence rates were higher for PsA patients who received prescriptions for PsA drugs compared with those who did not. The IRs for infection were higher in the PsA compared with the non-PsA cohort (IRR, 1.39; 95% CI, 1.31–1.47) and were significantly higher in patients who received prescriptions (IRR, 1.71; 95% CI, 1.52–1.91). Conclusions The rates of solid and nonmelanoma skin cancers were similar in patients with PsA compared with patients without PsA, but the rates of hematologic cancer and opportunistic infections were higher in patients with PsA. In patients with PsA, rates of all outcomes were higher among those who received prescriptions for systemic PsA therapy. PMID:26886439

  2. Impaired left ventricular filling rate induced by treatment with recombinant interleukin 2 for advanced cancer.

    PubMed Central

    Fragasso, G.; Tresoldi, M.; Benti, R.; Vidal, M.; Marcatti, M.; Borri, A.; Besana, C.; Gerundini, P. P.; Rugarli, C.; Chierchia, S.

    1994-01-01

    BACKGROUND--Immunotherapy with recombinant interleukin 2 (rIL 2) has been extensively used to treat cancer but its use has been hampered by serious side effects including severe hypotension, arrhythmias, and myocardial infarction. OBJECTIVE--To assess the effects of rIL 2 on human left ventricular function. METHODS--Left ventricular (LV) function was monitored in 22 patients (9 women, 13 men) (mean (SD) age 53 (10) years) undergoing a 120 h continuous intravenous infusion of rIL 2 (18 x 10(6) IU/m2/day) for melanoma (4), renal cell (16), ovarian (1), and colon cancer (1). Radionuclide ventriculography was performed before and 1 h after the end of treatment. Ejection fraction (EF), peak emptying rate (PER), peak filling rate (PFR), and regional left ventricular wall motion were analysed. Heart rate (HR), central venous pressure (CVP), systolic (SBP) and diastolic blood pressures (DBP), the electrocardiogram, and myocardial enzyme concentrations were monitored throughout the study. RESULTS--All variables (mean (SD)) were normal before rIL 2 was given. After rIL 2 administration HR increased significantly from 84 (11) to 125 (18) beats/min (p < 0.0001), SBP fell from 128 (11) to 100 (9) mmHg (p < 0.001) and DBP from 76 (9) to 65 (7) mmHg (p < 0.0001). CVP decreased from 3.70 (3.2) to 1.30 (0.45) cm H2O (p < 0.001). EF (65 (7) to 64 (8%) and PER (3.56 (0.60) to 3.86 (0.83) EDV/s) did not change significantly. PFR decreased significantly at the end of the rIL 2 infusion from 2.68 (0.46) to 2.37 (0.43) EDV/s (p < 0.01). Left ventricular segmental hypokinesia developed in 6 patients. Myocardial enzyme concentrations remained normal throughout the study. CONCLUSIONS--The results of this study confirmed that rIL 2 produces important haemodynamic changes, predominantly related to decreased systemic resistance. However, the observed reduction in PFR in most patients suggested that rIL 2 might exert its action at the level of the heart muscle itself. The localised systolic

  3. A crossover adjustment for improving sea surface height mapping from in-situ high rate ship-borne GNSS data using PPP technique

    NASA Astrophysics Data System (ADS)

    Guo, Jinyun; Dong, Zhenghua; Tan, Zhengguang; Liu, Xin; Chen, Chuanfa; Hwang, Cheinway

    2016-08-01

    Ship-borne global navigation satellite system (GNSS) technique can overcome the weakness of satellite altimetry and tide gauge in measuring sea surface heights (SSHs) over coastal seas. Ship-borne GNSS technique can be used to calibrate SSHs determined by the satellite altimetry and tide gauge. The ship-borne GNSS data are processed with the single-epoch precise point positioning (PPP) method to estimate SSHs which are filtered by the Gaussian filter to weaken and/or remove effects of sea wind and wave field. Tidal corrections are also taken into consideration to improve SSHs. One crossover adjustment method is put forward to calculate the bias and drift along the ship route and assess the accuracy of SSHs. We processed the in-situ ship-borne GPS data over the offshore sea around Keelung to compute precisely SSHs with the single-epoch PPP. Statistical results of SSH differences of crossover points indicate that the root mean squares error of SSHs determined by the ship-borne GPS is up to level of 12.9 cm over the offshore sea ~30 km far away to land.

  4. Women with BRCA1 and BRCA2 mutations survive ovarian cancer at higher rates

    Cancer.gov

    Results from a National Cancer Institute (NCI) sponsored multicenter study published in the Journal of the American Medical Association on January 25, 2012, provides strong evidence that BRCA1 and BRCA2 gene mutation carriers with ovarian cancer were more

  5. Racial and ethnic disparities in U.S. cancer screening rates

    Cancer.gov

    The percentage of U.S. citizens screened for cancer remains below national targets, with significant disparities among racial and ethnic populations, according to the first federal study to identify cancer screening disparities among Asian and Hispanic gr

  6. Gene May Explain Higher Rates of Some Cancers in Black People

    MedlinePlus

    ... News on: African American Health Cancer Genes and Gene Therapy Recent Health News Related MedlinePlus Health Topics African American Health Cancer Genes and Gene Therapy About MedlinePlus Site Map FAQs Contact Us Get ...

  7. Single fraction multimodal image guided focal salvage high-dose-rate brachytherapy for recurrent prostate cancer

    PubMed Central

    Rischke, Hans-Christian; Meyer, Philipp Tobias; Knobe, Sven; Volgeova-Neher, Natalja; Kollefrath, Michael; Jilg, Cordula Annette; Grosu, Anca Ligia; Baltas, Dimos; Kroenig, Malte

    2016-01-01

    Purpose We present a novel method for treatment of locally recurrent prostate cancer (PCa) following radiation therapy: focal, multimodal image guided high-dose-rate (HDR) brachytherapy. Material and methods We treated two patients with recurrent PCa after primary (#1) or adjuvant (#2) external beam radiation therapy. Multiparametric magnetic resonance imaging (mpMRI), choline, positron emission tomography combined with computed tomography (PET/CT), or prostate-specific membrane antigen (PSMA)-PET combined with CT identified a single intraprostatic lesion. Positron emission tomography or magnetic resonance imaging – transrectal ultrasound (MRI-TRUS) fusion guided transperineal biopsy confirmed PCa within each target lesion. We defined a PET and mpMRI based gross tumor volume (GTV). A 5 mm isotropic margin was applied additionally to each lesion to generate a planning target volume (PTV), which accounts for technical fusion inaccuracies. A D90 of 18 Gy was intended in one fraction to each PTV using ultrasound guided HDR brachytherapy. Results Six month follow-up showed adequate prostate specific antygen (PSA) decline in both patients (ΔPSA 83% in patient 1 and ΔPSA 59.3% in patient 2). Follow-up 3-tesla MRI revealed regressive disease in both patients and PSMA-PET/CT showed no evidence of active disease in patient #1. No acute or late toxicities occurred. Conclusions Single fraction, focal, multimodal image guided salvage HDR brachytherapy for recurrent prostate cancer is a feasible therapy for selected patients with single lesions. This approach has to be evaluated in larger clinical trials. PMID:27504134

  8. 5 CFR 9701.336 - Treatment of employees whose pay does not fall below the minimum adjusted rate of their band.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM (DEPARTMENT OF HOMELAND SECURITY-OFFICE OF PERSONNEL MANAGEMENT) DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Locality and Special Rate Supplements § 9701.336 Treatment of employees whose pay does not...

  9. 5 CFR 9701.336 - Treatment of employees whose pay does not fall below the minimum adjusted rate of their band.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM (DEPARTMENT OF HOMELAND SECURITY-OFFICE OF PERSONNEL MANAGEMENT) DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Locality and Special Rate Supplements § 9701.336 Treatment of employees whose pay does not...

  10. 5 CFR 9701.336 - Treatment of employees whose pay does not fall below the minimum adjusted rate of their band.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM (DEPARTMENT OF HOMELAND SECURITY-OFFICE OF PERSONNEL MANAGEMENT) DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Locality and Special Rate Supplements § 9701.336 Treatment of employees whose pay does not...

  11. CORRELATIONS BETWEEN AGE-ADJUSTED MORTALITY RATES FOR WHITE MALES AND FEMALES IN THE UNITED STATES BY COUNTY, 1968-1972

    EPA Science Inventory

    Intercorrelations among county mortality rates for about 50 causes of death were investigated for white males (WM) and white females (WF) for the 5-year period between 1968 and 1972. All possible pairwise correlations (1128 for WM and 1275 for WF) were calculated; those correlati...

  12. [Hemodynamic benefits of AV interval adjustment and heart rate increase during exercise in dual-chamber pacing as determined by Doppler].

    PubMed

    Sancho-Tello, M J; Salvador, A; Olagüe, J

    1990-01-01

    In order to determine the relative significance of ventricular rate increase and AV delay on exercise cardiac output, we have studied 10 patients (8 male and 2 female, 16-59 years) with complete chronic heart block treated with AV sequential pacing. Cardiac output variations (delta CO) were estimated by pulsed Doppler comparisons of the aortic flow velocity in the supine position, at rest and during bicycle exercise. The following pacing programs were tested: DDD with AV intervals of 50, 100 and 150 ms (DDD50 o DDDD100, DDD150), VVI at 70 ppm (VVI70), and VVI at the maximal available rate in this pacing mode-113 or 130 ppm depending on the PM type (VVIM). Exercise measurements in DDD mode were taken when that rate was reached. The delta CO was calculated as a percent change of the product flow velocity integral x heart rate, from that obtained with VVI70 mode at rest. At rest, the delta CO obtained with DDD pacing was 20.4 +/- 14.7% and the optimal AV delay was 50 ms in 1 patient, 100 ms in 3 patients and 150 ms in six. During exercise, the delta CO was higher in DDD and VVIM modes (82.0 +/- 30.8% and 56.2 +/- 37.6%, respectively; p less than 0.01) than in VVI70 mode (20.4 +/- 10.4%; p less than 0.005), the greatest delta CO was reached at DDD mode in 8 out of 10 patients (p less than 0.03). The optimal AV delays were 50 ms in 5 patients, 100 ms in 4 patients and 150 ms in one. Thus, DDD pacing with the optimal AV delay seems to obtain greater haemodynamic benefits during exercise than does rate-responsive pacing; the optimal exercise AV delay varies from patient to patient and is usually less than 150 ms. PMID:2236802

  13. Depression Screening Using Daily Mental-Health Ratings from a Smartphone Application for Breast Cancer Patients

    PubMed Central

    Kim, Junetae; Lim, Sanghee; Min, Yul Ha; Shin, Yong-Wook; Lee, Byungtae; Sohn, Guiyun; Jung, Kyung Hae; Lee, Jae-Ho; Son, Byung Ho; Ahn, Sei Hyun; Shin, Soo-Yong

    2016-01-01

    Background Mobile mental-health trackers are mobile phone apps that gather self-reported mental-health ratings from users. They have received great attention from clinicians as tools to screen for depression in individual patients. While several apps that ask simple questions using face emoticons have been developed, there has been no study examining the validity of their screening performance. Objective In this study, we (1) evaluate the potential of a mobile mental-health tracker that uses three daily mental-health ratings (sleep satisfaction, mood, and anxiety) as indicators for depression, (2) discuss three approaches to data processing (ratio, average, and frequency) for generating indicator variables, and (3) examine the impact of adherence on reporting using a mobile mental-health tracker and accuracy in depression screening. Methods We analyzed 5792 sets of daily mental-health ratings collected from 78 breast cancer patients over a 48-week period. Using the Patient Health Questionnaire-9 (PHQ-9) as the measure of true depression status, we conducted a random-effect logistic panel regression and receiver operating characteristic (ROC) analysis to evaluate the screening performance of the mobile mental-health tracker. In addition, we classified patients into two subgroups based on their adherence level (higher adherence and lower adherence) using a k-means clustering algorithm and compared the screening accuracy between the two groups. Results With the ratio approach, the area under the ROC curve (AUC) is 0.8012, indicating that the performance of depression screening using daily mental-health ratings gathered via mobile mental-health trackers is comparable to the results of PHQ-9 tests. Also, the AUC is significantly higher (P=.002) for the higher adherence group (AUC=0.8524) than for the lower adherence group (AUC=0.7234). This result shows that adherence to self-reporting is associated with a higher accuracy of depression screening. Conclusions Our results

  14. Incidence of Second Malignancies in Prostate Cancer Patients Treated With Low-Dose-Rate Brachytherapy and Radical Prostatectomy

    SciTech Connect

    Hamilton, Sarah Nicole; Tyldesley, Scott; Hamm, Jeremy; Jiang, Wei Ning; Keyes, Mira; Pickles, Tom; Lapointe, Vince; Kahnamelli, Adam; McKenzie, Michael; Miller, Stacy; Morris, W. James

    2014-11-15

    Purpose: To compare the second malignancy incidence in prostate cancer patients treated with brachytherapy (BT) relative to radical prostatectomy (RP) and to compare both groups with the cancer incidence in the general population. Methods and Materials: From 1998 to 2010, 2418 patients were treated with Iodine 125 prostate BT monotherapy at the British Columbia Cancer Agency, and 4015 referred patients were treated with RP. Cancer incidence was compared with the age-matched general population using standardized incidence ratios (SIRs). Pelvic malignancies included invasive and noninvasive bladder cancer and rectal cancer. Cox multivariable analysis was performed with adjustment for covariates to determine whether treatment (RP vs BT) was associated with second malignancy risk. Results: The median age at BT was 66 years and at RP 62 years. The SIR comparing BT patients with the general population was 1.06 (95% confidence interval [CI] 0.91-1.22) for second malignancy and was 1.53 (95% CI 1.12-2.04) for pelvic malignancy. The SIR comparing RP patients with the general population was 1.11 (95% CI 0.98-1.25) for second malignancy and was 1.11 (95% CI 0.82-1.48) for pelvic malignancy. On multivariable analysis, older age (hazard ratio [HR] 1.05) and smoking (HR 1.65) were associated with increased second malignancy risk (P<.0001). Radical prostatectomy was not associated with a decreased second malignancy risk relative to BT (HR 0.90, P=.43), even when excluding patients who received postprostatectomy external beam radiation therapy (HR 1.13, P=.25). Older age (HR 1.09, P<.0001) and smoking (HR 2.17, P=.0009) were associated with increased pelvic malignancy risk. Radical prostatectomy was not associated with a decreased pelvic malignancy risk compared with BT (HR 0.57, P=.082), even when excluding postprostatectomy external beam radiation therapy patients (HR 0.87, P=.56). Conclusions: After adjustment for covariates, BT patients did not have an increased second

  15. Social Support, Self-Rated Health, and Lesbian, Gay, Bisexual, and Transgender Identity Disclosure to Cancer Care Providers

    PubMed Central

    Kamen, Charles S.; Smith-Stoner, Marilyn; Heckler, Charles E.; Flannery, Marie; Margolies, Liz

    2015-01-01

    Purpose/Objectives To describe factors related to diagnosis, identity disclosure, and social support among lesbian, gay, bisexual, and transgender (LGBT) patients with cancer, and to explore associations between these factors and self-rated health. Design Cross-sectional self-report survey design using descriptive and exploratory multivariate statistical approaches. Setting Online, Internet-based. Sample 291 LGBT patients (89% Caucasian; 50% gay, 36% lesbian, 7% bisexual, 3% transgender) with mixed cancers. Methods Participants completed a researcher-designed online survey assessing experiences of cancer diagnosis among LGBT patients at a single time point. Main Research Variables Demographics, which provider(s) delivered the patients’ cancer diagnoses, to whom patients had disclosed their LGBT identity, how they disclosed, who was on their social support team at the time of diagnosis, and current self-rated health. Findings 79% of participants reported disclosing their identities to more than one cancer care provider. Participants most commonly introduced the topic of LGBT identity themselves, sometimes as a way to correct heterosexual assumptions (34%). Friends were the most common members of LGBT patients’ support teams (79%). Four disclosure and support factors were consistently associated with better self-rated health. Conclusions Disclosure of LGBT identity is a common experience in the context of cancer care, and disclosure and support factors are associated with better self-reported health among LGBT patients. Implications for Nursing Creating safe environments for LGBT patients to disclose could improve cancer care delivery to this underserved population. Nurses and other providers should acknowledge and include diverse support team members in LGBT patients’ care. PMID:25542320

  16. Predictors of Toxicity After Image-guided High-dose-rate Interstitial Brachytherapy for Gynecologic Cancer

    SciTech Connect

    Lee, Larissa J.; Viswanathan, Akila N.

    2012-12-01

    Purpose: To identify predictors of grade 3-4 complications and grade 2-4 rectal toxicity after three-dimensional image-guided high-dose-rate (HDR) interstitial brachytherapy for gynecologic cancer. Methods and Materials: Records were reviewed for 51 women (22 with primary disease and 29 with recurrence) treated with HDR interstitial brachytherapy. A single interstitial insertion was performed with image guidance by computed tomography (n = 43) or magnetic resonance imaging (n = 8). The median delivered dose in equivalent 2-Gy fractions was 72.0 Gy (45 Gy for external-beam radiation therapy and 24 Gy for brachytherapy). Toxicity was reported according to the Common Toxicity Criteria for Adverse Events. Actuarial toxicity estimates were calculated by the Kaplan-Meier method. Results: At diagnosis, the median patient age was 62 years and the median tumor size was 3.8 cm. The median D90 and V100 were 71.4 Gy and 89.5%; the median D2cc for the bladder, rectum, and sigmoid were 64.6 Gy, 61.0 Gy, and 52.7 Gy, respectively. The actuarial rates of all grade 3-4 complications at 2 years were 20% gastrointestinal, 9% vaginal, 6% skin, 3% musculoskeletal, and 2% lymphatic. There were no grade 3-4 genitourinary complications and no grade 5 toxicities. Grade 2-4 rectal toxicity was observed in 10 patients, and grade 3-4 complications in 4; all cases were proctitis with the exception of 1 rectal fistula. D2cc for rectum was higher for patients with grade 2-4 (68 Gy vs 57 Gy for grade 0-1, P=.03) and grade 3-4 (73 Gy vs 58 Gy for grade 0-2, P=.02) rectal toxicity. The estimated dose that resulted in a 10% risk of grade 2-4 rectal toxicity was 61.8 Gy (95% confidence interval, 51.5-72.2 Gy). Discussion: Image-guided HDR interstitial brachytherapy results in acceptable toxicity for women with primary or recurrent gynecologic cancer. D2cc for the rectum is a reliable predictor of late rectal complications. Three-dimensional-based treatment planning should be performed to ensure

  17. Controlling Type I Error Rate in Evaluating Differential Item Functioning for Four DIF Methods: Use of Three Procedures for Adjustment of Multiple Item Testing

    ERIC Educational Resources Information Center

    Kim, Jihye

    2010-01-01

    In DIF studies, a Type I error refers to the mistake of identifying non-DIF items as DIF items, and a Type I error rate refers to the proportion of Type I errors in a simulation study. The possibility of making a Type I error in DIF studies is always present and high possibility of making such an error can weaken the validity of the assessment.…

  18. A frequency-locked and frequency-doubled, hybrid Q-switched Yb:KYW laser at 515 nm with a widely adjustable repetition rate

    NASA Astrophysics Data System (ADS)

    Tjörnhammar, S.; Zukauskas, A.; Canalias, C.; Pasiskevicius, V.; Laurell, F.

    2015-09-01

    We demonstrate a compact wavelength-stabilized, frequency-doubled Yb-doped double-tungstate laser with widely tunable repetition rate, spanning from 35 Hz to 3 kHz obtained by hybrid Q-switching. The Q-switching unit consisted of a combination of a passive Cr:YAG crystal and an opto-mechanical active intensity modulator. The fundamental wavelength was locked at 1029 nm with a volume Bragg grating, and the pulse length and energy were 42 ns and 250 µJ, respectively. As the laser was stabilized with the VBG and the opto-mechanical modulator, the frequency instability was reduced six times from free running down to 0.29 %. Frequency doubling was done extra-cavity in PPKTP, and a repetition rate-independent conversion efficiency of 63 % was obtained. The controllable repetition rate together with stable temporal and spatial characteristics makes this laser a suitable candidate in many biology-related experiments, as a pump source for in vivo excitation of fluorophores, e.g., pumping of "living lasers" and matrix-assisted laser desorption/ionization mass spectroscopy.

  19. Environmental radioactivity and high incidence rates of stomach and esophagus cancer in the Van Lake region: a causal relationship?

    PubMed

    Akan, Zafer; Baskurt, Busranur; Asliyuksek, Hizir; Kam, Erol; Yilmaz, Ahmet; Yuksel, Mehmet Bilgehan; Biyik, Recep; Esen, Ramazan; Koca, Dogan

    2014-01-01

    This study examined the incidence rates of cancer cases (averages for 2006-2010) and relationships with environmental radioactivity levels. Soil and water samples were collected from provincial and district centers of Van city and the outdoor gamma doses were determined using a portable gamma scintillation detector. Gross alpha and beta, (226)Ra, (232)Th, and (40)K activities were measured in both tap water and soil samples. Although high rates of stomach and esophagus cancers have been reported previously in Van the underlying reasons have not hitherto been defined. Incidences of cancers were highest in the Gurpinar (326.0) and Ozalp (377.1) counties (p<0.001). As to the results of the gross alpha and gross beta radioactivity measurements in the drinking water, these two counties also had high beta radionuclide levels: Gurpinar (140 mBq/dm3) and Ozalp (206 mBq/dm3). Even if within the normal range, a relation between the higher rate of the incidence of stomach and esophagus cancers with that of the higher rate of beta radionuclide activity was clear. On Spearman correlation analysis, the relation between higher beta radionuclide levels and cancer incidence was found to be statistically significant (p<0.01). According to the results of the analysis, Van residents receive an average 1.86 mSv/y annual dose from outdoor gamma radiation, ingestion of radionuclides in the drinking water, and indoor 222Rn activity. Moreover, gross alpha and beta activities were found to be extremely high in all of the lakes around the city of Van, Turkey. Further investigations with long-term detailed environmental radiation measurements are needed regarding the relationship between cancer cases and environmental radioactivity in the city of Van. PMID:24528059

  20. 26 CFR 1.803-2 - Adjusted reserves.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) INCOME TAXES Life Insurance Companies § 1.803-2 Adjusted reserves. For the purpose of determining... insurance, no adjustment is to be made. The reserves are thus adjusted, and the rate of interest on...

  1. Prostate-Specific Antigen Bounce After High-Dose-Rate Monotherapy for Prostate Cancer

    SciTech Connect

    Mehta, Niraj H.; Kamrava, Mitchell; Wang, Pin-Chieh; Steinberg, Michael; Demanes, Jeffrey

    2013-07-15

    Purpose: To characterize the magnitude and kinetics of prostate-specific antigen (PSA) bounces after high-dose-rate (HDR) monotherapy and determine relationships between certain clinical factors and PSA bounce. Methods and Materials: Longitudinal PSA data and various clinical parameters were examined in 157 consecutive patients treated with HDR monotherapy between 1996 and 2005. We used the following definition for PSA bounce: rise in PSA ≥threshold, after which it returns to the prior level or lower. Prostate-specific antigen failure was defined per the Phoenix definition (nadir +2 ng/mL). Results: A PSA bounce was noted in 67 patients (43%). The number of bounces per patient was 1 in 45 cases (67%), 2 in 19 (28%), 3 in 2 (3%), 4 in 0, and 5 in 1 (1%). The median time to maximum PSA bounce was 1.3 years, its median magnitude was 0.7, and its median duration was 0.75 years. Three patients (2%) were noted to have PSA failure. None of the 3 patients who experienced biochemical failure exhibited PSA bounce. In the fully adjusted model for predicting each bounce, patients aged <55 years had a statistically significant higher likelihood of experiencing a bounce (odds ratio 2.22, 95% confidence interval 1.38-3.57, P=.001). There was also a statistically significant higher probability of experiencing a bounce for every unit decrease in Gleason score (odds ratio 1.52, 95% confidence interval 1.01-2.04, P=.045). Conclusions: A PSA bounce occurs in a significant percentage of patients treated with HDR monotherapy, with magnitudes varying from <1 in 28% of cases to ≥1 in 15%. The median duration of bounce is <1 year. More bounces were identified in patients with lower Gleason score and age <55 years. Further investigation using a model to correlate magnitude and frequency of bounces with clinical variables are under way.

  2. High-dose-rate interstitial brachytherapy for female peri-urethral cancer

    PubMed Central

    Gandhi, Ajeet Kumar; Bhatla, Neerja; Kumar, Sunesh; Rath, Goura Kisor

    2016-01-01

    Purpose Peri-urethral cancer (PUC) in females is a rare malignancy. Surgery is not usually contemplated due to associated morbidity. Radiation therapy (RT) can be employed in the form of interstitial brachytherapy (IBT) alone for early lesions, and external beam radiation therapy (EBRT) with or without IBT for advanced lesions. We report our first experience in the literature to evaluate the role of high-dose-rate (HDR) IBT in female PUC. Material and methods Between 2008 and 2013, 10 female patients with PUC (5 primary and 5 recurrent) were treated with HDR-IBT with or without EBRT at our center. Size of the lesion ranged from 1.5 cm to 5.0 cm. A 2-3 plane free-hand implant was performed using plastic catheters. The prescribed dose of HDR-IBT was 42 Gy in 14 fractions for brachytherapy alone (5 patients), and 18-21 Gy for the boost along with EBRT (5 patients). Patients were followed up regularly for assessment of disease control and toxicity. Results At a median follow up of 25 months, six patients were disease free at their last follow up. Four patients developed recurrence: 2 at inguinal nodes, 1 at local site, and 1 at both local as well as inguinal nodes. Moist desquamation was the commonest acute toxicity observed in all 5 patients treated with IBT alone, which healed within 4 weeks’ time. Overall, grade II delayed complication rate was 30%. Conclusions Though small sample size, the results of our study have shown that HDR-IBT provides good loco-regional control with acceptable toxicity for female PUC. PMID:26985196

  3. Colorectal Cancer Incidence Rates in the Louisiana Acadian Parishes Demonstrated to be Among the Highest in the United States

    PubMed Central

    Karlitz, Jordan J; Blanton, Christine; Andrews, Patricia; Chen, Vivien W; Wu, Xiao-Cheng; Fontham, Elizabeth

    2014-01-01

    Objectives: Determine whether colorectal cancer (CRC) rates are disproportionately high in the French-Acadian region (population 1.2 million) of Louisiana, home of the Cajuns, a founder population. Methods: 2005–2009 cancer incidence rates were stratified by age/race/gender in the 18 Acadian parish region and 9-parish subgroup with higher proportions of French speakers and compared with Louisiana and United States rates. Parishes were identified through language census data. A total of 3,288 CRC cases were identified in the Acadian region and 11,737 in Louisiana. Results: CRC rates in whites and white males in the 18 parishes were statistically significantly higher than both Louisiana and US rates. In the 9 parishes, rates increased further; whites had an incidence of 56.1/100,000, 13% higher than Louisiana (P<0.0003) and 23% higher than US rates (P<0.0001). In white males, incidence was 72.6/100,000, 19% higher than Louisiana (P<0.0002) and 37% higher than US rates (P<0.0001). If the 9-parish regions were considered a “state,” white males would have the highest CRC incidence in the United States by 11% (P<0.0175) compared with other white male populations. Conclusions: CRC rates are among the highest in the United States, increasing with the proportion of French speakers, a marker for the Cajun population. This appears to be the first study identifying a high rate of cancer in a large, regional, US founder population, raising the possibility of a genetic predisposition. Alternatively, an unidentified, robust environmental risk factor may be present. Future studies are needed to identify genetic and/or other risk factors in this population. PMID:25273154

  4. High Hospitalization Rates in Survivors of Childhood Cancer: A Longitudinal Follow-Up Study Using Medical Record Linkage

    PubMed Central

    Sieswerda, Elske; Font-Gonzalez, Anna; Reitsma, Johannes B.; Dijkgraaf, Marcel G. W.; Heinen, Richard C.; Jaspers, Monique W.; van der Pal, Helena J.; van Leeuwen, Flora E.; Caron, Huib N.

    2016-01-01

    Hospitalization rates over time of childhood cancer survivors (CCS) provide insight into the burden of unfavorable health conditions on CCS and health care resources. The objective of our study was to examine trends in hospitalizations of CCS and risk factors in comparison with the general population. We performed a medical record linkage study of a cohort of 1564 ≥five-year CCS with national registers. We obtained a random sample of the general population matched on year of birth, gender and calendar year per CCS retrieved. We quantified and compared hospitalization rates of CCS and reference persons from 1995 until 2005, and we analyzed risk factors for hospitalization within the CCS cohort with multivariable Poisson models. We retrieved hospitalization information from 1382 CCS and 25583 reference persons. The overall relative hospitalization rate (RHR) was 2.2 (95%CI:1.9–2.5) for CCS compared to reference persons. CCS with central nervous system and solid tumors had highest RHRs. Hospitalization rates in CCS were increased compared to reference persons up to at least 30 years after primary diagnosis, with highest rates 5–10 and 20–30 years after primary cancer. RHRs were highest for hospitalizations due to neoplasms (10.7; 95%CI:7.1–16.3) and endocrine/nutritional/metabolic disorders (7.3; 95%CI:4.6–11.7). Female gender (P<0.001), radiotherapy to head and/or neck (P<0.001) or thorax and/or abdomen (P = 0.03) and surgery (P = 0.01) were associated with higher hospitalization rates in CCS. In conclusion, CCS have increased hospitalization rates compared to the general population, up to at least 30 years after primary cancer treatment. These findings imply a high and long-term burden of unfavorable health conditions after childhood cancer on survivors and health care resources. PMID:27433937

  5. Age-Period-Cohort approaches to back-calculation of cancer incidence rate

    PubMed Central

    Oh, Cheongeun; Holford, Theodore R.

    2016-01-01

    A compartment model for cancer incidence and mortality is developed in which healthy subjects may develop cancer, and subsequently die of cancer or another cause. In order to adequately represent the experience of a defined population, it is also necessary to allow for subjects who are diagnosed at death, as well as subjects who migrate and are subsequently lost to follow-up. Expressions are derived for the number of cancer deaths as a function of the number of incidence cases and vice versa, which allows for the use of mortality statistics to obtain estimates of incidence using survival information. In addition, the model can be used to obtain estimates of cancer prevalence, which is useful for health care planning. The method is illustrated using data on lung cancer among males in Connecticut. PMID:25715831

  6. BubR1 as a prognostic marker for recurrence-free survival rates in epithelial ovarian cancers

    PubMed Central

    Lee, Y-K; Choi, E; Kim, M A; Park, P-G; Park, N-H; Lee, H

    2009-01-01

    Background: Epithelial ovarian cancer is one of the most lethal malignancies, and has a high recurrence rate. Thus, prognostic markers for recurrence are crucial for the care of ovarian cancer. As ovarian cancers frequently exhibit chromosome instability, we aimed at assessing the prognostic significance of two key mitotic kinases, BubR1 and Aurora A. Methods: We analysed paraffin-embedded tissue sections from 160 ovarian cancer patients whose clinical outcomes had been tracked after first-line treatment. Results: The median recurrence-free survival in patients with a positive and negative expression of BubR1 was 27 and 83 months, respectively (P<0.001). A positive BubR1 expression was also associated with advanced stage, serous histology and high grade. In contrast, Aurora A immunostaining did not correlate with any of the clinical parameters analysed. Conclusion: BubR1, but not Aurora A, is a prognostic marker for recurrence-free survival rates in epithelial ovarian cancers. PMID:19603021

  7. Direction-Modulated Brachytherapy for High-Dose-Rate Treatment of Cervical Cancer. I: Theoretical Design

    SciTech Connect

    Han, Dae Yup; Webster, Matthew J.; Scanderbeg, Daniel J.; Yashar, Catheryn; Choi, Dongju; Song, Bongyong; Devic, Slobodan; Ravi, Ananth; Song, William Y.

    2014-07-01

    Purpose: To demonstrate that utilization of the direction-modulated brachytherapy (DMBT) concept can significantly improve treatment plan quality in the setting of high-dose-rate (HDR) brachytherapy for cervical cancer. Methods and Materials: The new, MRI-compatible, tandem design has 6 peripheral holes of 1.3-mm diameter, grooved along a nonmagnetic tungsten-alloy rod (ρ = 18.0 g/cm{sup 3}), enclosed in Delrin tubing (polyoxymethylene, ρ = 1.41 g/cm{sup 3}), with a total thickness of 6.4 mm. The Monte Carlo N-Particle code was used to calculate the anisotropic {sup 192}Ir dose distributions. An in-house-developed inverse planning platform, geared with simulated annealing and constrained-gradient optimization algorithms, was used to replan 15 patient cases (total 75 plans) treated with a conventional tandem and ovoids (T and O) applicator. Prescription dose was 6 Gy. For replanning, we replaced the conventional tandem with that of the new DMBT tandem for optimization but left the ovoids in place and kept the dwell positions as originally planned. All DMBT plans were normalized to match the high-risk clinical target volume V100 coverage of the T and O plans. Results: In general there were marked improvements in plan quality for the DMBT plans. On average, D2cc for the bladder, rectum, and sigmoid were reduced by 0.59 ± 0.87 Gy (8.5% ± 28.7%), 0.48 ± 0.55 Gy (21.1% ± 27.2%), and 0.10 ± 0.38 Gy (40.6% ± 214.9%) among the 75 plans, with best single-plan reductions of 3.20 Gy (40.8%), 2.38 Gy (40.07%), and 1.26 Gy (27.5%), respectively. The high-risk clinical target volume D90 was similar, with 6.55 ± 0.96 Gy and 6.59 ± 1.06 Gy for T and O and DMBT, respectively. Conclusions: Application of the DMBT concept to cervical cancer allowed for improved organ at risk sparing while achieving similar target coverage on a sizeable patient population, as intended, by maximally utilizing the anatomic information contained in 3-dimensional

  8. Changes in the management and survival rates of patients with oral cancer: a 30-year single-institution study

    PubMed Central

    2016-01-01

    Objectives The aim of the present study was to evaluate changes in the management and 5-year survival rates of patients with oral cancer in our department over a 30-year period. Materials and Methods We investigated the patient distributions, treatment methods, method of neck dissection according to cancer stage, and 5-year survival rates for 700 oral cancer patients over the periods of 1982–1996 (256 patients), 1999–2006 (248 patients), and 2007–2011 (196 patients). Results Stage IV patients were the largest group in all of the time periods evaluated. Although surgery and radiotherapy were the most common methods in all periods (over 50%), the prevalence of patients who underwent concomitant chemoradiotherapy increased from 7.0% to 16.2%. The use of radical neck dissection decreased from 43.0% to 5.3%, while conservative surgical methods increased from 24.1% to 76.3%. Lastly, the overall 5-year survival rate increased from 31.6% to 63.5% during the study period. Conclusion Although the 5-year survival rate reached the same level as that of other developed countries during the course of our study, most patients continue to come to the hospital with stage IV disease. In order to increase the 5-year survival rate of oral carcinoma, it may be necessary to improve public education and social efforts relevant to early diagnosis. PMID:26904492

  9. Patterns and trends of pancreatic cancer mortality rates in Arkansas, 1969-2002: a comparison with the US population.

    PubMed

    Zhang, Jianjun; Dhakal, Ishwori; Ning, Baitang; Kesteloot, Hugo

    2008-02-01

    Little is known about trends in pancreatic cancer mortality in individual states of the US and its whole population. This study aimed to describe the patterns and trends of pancreatic cancer mortality in Arkansas, 1969-2002, using the US national rates as a reference. Joinpoint regression analyses were performed to evaluate trends in age-standardized mortality rates of pancreatic cancer by age group, sex, and race, using data obtained from the National Center for Health Statistics. Throughout the period examined, mortality decreased in young and middle-aged people (<60 years) and men but increased in old people (>/=60 years) and women. A continuous fall in mortality occurred among whites except for a transient rise in the late 1970s. For blacks, mortality rates did not cease to increase until 1995. Unlike in Arkansas, a monotonic upward or downward trend in mortality by age group and sex was not observed in the US. A decline of mortality stopped in 1997 for US whites. Recent decreasing trends were more pronounced in Arkansas blacks than in US blacks. Changes of pancreatic cancer mortality in the last three decades in Arkansas remarkably differed by age, sex, and race and were different in patterns from those of the US population. PMID:18090906

  10. Indirectly estimated absolute lung cancer mortality rates by smoking status and histological type based on a systematic review

    PubMed Central

    2013-01-01

    Background National smoking-specific lung cancer mortality rates are unavailable, and studies presenting estimates are limited, particularly by histology. This hinders interpretation. We attempted to rectify this by deriving estimates indirectly, combining data from national rates and epidemiological studies. Methods We estimated study-specific absolute mortality rates and variances by histology and smoking habit (never/ever/current/former) based on relative risk estimates derived from studies published in the 20th century, coupled with WHO mortality data for age 70–74 for the relevant country and period. Studies with populations grossly unrepresentative nationally were excluded. 70–74 was chosen based on analyses of large cohort studies presenting rates by smoking and age. Variations by sex, period and region were assessed by meta-analysis and meta-regression. Results 148 studies provided estimates (Europe 59, America 54, China 22, other Asia 13), 54 providing estimates by histology (squamous cell carcinoma, adenocarcinoma). For all smoking habits and lung cancer types, mortality rates were higher in males, the excess less evident for never smokers. Never smoker rates were clearly highest in China, and showed some increasing time trend, particularly for adenocarcinoma. Ever smoker rates were higher in parts of Europe and America than in China, with the time trend very clear, especially for adenocarcinoma. Variations by time trend and continent were clear for current smokers (rates being higher in Europe and America than Asia), but less clear for former smokers. Models involving continent and trend explained much variability, but non-linearity was sometimes seen (with rates lower in 1991–99 than 1981–90), and there was regional variation within continent (with rates in Europe often high in UK and low in Scandinavia, and higher in North than South America). Conclusions The indirect method may be questioned, because of variations in definition of smoking and

  11. Effects of uncertainty in SAPRC90 rate constants and selected product yields on reactivity adjustment factors for alternative fuel vehicle emissions. Final report

    SciTech Connect

    Bergin, M.S.; Russell, A.G.; Yang, Y.J.; Milford, J.B.; Kirchner, F.; Stockwell, W.R.

    1996-07-01

    Tropospheric ozone is formed in the atmosphere by a series of reactions involving volatile organic compounds (VOCs) and nitrogen oxides (NO{sub x}). While NOx emissions are primarily composed of only two compounds, nitrogen oxide (NO) and nitrogen dioxide (NO{sub 2}), there are hundreds of different VOCs being emitted. In general, VOCs promote ozone formation, however, the rate and extent of ozone produced by the individual VOCs varies considerably. For example, it is widely acknowledged that formaldehyde (HCHO) is a very reactive VOC, and produces ozone rapidly and efficiently under most conditions. On the other hand, VOCs such as methane, ethane, propane, and methanol do not react as quickly, and are likely to form less urban ozone than a comparable mass of HCHO. The difference in ozone forming potential is one of the bases for the use of alternative fuels. The fuels considered in this study included compressed natural gas, LPG, mixtures of methanol and gasoline, ethanol and gasoline, and a reformulated gasoline.

  12. Associations of census-tract poverty with subsite-specific colorectal cancer incidence rates and stage of disease at diagnosis in the United States.

    PubMed

    Henry, Kevin A; Sherman, Recinda L; McDonald, Kaila; Johnson, Christopher J; Lin, Ge; Stroup, Antoinette M; Boscoe, Francis P

    2014-01-01

    Background. It remains unclear whether neighborhood poverty contributes to differences in subsite-specific colorectal cancer (CRC) incidence. We examined associations between census-tract poverty and CRC incidence and stage by anatomic subsite and race/ethnicity. Methods. CRC cases diagnosed between 2005 and 2009 from 15 states and Los Angeles County (N = 278,097) were assigned to 1 of 4 groups based on census-tract poverty. Age-adjusted and stage-specific CRC incidence rates (IRs) and incidence rate ratios (IRRs) were calculated. Analyses were stratified by subsite (proximal, distal, and rectum), sex, race/ethnicity, and poverty. Results. Compared to the lowest poverty areas, CRC IRs were significantly higher in the most impoverished areas for men (IRR = 1.14 95% CI 1.12-1.17) and women (IRR = 1.06 95% CI 1.05-1.08). Rate differences between high and low poverty were strongest for distal colon (male IRR = 1.24 95% CI 1.20-1.28; female IRR = 1.14 95% CI 1.10-1.18) and weakest for proximal colon. These rate differences were significant for non-Hispanic whites and blacks and for Asian/Pacific Islander men. Inverse associations between poverty and IRs of all CRC and proximal colon were found for Hispanics. Late-to-early stage CRC IRRs increased monotonically with increasing poverty for all race/ethnicity groups. Conclusion. There are differences in subsite-specific CRC incidence by poverty, but associations were moderated by race/ethnicity. PMID:25165475

  13. High rates of cervical cancer among HIV-infected women at a referral hospital in Malawi.

    PubMed

    Kohler, Racquel E; Tang, Jennifer; Gopal, Satish; Chinula, Lameck; Hosseinipour, Mina C; Liomba, N George; Chiudzu, Grace

    2016-08-01

    Cervical cancer is the most common cancer among women in Malawi. National guidelines recommend screening women aged 30-45 years every five years; however, no specific recommendations exist for women with HIV. We aimed to assess the frequency of high-grade dysplasia (CIN 2 or CIN3) and cervical cancer among women in central Malawi and to examine associations with CIN2+ (CIN2/3 or cancer). We extracted cervical Pap smear, biopsy, loop electrosurgical excision procedure and uterine specimen reports from a hospital pathology database from November 2012 to November 2013. We used logistic regression to estimate associations with CIN2+. We reviewed specimens from 824 women; we excluded 194 with unknown HIV status, leaving 630 in the analytic sample. Twelve percent had high-grade dysplasia and 109 women (17%) had cancer. Twenty-five percent of high-grade dysplasia cases and 35% of cancers occurred among women outside recommended screening ages. The odds of having CIN2+ were 6.55 times (95% CI 4.44-9.67) greater for HIV+ women. High-grade dysplasia and cervical cancer are very common among Malawian women, especially HIV+ women. HIV infection was strongly associated with CIN2+. Expanding screening to women not covered by current guidelines could avert a substantial proportion of cervical cancer cases in Malawi. PMID:26130691

  14. Cancer

    MedlinePlus

    ... body. Cancerous cells are also called malignant cells. Causes Cancer grows out of cells in the body. Normal ... of many cancers remains unknown. The most common cause of cancer-related death is lung cancer. In the U.S., ...

  15. Radiosensitization of Human Cervical Cancer Cells by Inhibiting Ribonucleotide Reductase: Enhanced Radiation Response at Low-Dose Rates

    SciTech Connect

    Kunos, Charles A.; Colussi, Valdir C.; Pink, John; Radivoyevitch, Tomas; Oleinick, Nancy L.

    2011-07-15

    Purpose: To test whether pharmacologic inhibition of ribonucleotide reductase (RNR) by 3-aminopyridine-2-carboxaldehyde thiosemicarbazone (3-AP, NSC no. 663249) enhances radiation sensitivity during low-dose-rate ionizing radiation provided by a novel purpose-built iridium-192 cell irradiator. Methods and Materials: The cells were exposed to low-dose-rate radiation (11, 23, 37, 67 cGy/h) using a custom-fabricated cell irradiator or to high-dose-rate radiation (330 cGy/min) using a conventional cell irradiator. The radiation sensitivity of human cervical (CaSki, C33-a) cancer cells with or without RNR inhibition by 3-AP was evaluated using a clonogenic survival and an RNR activity assay. Alteration in the cell cycle distribution was monitored using flow cytometry. Results: Increasing radiation sensitivity of both CaSki and C33-a cells was observed with the incremental increase in radiation dose rates. 3-AP treatment led to enhanced radiation sensitivity in both cell lines, eliminating differences in cell cytotoxicity from the radiation dose rate. RNR blockade by 3-AP during low-dose-rate irradiation was associated with low RNR activity and extended G{sub 1}-phase cell cycle arrest. Conclusions: We conclude that RNR inhibition by 3-AP impedes DNA damage repair mechanisms that rely on deoxyribonucleotide production and thereby increases radiation sensitivity of human cervical cancers to low-dose-rate radiation.

  16. Obstructive urination problems after high-dose-rate brachytherapy boost treatment for prostate cancer are avoidable

    PubMed Central

    Kragelj, Borut

    2016-01-01

    Background Aiming at improving treatment individualization in patients with prostate cancer treated with combination of external beam radiotherapy and high-dose-rate brachytherapy to boost the dose to prostate (HDRB-B), the objective was to evaluate factors that have potential impact on obstructive urination problems (OUP) after HDRB-B. Patients and methods In the follow-up study 88 patients consecutively treated with HDRB-B at the Institute of Oncology Ljubljana in the period 2006-2011 were included. The observed outcome was deterioration of OUP (DOUP) during the follow-up period longer than 1 year. Univariate and multivariate relationship analysis between DOUP and potential risk factors (treatment factors, patients’ characteristics) was carried out by using binary logistic regression. ROC curve was constructed on predicted values and the area under the curve (AUC) calculated to assess the performance of the multivariate model. Results Analysis was carried out on 71 patients who completed 3 years of follow-up. DOUP was noted in 13/71 (18.3%) of them. The results of multivariate analysis showed statistically significant relationship between DOUP and anti-coagulation treatment (OR 4.86, 95% C.I. limits: 1.21-19.61, p = 0.026). Also minimal dose received by 90% of the urethra volume was close to statistical significance (OR = 1.23; 95% C.I. limits: 0.98-1.07, p = 0.099). The value of AUC was 0.755. Conclusions The study emphasized the relationship between DOUP and anticoagulation treatment, and suggested the multivariate model with fair predictive performance. This model potentially enables a reduction of DOUP after HDRB-B. It supports the belief that further research should be focused on urethral sphincter as a critical structure for OUP. PMID:27069455

  17. Reporting small bowel dose in cervix cancer high-dose-rate brachytherapy.

    PubMed

    Liao, Yixiang; Dandekar, Virag; Chu, James C H; Turian, Julius; Bernard, Damian; Kiel, Krystyna

    2016-01-01

    Small bowel (SB) is an organ at risk (OAR) that may potentially develop toxicity after radiotherapy for cervix cancer. However, its dose from brachytherapy (BT) is not systematically reported as in other OARs, even with image-guided brachytherapy (IGBT). This study aims to introduce consideration of quantified objectives for SB in BT plan optimization and to evaluate the feasibility of sparing SB while maintaining adequate target coverage. In all, 13 patients were included in this retrospective study. All patients were treated with external beam radiotherapy (EBRT) 45Gy in 25 fractions followed by high dose rate (HDR)-BT boost of 28Gy in 4 fractions using tandem/ring applicator. Magnetic resonance imaging (MRI) and computed tomographic (CT) images were obtained to define the gross tumor volume (GTV), high-risk clinical target volume (HR-CTV) and OARs (rectum, bladder, sigmoid colon, and SB). Treatment plans were generated for each patient using GEC-ESTRO recommendations based on the first CT/MRI. Treatment plans were revised to reduce SB dose when the [Formula: see text] dose to SB was > 5Gy, while maintaining other OAR constraints. For the 7 patients with 2 sets of CT and MRI studies, the interfraction variation of the most exposed SB was analyzed. Plan revisions were done in 6 of 13 cases owing to high [Formula: see text] of SB. An average reduction of 19% in [Formula: see text] was achieved. Meeting SB and other OAR constraints resulted in less than optimal target coverage in 2 patients (D90 of HR-CTV < 77Gyαβ10). The highest interfraction variation was observed for SB at 16 ± 59%, as opposed to 28 ± 27% for rectum and 21 ± 16% for bladder. Prospective reporting of SB dose could provide data required to establish a potential correlation with radiation-induced late complication for SB. PMID:26235549

  18. 14C BOMB-PULSE DATING AND STABLE ISOTOPE ANALYSIS FOR GROWTH RATE AND DIETARY INFORMATION IN BREAST CANCER?

    PubMed

    Lång, K; Eriksson Stenström, K; Rosso, A; Bech, M; Zackrisson, S; Graubau, D; Mattsson, S

    2016-06-01

    The purpose of this study was to perform an initial investigation of the possibility to determine breast cancer growth rate with (14)C bomb-pulse dating. Tissues from 11 breast cancers, diagnosed in 1983, were retrieved from a regional biobank. The estimated average age of the majority of the samples overlapped the year of collection (1983) within 3σ Thus, this first study of tumour tissue has not yet demonstrated that (14)C bomb-pulse dating can obtain information on the growth of breast cancer. However, with further refinement, involving extraction of cell types and components, there is a possibility that fundamental knowledge of tumour biology might still be gained by the bomb-pulse technique. Additionally, δ (13)C and δ (15)N analyses were performed to obtain dietary and metabolic information, and to serve as a base for improvement of the age determination. PMID:27179119

  19. 14C BOMB-PULSE DATING AND STABLE ISOTOPE ANALYSIS FOR GROWTH RATE AND DIETARY INFORMATION IN BREAST CANCER?

    PubMed Central

    Lång, K.; Eriksson Stenström, K.; Rosso, A.; Bech, M.; Zackrisson, S.; Graubau, D.; Mattsson, S.

    2016-01-01

    The purpose of this study was to perform an initial investigation of the possibility to determine breast cancer growth rate with 14C bomb-pulse dating. Tissues from 11 breast cancers, diagnosed in 1983, were retrieved from a regional biobank. The estimated average age of the majority of the samples overlapped the year of collection (1983) within 3σ. Thus, this first study of tumour tissue has not yet demonstrated that 14C bomb-pulse dating can obtain information on the growth of breast cancer. However, with further refinement, involving extraction of cell types and components, there is a possibility that fundamental knowledge of tumour biology might still be gained by the bomb-pulse technique. Additionally, δ 13C and δ 15N analyses were performed to obtain dietary and metabolic information, and to serve as a base for improvement of the age determination. PMID:27179119

  20. High dose rate brachytherapy as monotherapy for localised prostate cancer: a hypofractionated two-implant approach in 351 consecutive patients

    PubMed Central

    2013-01-01

    Background To report the clinical outcome of high dose rate brachytherapy as sole treatment for clinically localised prostate cancer. Methods Between March 2004 and January 2008, a total of 351 consecutive patients with clinically localised prostate cancer were treated with transrectal ultrasound guided high dose rate brachytherapy. The prescribed dose was 38.0 Gy in four fractions (two implants of two fractions each of 9.5 Gy with an interval of 14 days between the implants) delivered to an intraoperative transrectal ultrasound real-time defined planning treatment volume. Biochemical failure was defined according to the Phoenix Consensus and toxicity evaluated using the Common Toxicity Criteria for Adverse Events version 3. Results The median follow-up time was 59.3 months. The 36 and 60 month biochemical control and metastasis-free survival rates were respectively 98%, 94% and 99%, 98%. Toxicity was scored per event with 4.8% acute Grade 3 genitourinary and no acute Grade 3 gastrointestinal toxicity. Late Grade 3 genitourinary and gastrointestinal toxicity were respectively 3.4% and 1.4%. No instances of Grade 4 or greater acute or late adverse events were reported. Conclusions Our results confirm high dose rate brachytherapy as safe and effective monotherapy for clinically organ-confined prostate cancer. PMID:23656899