Science.gov

Sample records for adjusted cancer rates

  1. QuickStats: Age-Adjusted Death Rates* for Top Five Causes of Cancer Death,(†) by Race/Hispanic Ethnicity - United States, 2014.

    PubMed

    2016-09-16

    In 2014, the top five causes of cancer deaths for the total population were lung, colorectal, female breast, pancreatic, and prostate cancer. The non-Hispanic black population had the highest age-adjusted death rates for each of these five cancers, followed by non-Hispanic white and Hispanic groups. The age-adjusted death rate for lung cancer, the leading cause of cancer death in all groups, was 42.1 per 100,000 standard population for the total population, 45.4 for non-Hispanic white, 45.7 for non-Hispanic black, and 18.3 for Hispanic populations.

  2. 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.

  3. Standardization of age-adjusted mortality rates

    SciTech Connect

    Selvin, S.; Sacks, S.T.; Merrill, D.W.

    1980-02-01

    Because age is a significant variable in the occurrence and frequency of human disease, any comparison of disease or mortality rates, to be useful, must be age-specific or age-adjusted. Age-specific comparisons are not always appropriate or possible, however. A common method of eliminating the influence of age in comparing mortality rates from one community to another is to employ statistical methods of age-adjustment. While a variety of methods will accomplish this task, most are weighted averages of the age-specific rates. Two widely used adjustment procedures are direct and indirect age-adjustment.

  4. 39 CFR 3010.28 - Maximum size of unused rate adjustment authority rate adjustments.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 39 Postal Service 1 2011-07-01 2011-07-01 false Maximum size of unused rate adjustment authority... REGULATION OF RATES FOR MARKET DOMINANT PRODUCTS Rules for Applying the Price Cap § 3010.28 Maximum size of... of rate adjustments for any class in any 12-month period may not exceed the applicable...

  5. 39 CFR 3010.28 - Maximum size of unused rate adjustment authority rate adjustments.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 39 Postal Service 1 2013-07-01 2013-07-01 false Maximum size of unused rate adjustment authority... REGULATION OF RATES FOR MARKET DOMINANT PRODUCTS Rules for Applying the Price Cap § 3010.28 Maximum size of... of rate adjustments for any class in any 12-month period may not exceed the applicable...

  6. 39 CFR 3010.28 - Maximum size of unused rate adjustment authority rate adjustments.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 39 Postal Service 1 2012-07-01 2012-07-01 false Maximum size of unused rate adjustment authority... REGULATION OF RATES FOR MARKET DOMINANT PRODUCTS Rules for Applying the Price Cap § 3010.28 Maximum size of... of rate adjustments for any class in any 12-month period may not exceed the applicable...

  7. 76 FR 7883 - Postal Service Rate Adjustment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-11

    ... as a functionally equivalent agreement under the Inbound Multi-Service Agreements with Foreign Postal... Service of Type 2 Rate Adjustment, and Notice of Filing Functionally Equivalent Agreement, January 31... Foreign Postal Operators 1 product and two functionally equivalent agreements, Strategic...

  8. 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.

  9. Helping survivors to adjust after cancer.

    PubMed

    Harmer, Victoria

    The concept of "cancer survivorship" has received considerable attention over the past three years as increasing numbers of people live with and beyond cancer. Previously, attention may have focused more on treatments for cancer and the likelihood of their success. In recent years, interest has moved to the after-effects of treatment, and how people can return to their lives while recovering. This article discusses the various ways in which cancer and its treatment may affect survivors, and how nurses, in both hospital and the community, can help them to adjust and recover.

  10. 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.

  11. 5 CFR 9701.322 - Setting and adjusting rate ranges.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 3 2014-01-01 2014-01-01 false Setting and adjusting rate ranges. 9701... SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Setting and Adjusting Rate Ranges § 9701.322 Setting and adjusting rate ranges. (a) Within its sole and exclusive discretion, DHS...

  12. 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... SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Setting and Adjusting Rate Ranges § 9701.322 Setting and adjusting rate ranges. (a) Within its sole and exclusive discretion, DHS...

  13. 5 CFR 9701.322 - Setting and adjusting rate ranges.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 3 2013-01-01 2013-01-01 false Setting and adjusting rate ranges. 9701... SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Setting and Adjusting Rate Ranges § 9701.322 Setting and adjusting rate ranges. (a) Within its sole and exclusive discretion, DHS...

  14. 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...

  15. Survival Rates for Thymus Cancer

    MedlinePlus

    ... Early Detection, Diagnosis, and Staging Survival Rates for Thymus Cancer Survival rates are often used by doctors ... Ask Your Doctor About Thymus Cancer? More In Thymus Cancer About Thymus Cancer Causes, Risk Factors, and ...

  16. 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 ...

  17. 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...

  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. 5 CFR 9901.322 - Setting and adjusting rate ranges.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Setting and adjusting rate ranges. 9901... NATIONAL SECURITY PERSONNEL SYSTEM (NSPS) Pay and Pay Administration Rate Ranges and General Salary Increases § 9901.322 Setting and adjusting rate ranges. (a) Subject to § 9901.105, the Secretary may set...

  20. 10 CFR 903.11 - Advance announcement of rate adjustment.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Advance announcement of rate adjustment. 903.11 Section 903.11 Energy DEPARTMENT OF ENERGY POWER AND TRANSMISSION RATES Procedures for Public Participation in Power and Transmission Rate Adjustments and Extensions for the Alaska, Southeastern, Southwestern,...

  1. 10 CFR 903.11 - Advance announcement of rate adjustment.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Advance announcement of rate adjustment. 903.11 Section 903.11 Energy DEPARTMENT OF ENERGY POWER AND TRANSMISSION RATES Procedures for Public Participation in Power and Transmission Rate Adjustments and Extensions for the Alaska, Southeastern, Southwestern,...

  2. 10 CFR 903.11 - Advance announcement of rate adjustment.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Advance announcement of rate adjustment. 903.11 Section 903.11 Energy DEPARTMENT OF ENERGY POWER AND TRANSMISSION RATES Procedures for Public Participation in Power and Transmission Rate Adjustments and Extensions for the Alaska, Southeastern, Southwestern,...

  3. 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...

  4. 10 CFR 436.22 - Adjusted internal rate of return.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 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...

  5. 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 ...

  6. 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

    ... conversion under § 536.303(b) or any other simultaneous pay action. The retained rate adjustment under... new retained rate must be determined under the geographic conversion rule in § 536.303(b). (4... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Adjusting an employee's retained...

  7. A statistical test for the equality of differently adjusted incidence rate ratios.

    PubMed

    Hoffmann, Kurt; Pischon, Tobias; Schulz, Mandy; Schulze, Matthias B; Ray, Jennifer; Boeing, Heiner

    2008-03-01

    An incidence rate ratio (IRR) is a meaningful effect measure in epidemiology if it is adjusted for all important confounders. For evaluation of the impact of adjustment, adjusted IRRs should be compared with crude IRRs. The aim of this methodological study was to present a statistical approach for testing the equality of adjusted and crude IRRs and to derive a confidence interval for the ratio of the two IRRs. The method can be extended to compare two differently adjusted IRRs and, thus, to evaluate the effect of additional adjustment. The method runs immediately on existing software. To illustrate the application of this approach, the authors studied adjusted IRRs for two risk factors of type 2 diabetes using data from the European Prospective Investigation into Cancer and Nutrition-Potsdam Study from 2005. The statistical method described may be helpful as an additional tool for analyzing epidemiologic cohort data and for interpreting results obtained from Cox regression models with adjustment for different covariates.

  8. 5 CFR 9701.322 - Setting and adjusting rate ranges.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 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 RESOURCES... SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Setting and Adjusting Rate...

  9. 5 CFR 9701.322 - 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. 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...

  10. 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…

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

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... announcement may be through direct contact with customers, at public meetings, by press release, by newspaper... 10 Energy 4 2011-01-01 2011-01-01 false Advance announcement of rate adjustment. 903.11 Section 903.11 Energy DEPARTMENT OF ENERGY POWER AND TRANSMISSION RATES Procedures for Public Participation...

  12. 10 CFR 903.11 - Advance announcement of rate adjustment.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... announcement may be through direct contact with customers, at public meetings, by press release, by newspaper... 10 Energy 4 2010-01-01 2010-01-01 false Advance announcement of rate adjustment. 903.11 Section 903.11 Energy DEPARTMENT OF ENERGY POWER AND TRANSMISSION RATES Procedures for Public Participation...

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

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... adjusted internal rate of return is the overall rate of return on an energy or water conservation measure... attributable to the proposed energy or water conservation measure. The denominator of the ratio is the present... proposed energy or water conservation measure....

  14. 10 CFR 436.22 - Adjusted internal rate of return.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... adjusted internal rate of return is the overall rate of return on an energy or water conservation measure... attributable to the proposed energy or water conservation measure. The denominator of the ratio is the present... proposed energy or water conservation measure....

  15. 75 FR 455 - Adjustment of Cable Statutory License Royalty Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-05

    ... United States Code, grants a statutory copyright license to cable television systems for the... Doc No: E9-30825] LIBRARY OF CONGRESS Copyright Royalty Board [Docket No. 2010-1 CRB Cable Rate] Adjustment of Cable Statutory License Royalty Rates AGENCY: Copyright Royalty Board, Library of...

  16. 18 CFR 154.403 - Periodic rate adjustments.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... adjustments. 154.403 Section 154.403 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER NATURAL GAS ACT RATE SCHEDULES AND TARIFFS Limited Rate... computations supporting the allocation, segregated into reservation and usage amounts, where appropriate....

  17. 18 CFR 154.403 - Periodic rate adjustments.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... adjustments. 154.403 Section 154.403 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER NATURAL GAS ACT RATE SCHEDULES AND TARIFFS Limited Rate... computations supporting the allocation, segregated into reservation and usage amounts, where appropriate....

  18. 18 CFR 154.403 - Periodic rate adjustments.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... adjustments. 154.403 Section 154.403 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER NATURAL GAS ACT RATE SCHEDULES AND TARIFFS Limited Rate... computations supporting the allocation, segregated into reservation and usage amounts, where appropriate....

  19. Adjusted Age-Adjusted Charlson Comorbidity Index Score as a Risk Measure of Perioperative Mortality before Cancer Surgery

    PubMed Central

    Chang, Chun-Ming; Yin, Wen-Yao; Wei, Chang-Kao; Wu, Chin-Chia; Su, Yu-Chieh; Yu, Chia-Hui; Lee, Ching-Chih

    2016-01-01

    Background Identification of patients at risk of death from cancer surgery should aid in preoperative preparation. The purpose of this study is to assess and adjust the age-adjusted Charlson comorbidity index (ACCI) to identify cancer patients with increased risk of perioperative mortality. Methods We identified 156,151 patients undergoing surgery for one of the ten common cancers between 2007 and 2011 in the Taiwan National Health Insurance Research Database. Half of the patients were randomly selected, and a multivariate logistic regression analysis was used to develop an adjusted-ACCI score for estimating the risk of 90-day mortality by variables from the original ACCI. The score was validated. The association between the score and perioperative mortality was analyzed. Results The adjusted-ACCI score yield a better discrimination on mortality after cancer surgery than the original ACCI score, with c-statics of 0.75 versus 0.71. Over 80 years of age, 70–80 years, and renal disease had the strongest impact on mortality, hazard ratios 8.40, 3.63, and 3.09 (P < 0.001), respectively. The overall 90-day mortality rates in the entire cohort varied from 0.9%, 2.9%, 7.0%, and 13.2% in four risk groups stratifying by the adjusted-ACCI score; the adjusted hazard ratio for score 4–7, 8–11, and ≥ 12 was 2.84, 6.07, and 11.17 (P < 0.001), respectively, in 90-day mortality compared to score 0–3. Conclusions The adjusted-ACCI score helps to identify patients with a higher risk of 90-day mortality after cancer surgery. It might be particularly helpful for preoperative evaluation of patients over 80 years of age. PMID:26848761

  20. 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…

  1. 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…

  2. 78 FR 649 - Adjustments of Certain Rates of Pay

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-03

    ... Public Law 112-175, it is hereby ordered as follows: Section 1. Statutory Pay Systems. The rates of basic pay or salaries of the statutory pay systems (as defined in 5 U.S.C. 5302(1)), as adjusted under 5 U.S... See Food Safety and Inspection Service See Rural Utilities Service NOTICES Agency...

  3. 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.

  4. 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)

  5. 18 CFR 154.403 - Periodic rate adjustments.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...) Where the costs, revenues, rates, quantities, indices, load factors, percentages, or other numbers used... filing. (vi) Where a number is derived from another number by applying a load factor, percentage, or other adjusting factor not referenced in paragraph (d)(1)(i) of this section, include workpapers and...

  6. 18 CFR 154.403 - Periodic rate adjustments.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...) Where the costs, revenues, rates, quantities, indices, load factors, percentages, or other numbers used... filing. (vi) Where a number is derived from another number by applying a load factor, percentage, or other adjusting factor not referenced in paragraph (d)(1)(i) of this section, include workpapers and...

  7. 24 CFR 203.49 - Eligibility of adjustable rate mortgages.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... most recent figure available before the date of mortgage loan origination. The current index figure shall be the most recent index figure available 30 days before the date of each interest rate adjustment... houses in federally impacted areas), 203.45 (graduated payment mortgages), or 203.47 (growing...

  8. 24 CFR 203.49 - Eligibility of adjustable rate mortgages.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... most recent figure available before the date of mortgage loan origination. The current index figure shall be the most recent index figure available 30 days before the date of each interest rate adjustment... houses in federally impacted areas), 203.45 (graduated payment mortgages), or 203.47 (growing...

  9. 24 CFR 203.49 - Eligibility of adjustable rate mortgages.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... most recent figure available before the date of mortgage loan origination. The current index figure shall be the most recent index figure available 30 days before the date of each interest rate adjustment... houses in federally impacted areas), 203.45 (graduated payment mortgages), or 203.47 (growing...

  10. 24 CFR 203.49 - Eligibility of adjustable rate mortgages.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... most recent figure available before the date of mortgage loan origination. The current index figure shall be the most recent index figure available 30 days before the date of each interest rate adjustment... houses in federally impacted areas), 203.45 (graduated payment mortgages), or 203.47 (growing...

  11. 24 CFR 203.49 - Eligibility of adjustable rate mortgages.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... most recent figure available before the date of mortgage loan origination. The current index figure shall be the most recent index figure available 30 days before the date of each interest rate adjustment... houses in federally impacted areas), 203.45 (graduated payment mortgages), or 203.47 (growing...

  12. 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 ...

  13. Prostate Cancer Rates by Race and Ethnicity

    MedlinePlus

    ... HPV-Associated Lung Ovarian Skin Uterine Cancer Home Prostate Cancer Rates by Race and Ethnicity Language: English Español ( ... Tweet Share Compartir The rate of men getting prostate cancer or dying from prostate cancer varies by race ...

  14. 5 CFR 9701.323 - Eligibility for pay increase associated with a rate range adjustment.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... with a rate range adjustment. 9701.323 Section 9701.323 Administrative Personnel DEPARTMENT OF HOMELAND... Adjusting Rate Ranges § 9701.323 Eligibility for pay increase associated with a rate range adjustment. (a) When a band rate range is adjusted under § 9701.322, employees covered by that band are eligible for...

  15. 5 CFR 9701.323 - Eligibility for pay increase associated with a rate range adjustment.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... with a rate range adjustment. 9701.323 Section 9701.323 Administrative Personnel DEPARTMENT OF HOMELAND... Adjusting Rate Ranges § 9701.323 Eligibility for pay increase associated with a rate range adjustment. (a) When a band rate range is adjusted under § 9701.322, employees covered by that band are eligible for...

  16. 5 CFR 9701.323 - Eligibility for pay increase associated with a rate range adjustment.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... with a rate range adjustment. 9701.323 Section 9701.323 Administrative Personnel DEPARTMENT OF HOMELAND... Adjusting Rate Ranges § 9701.323 Eligibility for pay increase associated with a rate range adjustment. (a) When a band rate range is adjusted under § 9701.322, employees covered by that band are eligible for...

  17. 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

    ... 25 Indians 1 2012-04-01 2011-04-01 true Procedures for adjusting electric power rates except for... INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN ELECTRIC POWER UTILITIES Service Fees, Electric Power Rates and Revenues § 175.12 Procedures for adjusting electric power rates except...

  18. 25 CFR 175.12 - Procedures for adjusting electric power rates except for adjustments due to changes in the cost...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false Procedures for adjusting electric power rates except for... INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN ELECTRIC POWER UTILITIES Service Fees, Electric Power Rates and Revenues § 175.12 Procedures for adjusting electric power rates except...

  19. 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

    ... 25 Indians 1 2010-04-01 2010-04-01 false Procedures for adjusting electric power rates except for... INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN ELECTRIC POWER UTILITIES Service Fees, Electric Power Rates and Revenues § 175.12 Procedures for adjusting electric power rates except...

  20. 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

    ... 25 Indians 1 2011-04-01 2011-04-01 false Procedures for adjusting electric power rates except for... INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN ELECTRIC POWER UTILITIES Service Fees, Electric Power Rates and Revenues § 175.12 Procedures for adjusting electric power rates except...

  1. 25 CFR 175.12 - Procedures for adjusting electric power rates except for adjustments due to changes in the cost...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false Procedures for adjusting electric power rates except for... INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN ELECTRIC POWER UTILITIES Service Fees, Electric Power Rates and Revenues § 175.12 Procedures for adjusting electric power rates except...

  2. 39 CFR 3010.14 - Contents of notice of rate adjustment.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... DOMINANT PRODUCTS Rules for Rate Adjustments for Rates of General Applicability (Type 1-A and 1-B Rate... costs; (7) A discussion that demonstrates how the planned rate adjustments are designed to help...

  3. 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:…

  4. Family Functioning and Sibling Adjustment Following Treatment of Childhood Cancer.

    ERIC Educational Resources Information Center

    Tucker, Cindy L.; Hansen, James C.; Zevon, Michael A.

    Childhood cancer and its treatment have been identified as significant stressors for individuals and families. The impact of this experience on healthy siblings has not been clearly determined. This study was designed to assess siblings regarding their adjustment and their perceptions of their families following a sick sibling's treatment.…

  5. 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.

  6. 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.

  7. 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.

  8. 39 CFR 3010.28 - Maximum size of Type 1-B rate adjustments.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 39 Postal Service 1 2014-07-01 2014-07-01 false Maximum size of Type 1-B rate adjustments. 3010.28... DOMINANT PRODUCTS Rules for Determining the Maximum Rate Adjustment § 3010.28 Maximum size of Type 1-B rate... used to make a Type 1-B rate adjustment for any class in any 12-month period may not exceed...

  9. 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…

  10. Adjustment process in Iranian men to their wives' breast cancer.

    PubMed

    Nasiri, A; Taleghani, F; Irajpour, A

    2016-03-01

    Women's breast cancer causes various problems in both spouses' family life as well as enormous stress for their husbands. This grounded theory study aimed to define ways in which men adjust to their wives' breast cancer and to present an appropriate model in this respect. Twenty-six individuals (22 husbands, 2 patients and 2 physicians) were selected through purposive and theoretical sampling. The data were collected through in-depth individual interviews. Strauss and Corbin's method was used for data analysis. Data analysis revealed that Iranian men's adjustment to their wives' breast cancer occurs during the following three stages: the first stage turbulence after confrontation with the disease that contains categories 'internal unrest', 'concerns about disease management' and 'sensing the beginning of disorganization in family life'; the second stage disorganisation of family life that contains 'disturbance of family life', 'attempt to get rid of tension' and 'resistance against family life disorganisation'; and the third stage struggle to reorder family life consisting of 'support to the wife', 'revision in communications with relatives' and 'seeking external support' categories. Iranian men struggled for constant organisation of family life after their wives' disease. Health providers should take measures to support the men by facilitating their adjustment to their wives' disease.

  11. Risk adjusting survival outcomes of hospitals that treat cancer patients without information on cancer stage

    PubMed Central

    Pfister, David G.; Rubin, David M.; Elkin, Elena B.; Neill, Ushma S.; Duck, Elaine; Radzyner, Mark; Bach, Peter B.

    2016-01-01

    Importance Instituting widespread measurement of outcomes for cancer hospitals using administrative data is difficult due to the lack of cancer specific information such as disease stage. Objective To evaluate the performance of hospitals that treat cancer patients using Medicare data for outcome ascertainment and risk adjustment, and to assess whether hospital rankings based on these measures are influenced by the addition of cancer-specific information. Design Risk adjusted cumulative mortality of patients with cancer captured in Medicare claims from 2005–2009 nationally were assessed at the hospital level. Similar analyses were conducted in the Surveillance, Epidemiology and End Result (SEER)-Medicare data for the subset of the US covered by the SEER program to determine whether the exclusion of cancer specific information (only available in cancer registries) from risk adjustment altered measured hospital performance. Setting Administrative claims data and SEER cancer registry data Participants Sample of 729,279 fee-for-service Medicare beneficiaries treated for cancer in 2006 at hospitals treating 10+ patients with each of the following cancers, according to Medicare claims: lung, prostate, breast, colon. An additional sample of 18,677 similar patients in SEER-Medicare administrative data. Main Outcomes and Measures Risk-adjusted mortality overall and by cancer type, stratified by type of hospital; measures of correlation and agreement between hospital-level outcomes risk adjusted using Medicare data alone and Medicare data with SEER data. Results There were large outcome differences between different types of hospitals that treat Medicare patients with cancer. At one year, cumulative mortality for Medicare-prospective-payment-system exempt hospitals was 10% lower than at community hospitals (18% versus 28%) across all cancers, the pattern persisted through five years of follow-up and within specific cancer types. Performance ranking of hospitals was

  12. 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

    ... adjustments to the fee rates applicable under Sections 31(b) and (c) of the Exchange Act shall take effect on... circumstances, to make a mid-year adjustment to the fee rates under Sections 31(b) and (c) of the Exchange Act... national securities exchange to pay the Commission a fee at a rate, as adjusted by our order pursuant...

  13. 37 CFR 255.3 - Adjustment of royalty rate.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... further adjustment pursuant to paragraphs (i) through (m) of this section. (i) For every phonorecord made... thereof, whichever amount is larger, subject to further adjustment pursuant to paragraphs (l) through (m...) through (m) of this section. (b) For every phonorecord made and distributed on or after July 1, 1984,...

  14. 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...

  15. 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...

  16. 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...

  17. 42 CFR 422.308 - Adjustments to capitation rates, benchmarks, bids, and payments.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Adjustments to capitation rates, benchmarks, bids... Payments to Medicare Advantage Organizations § 422.308 Adjustments to capitation rates, benchmarks, bids...) Data collection. To adjust for health status, CMS applies a risk factor based on data obtained...

  18. 42 CFR 422.308 - Adjustments to capitation rates, benchmarks, bids, and payments.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Adjustments to capitation rates, benchmarks, bids... Medicare Advantage Organizations § 422.308 Adjustments to capitation rates, benchmarks, bids, and payments... the determination of actuarial equivalence. (2) Risk adjustment: Health status—(i) Data collection....

  19. 25 CFR 166.408 - Is the grazing rental rate established by the BIA adjusted periodically?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false Is the grazing rental rate established by the BIA... LAND AND WATER GRAZING PERMITS Grazing Rental Rates, Payments, and Late Payment Collections Rental Rate Determination and Adjustment § 166.408 Is the grazing rental rate established by the BIA adjusted...

  20. 25 CFR 166.408 - Is the grazing rental rate established by the BIA adjusted periodically?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Is the grazing rental rate established by the BIA... LAND AND WATER GRAZING PERMITS Grazing Rental Rates, Payments, and Late Payment Collections Rental Rate Determination and Adjustment § 166.408 Is the grazing rental rate established by the BIA adjusted...

  1. 5 CFR 535.105 - Setting and adjusting rates of basic pay.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 1 2013-01-01 2013-01-01 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...

  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. 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…

  4. Cumulative Family Risk Predicts Sibling Adjustment to Childhood Cancer

    PubMed Central

    Long, Kristin A.; Marsland, Anna L.; Alderfer, Melissa A.

    2013-01-01

    Background Prolonged, intensive treatment regimens often disrupt families of children with cancer. Siblings are at increased risk for distress, but factors underlying this risk have received limited empirical attention. This study examined associations between the family context and sibling distress. Methods Siblings of children with cancer (ages 8–18, N=209) and parents (186 mothers, 70 fathers) completed measures of sibling distress, family functioning, parenting, and parent posttraumatic stress. Associations between sibling distress and each family risk factor were evaluated. Then, family risks were considered simultaneously by calculating cumulative family risk index scores. Results After controlling for socio-demographic covariates, greater sibling distress was associated with more sibling-reported problems with family functioning and parental psychological control, lower sibling-reported maternal acceptance, and lower paternal self-reported acceptance. When risk factors were considered together, results supported a quadratic model in which associations between family risk and sibling distress were stronger at higher levels of risk. Conclusions Findings support a contextual model of sibling adjustment to childhood cancer in which elevated distress is predicted by family risk factors, alone and in combination. PMID:23576115

  5. 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...

  6. 10 CFR 903.17 - Informal public meetings for minor rate adjustments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Informal public meetings for minor rate adjustments. 903.17 Section 903.17 Energy DEPARTMENT OF ENERGY POWER AND TRANSMISSION RATES Procedures for Public Participation in Power and Transmission Rate Adjustments and Extensions for the Alaska,...

  7. 10 CFR 903.17 - Informal public meetings for minor rate adjustments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Informal public meetings for minor rate adjustments. 903.17 Section 903.17 Energy DEPARTMENT OF ENERGY POWER AND TRANSMISSION RATES Procedures for Public Participation in Power and Transmission Rate Adjustments and Extensions for the Alaska,...

  8. 10 CFR 903.17 - Informal public meetings for minor rate adjustments.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Informal public meetings for minor rate adjustments. 903.17 Section 903.17 Energy DEPARTMENT OF ENERGY POWER AND TRANSMISSION RATES Procedures for Public Participation in Power and Transmission Rate Adjustments and Extensions for the Alaska,...

  9. 10 CFR 903.17 - Informal public meetings for minor rate adjustments.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Informal public meetings for minor rate adjustments. 903.17 Section 903.17 Energy DEPARTMENT OF ENERGY POWER AND TRANSMISSION RATES Procedures for Public Participation in Power and Transmission Rate Adjustments and Extensions for the Alaska,...

  10. 77 FR 13663 - Order Making Fiscal Year 2012 Mid-Year Adjustments to Transaction Fee Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-07

    ... take effect on April 1 of the fiscal year in which such rate applies. Therefore, the exchanges and the... Exchange Act requires the Commission to annually adjust the fee rates applicable under Sections 31(b) and... adjusting the fee rates applicable under Sections 31(b) and (c) of the Exchange Act. Specifically,...

  11. Standardization of Rates To Adjust for Differences in Enrollment Composition.

    ERIC Educational Resources Information Center

    Hom, Willard

    Community colleges must often analyze and report rates for outcomes, such as transfer to four-year colleges. A single, summary rate may be an invalid measure of its achievement in the transfer goal if the summary rate ignores the real difference in enrollment composition at different institutions. California's community colleges embody a very…

  12. Unmitigated agency, social support, and psychological adjustment in men with cancer.

    PubMed

    Hoyt, Michael A; Stanton, Annette L

    2011-04-01

    Unmitigated agency (UA), a gender-linked characteristic, has been associated with poorer cancer adjustment. Support from one's social network typically predicts adjustment but may be poorly matched to UA. The influence of UA on the utility of social support on adjustment over time is examined. Men with cancer (N=55) were assessed initially and 6 months later on three indicators of adjustment. Multilevel modeling analyses varied by adjustment indicator. UA was associated with increased cancer-related psychosocial symptoms but not depressive symptoms or cancer-related thought intrusion. Social support predicted fewer depressive symptoms and less cancer-related thought intrusion. However, a cross-level interaction revealed that the utility of social support on cancer-related thought intrusion was weaker for men with greater levels of UA. Men with cancer likely respond differently to changes in social support depending on their endorsement of UA.

  13. 78 FR 80451 - Adjustments of Certain Rates of Pay

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-31

    ... Pay Systems. The rates of basic pay or salaries of the statutory pay systems (as defined in 5 U.S.C... hereto and made a part hereof. Sec. 3. Certain Executive, Legislative, and Judicial Salaries. The rates of basic pay or salaries for the following offices and positions are set forth on the...

  14. 7 CFR 1421.102 - Adjustment of basic loan rates.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...-MARKETING ASSISTANCE LOANS AND LOAN DEFICIENCY PAYMENTS FOR 2008 THROUGH 2012 Marketing Assistance Loans... county marketing assistance loan rate. (2) For farm-stored commodities where the test weight discounts... schedule of discounts, the marketing assistance loan rate shall be reduced to 20 percent of the county...

  15. 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

  16. 5 CFR 9901.312 - Maximum rates of base salary and adjusted salary.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Maximum rates of base salary and adjusted salary. 9901.312 Section 9901.312 Administrative Personnel DEPARTMENT OF DEFENSE HUMAN RESOURCES....312 Maximum rates of base salary and adjusted salary. (a) Subject to § 9901.105, the Secretary...

  17. 5 CFR 9901.312 - Maximum rates of base salary and adjusted salary.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Maximum rates of base salary and adjusted salary. 9901.312 Section 9901.312 Administrative Personnel DEPARTMENT OF DEFENSE HUMAN RESOURCES....312 Maximum rates of base salary and adjusted salary. (a) Subject to § 9901.105, the Secretary...

  18. Prospective prediction of college adjustment using self- and informant-rated personality traits.

    PubMed

    Kurtz, John E; Puher, Meredith A; Cross, Nicole A

    2012-01-01

    Studies that relate normal personality traits to students' adjustment to college have relied heavily on self-rating methods, concurrent designs, and academic performance indicators as criteria. We conducted a prospective study of high school seniors with a follow-up assessment made near the end of their freshman year of college. Self-ratings of personality traits and college adjustment were obtained from 90 students using the revised NEO personality inventory (NEO PI-R; Costa & McCrae, 1992) and the student adaptation to college questionnaire (SACQ; Baker & Siryk, 1989 ). Ratings of personality were also obtained from parents (n = 66) and same-sex peers from the college setting (n = 78) using the NEO five-factor inventory (NEO-FFI; Costa & McCrae, 1992 ). SACQ academic adjustment was correlated with conscientiousness ratings by all three sources and with openness ratings by parents and peers. SACQ Social Adjustment was correlated with self-ratings of neuroticism and peer ratings of extraversion. SACQ personal-emotional adjustment was correlated with self-ratings and parent ratings of neuroticism. Ratings by parents and peers showed significant incremental validity over self-ratings in the prediction of certain trait-adjustment relationships.

  19. 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.

  20. 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.

  1. Reliability of Urinary Excretion Rate Adjustment in Measurements of Hippuric Acid in Urine

    PubMed Central

    Nicolli, Annamaria; Chiara, Federica; Gambalunga, Alberto; Carrieri, Mariella; Bartolucci, Giovanni Battista; Trevisan, Andrea

    2014-01-01

    The urinary excretion rate is calculated based on short-term, defined time sample collections with a known sample mass, and this measurement can be used to remove the variability in urine concentrations due to urine dilution. Adjustment to the urinary excretion rate of hippuric acid was evaluated in 31 healthy volunteers (14 males and 17 females). Urine was collected as short-term or spot samples and tested for specific gravity, creatinine and hippuric acid. Hippuric acid values were unadjusted or adjusted to measurements of specific gravity, creatinine or urinary excretion rate. Hippuric acid levels were partially independent of urinary volume and urinary flow rate, in contrast to specific gravity and creatinine, which were both highly dependent on the hippuric acid level. Accordingly, hippuric acid was independent on urinary specific gravity and creatinine excretion. Unadjusted and adjusted values for specific gravity or creatinine were generally closely correlated, especially in spot samples. Values adjusted to the urinary excretion rate appeared well correlated to those unadjusted and adjusted to specific gravity or creatinine values. Thus, adjustment of crude hippuric acid values to the urinary excretion rate is a valid procedure but is difficult to apply in the field of occupational medicine and does not improve the information derived from values determined in spot urine samples, either unadjusted or adjusted to specific gravity and creatinine. PMID:25019265

  2. 5 CFR 9701.334 - Setting and adjusting locality and special rate supplements.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 3 2014-01-01 2014-01-01 false Setting and adjusting locality and...) Within its sole and exclusive discretion, DHS may, after coordination with OPM, set and adjust locality and special rate supplements. In determining the amounts of the supplements, DHS and OPM may...

  3. 5 CFR 9701.334 - Setting and adjusting locality and special rate supplements.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 3 2013-01-01 2013-01-01 false Setting and adjusting locality and...) Within its sole and exclusive discretion, DHS may, after coordination with OPM, set and adjust locality and special rate supplements. In determining the amounts of the supplements, DHS and OPM may...

  4. 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,...

  5. 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,...

  6. 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,...

  7. 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,...

  8. 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,...

  9. 78 FR 71501 - Cost of Living Adjustment to Satellite Carrier Compulsory License Royalty Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-29

    ... Copyright Royalty Board 37 CFR Part 386 Cost of Living Adjustment to Satellite Carrier Compulsory License... Copyright Royalty Judges announce a cost of living adjustment (COLA) of 1% in the royalty rates satellite....gov . SUPPLEMENTARY INFORMATION: The satellite carrier compulsory license establishes a...

  10. Cancer-specific incidence rates of tuberculosis

    PubMed Central

    Seo, Gi Hyeon; Kim, Min Jae; Seo, Soyoung; Hwang, Boram; Lee, Eugene; Yun, Yujin; Choi, Minsun; Kim, Moonsuk; Kim, Jin Won; Kim, Eu Suk; Kim, Hong Bin; Song, Kyoung-Ho

    2016-01-01

    Abstract Population-based studies of the incidence of tuberculosis in cancer patients according to the type of cancer are limited. We investigated the cancer-specific incidence of tuberculosis in a nationwide population-based cohort in a country with an intermediate burden of tuberculosis. We used mandatory National Health Insurance claims data to construct a cancer cohort of adults (aged 20–99 years) with newly diagnosed malignancies other than lung cancer, from January 2008 to December 2012. Patients who developed tuberculosis in this period were identified in the cancer cohort and the general population. Standardized incidence ratios (SIRs) of tuberculosis in the cancer cohort according to type of cancer and time after cancer diagnosis were calculated by comparing the observed incidence rates with those inferred from the age- and gender-specific incidence rates in the general population. A total of 855,382 cancer patients and 1589,876 person-years (py) were observed. A total of 5745 patients developed tuberculosis; the mean incidence rate was 361.3 per 100,000 py, and the SIR was 2.22 (95% confidence interval [CI], 2.17–2.27). The incidence rate was highest for hematologic malignancy and lowest for thyroid cancer. It was also highest as 650.1 per 100,000 py, with SIR of 3.70 (CI, 3.57–3.83) for the first 6 months after diagnosis of malignancy and then declined. However, it still remained higher than that of the general population after 24 months (SIR = 1.43, CI, 1.36–1.51). The incidence of tuberculosis increases after diagnosis in patients with malignancies. The risk of tuberculosis differs according to the type of cancer and remains elevated even 24 months after cancer diagnosis. Tuberculosis should be considered an important comorbidity in patients with malignancies. PMID:27661041

  11. 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

    ... Copyright Royalty Board Adjustment or Determination of Compulsory License Rates for Making and Distributing Phonorecords AGENCY: Copyright Royalty Board, Library of Congress. ACTION: Notice announcing commencement of proceeding with request for Petitions to Participate. SUMMARY: The Copyright Royalty Judges are...

  12. 5 CFR 535.105 - Setting and adjusting rates of basic pay.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... REGULATIONS CRITICAL POSITION PAY AUTHORITY § 535.105 Setting and adjusting rates of basic pay. (a) The rate of basic pay for a critical position may not be less than the rate of basic pay, including any... be payable for the position. (b) If critical position pay authority is granted for a position,...

  13. 39 CFR 3010.12 - Contents of notice of rate adjustment.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., including all relevant CPI-U values, are listed with citations to the original sources. (2) A schedule... input values, including current rates, new rates, and billing determinants, are listed with citations to... citations to the original sources. If new unused rate adjustment authority will be generated for a class...

  14. 39 CFR 3010.14 - Contents of notice of rate adjustment.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... relevant CPI-U values are listed with citations to the original sources; (2) A schedule showing unused rate... including current rates, new rates, and billing determinants are listed with citations to the original... adjustment calculated as required by § 3010.26. All calculations are to be shown with citations to...

  15. 39 CFR 3010.14 - Contents of notice of rate adjustment.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... relevant CPI-U values are listed with citations to the original sources; (2) A schedule showing unused rate... including current rates, new rates, and billing determinants are listed with citations to the original... adjustment calculated as required by § 3010.26. All calculations are to be shown with citations to...

  16. 39 CFR 3010.14 - Contents of notice of rate adjustment.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... relevant CPI-U values are listed with citations to the original sources; (2) A schedule showing unused rate... including current rates, new rates, and billing determinants are listed with citations to the original... adjustment calculated as required by § 3010.26. All calculations are to be shown with citations to...

  17. Skin Cancer Rates by Race and Ethnicity

    MedlinePlus

    ... for School Programs to Prevent Skin Cancer Research Melanoma Surveillance in the U.S. Related Links Buttons and ... Tweet Share Compartir The rate of people getting melanoma of the skin or dying from melanoma of ...

  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. 48 CFR 52.222-31 - Construction Wage Rate Requirements-Price Adjustment (Percentage Method).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 2 2014-10-01 2014-10-01 false Construction Wage Rate... CLAUSES Text of Provisions and Clauses 52.222-31 Construction Wage Rate Requirements—Price Adjustment (Percentage Method). As prescribed in 22.407(f), insert the following clause: Construction Wage...

  20. 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... Executive Service. The ranges of rates of basic pay for senior executives in the Senior Executive...

  1. 10 CFR 903.17 - Informal public meetings for minor rate adjustments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ....17 Section 903.17 Energy DEPARTMENT OF ENERGY POWER AND TRANSMISSION RATES Procedures for Public 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...

  2. 43 CFR 38.3 - Administration of adjusted rates of pay.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...) Retirement deductions and benefits; (2) Life insurance premiums and benefits; (3) Premium pay; (4) Severance... rate of pay begins on the effective date of the change in official duty station. (d) An adjusted rate... first day of the first pay period beginning on or after the date on which a change in the definition...

  3. 43 CFR 38.3 - Administration of adjusted rates of pay.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...) Retirement deductions and benefits; (2) Life insurance premiums and benefits; (3) Premium pay; (4) Severance... rate of pay begins on the effective date of the change in official duty station. (d) An adjusted rate... first day of the first pay period beginning on or after the date on which a change in the definition...

  4. 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.

  5. 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,…

  6. 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,...

  7. 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,...

  8. Trends in age-adjusted coronary heart disease mortality rates in Slovakia between 1993 and 2009.

    PubMed

    Psota, Marek; Pekarciková, Jarmila; O'Mullane, Monica; Rusnák, Martin

    2013-06-01

    Cardiovascular diseases (CVD) and especially coronary heart disease (CHD) are the main causes of death in the Slovak Republic (SR). The aim of this study is to explore trends in age-adjusted coronary heart disease mortality rates in the whole Slovak population and in the population of working age between the years 1993 and 2009. A related indicator - potential years of life lost (PYLL) due to CHD--was calculated in the same period for males and females. Crude CHD mortality rates were age-adjusted using European standard population. The joinpoint Poisson regression was performed in order to find out the annual percentage change in trends. The age-adjusted CHD mortality rates decreased in the Slovak population and also in the population of working age. The change was significant only within the working-age sub-group. We found that partial diagnoses (myocardial infarction and chronic ischaemic heart disease) developed in the mirror-like manner. PYLL per 100,000 decreased during the observed period and the decline was more prominent in males. For further research we recommend to focus on several other issues, namely, to examine the validity of cause of death codes, to examine the development of mortality rates in selected age groups, to find out the cause of differential development of mortality rates in the Slovak Republic in comparison with the Czech Republic and Poland, and to explain the causes of decrease of the age-adjusted CHD mortality rates in younger age groups in Slovakia.

  9. Use of age-adjusted rates of suicide in time series studies in Israel.

    PubMed

    Bridges, F Stephen; Tankersley, William B

    2009-01-01

    Durkheim's modified theory of suicide was examined to explore how consistent it was in predicting Israeli rates of suicide from 1965 to 1997 when using age-adjusted rates rather than crude ones. In this time-series study, Israeli male and female rates of suicide increased and decreased, respectively, between 1965 and 1997. Conforming to Durkheim's modified theory, the Israeli male rate of suicide was lower in years when rates of marriage and birth are higher, while rates of suicide are higher in years when rates of divorce are higher, the opposite to that of Israeli women. The corrected regression coefficients suggest that the Israeli female rate of suicide remained lower in years when rate of divorce is higher, again the opposite suggested by Durkheim's modified theory. These results may indicate that divorce affects the mental health of Israeli women as suggested by their lower rate of suicide. Perhaps the "multiple roles held by Israeli females creates suicidogenic stress" and divorce provides some sense of stress relief, mentally speaking. The results were not as consistent with predictions suggested by Durkheim's modified theory of suicide as were rates from the United States for the same period nor were they consistent with rates based on "crude" suicide data. Thus, using age-adjusted rates of suicide had an influence on the prediction of the Israeli rate of suicide during this period.

  10. Biplot models applied to cancer mortality rates.

    PubMed

    Osmond, C

    1985-01-01

    "A graphical method developed by Gabriel to display the rows and columns of a matrix is applied to tables of age- and period-specific cancer mortality rates. It is particularly useful when the pattern of age-specific rates changes with time. Trends in age-specific rates and changes in the age distribution are identified as projections. Three examples [from England and Wales] are given."

  11. Optimism, social support, and adjustment in African American women with breast cancer.

    PubMed

    Shelby, Rebecca A; Crespin, Tim R; Wells-Di Gregorio, Sharla M; Lamdan, Ruth M; Siegel, Jamie E; Taylor, Kathryn L

    2008-10-01

    Past studies show that optimism and social support are associated with better adjustment following breast cancer treatment. Most studies have examined these relationships in predominantly non-Hispanic White samples. The present study included 77 African American women treated for nonmetastatic breast cancer. Women completed measures of optimism, social support, and adjustment within 10-months of surgical treatment. In contrast to past studies, social support did not mediate the relationship between optimism and adjustment in this sample. Instead, social support was a moderator of the optimism-adjustment relationship, as it buffered the negative impact of low optimism on psychological distress, well-being, and psychosocial functioning. Women with high levels of social support experienced better adjustment even when optimism was low. In contrast, among women with high levels of optimism, increasing social support did not provide an added benefit. These data suggest that perceived social support is an important resource for women with low optimism.

  12. 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

  13. 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…

  14. 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,…

  15. 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

    ... pay or salaries of the statutory pay systems (as defined in 5 U.S.C. 5302(1)), as adjusted under 5 U.S.... 3. Certain Executive, Legislative, and Judicial Salaries. The rates of basic pay or salaries for the... superseded as of the effective dates specified in section 7 of this order.Barack ObamaThe White...

  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). 417.594 Section 417.594 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS,...

  17. 78 FR 25515 - Order Making Fiscal Year 2013 Annual Adjustments to Transaction Fee Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-01

    ... COMMISSION Order Making Fiscal Year 2013 Annual Adjustments to Transaction Fee Rates I. Background Section 31... forecast ADS of 1.0178 x $252,666,501,426 = $257,167,513,594. Multiply this figure by the 20 trading days... figure by the 22 trading days in April 2013 to obtain a total dollar volume forecast of...

  18. 78 FR 52694 - Price Cap Rules for Certain Postal Rate Adjustments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-26

    ... Postal Service's Annual Compliance Report. Id. Valpak's concerns stem from the Postal Service's reporting... appear below the signature of this order. Section 3010.1 defines the terms ``annual limitation... rate adjustment authority may only be applied after applying the annual limitation. Section...

  19. Family rituals, financial burden, and mothers' adjustment in pediatric cancer.

    PubMed

    Santos, Susana; Crespo, Carla; Canavarro, M Cristina; Alderfer, Melissa A; Kazak, Anne E

    2016-12-01

    The financial burden of childhood cancer may contribute to the distress that parents experience during and after treatment. Inconsistent relationships between financial burden and parental psychological distress highlight the need to identify psychosocial factors that may moderate this relationship. In this study, we aimed to determine if family ritual meaning moderates the relationship between financial burden and anxiety and depression symptoms among mothers of children with cancer. Portuguese mothers of children with cancer on-treatment and off-treatment (N = 244) completed measures of financial burden, anxiety and depression symptoms, and family ritual meaning. Moderating effects were tested using hierarchical multiple regression analyses. Family ritual meaning buffered the effect of financial burden on anxiety, but not on depression symptoms. The relationship between financial burden and anxiety symptoms was not significant when mothers endorsed higher levels of family ritual meaning. Although preliminary, the current findings suggest that high levels of perceived family ritual meaning may constitute a protective factor against the effect of financial burden on mothers' anxiety symptoms. Promoting family ritual meaning might be an effective approach to reducing anxiety symptoms of mothers of children with cancer in the context of financial burden. (PsycINFO Database Record

  20. Cervix cancer brachytherapy: high dose rate.

    PubMed

    Miglierini, P; Malhaire, J-P; Goasduff, G; Miranda, O; Pradier, O

    2014-10-01

    Cervical cancer, although less common in industrialized countries, is the fourth most common cancer affecting women worldwide and the fourth leading cause of cancer death. In developing countries, these cancers are often discovered at a later stage in the form of locally advanced tumour with a poor prognosis. Depending on the stage of the disease, treatment is mainly based on a chemoradiotherapy followed by uterovaginal brachytherapy ending by a potential remaining tumour surgery or in principle for some teams. The role of irradiation is crucial to ensure a better local control. It has been shown that the more the delivered dose is important, the better the local results are. In order to preserve the maximum of organs at risk and to allow this dose escalation, brachytherapy (intracavitary and/or interstitial) has been progressively introduced. Its evolution and its progressive improvement have led to the development of high dose rate brachytherapy, the advantages of which are especially based on the possibility of outpatient treatment while maintaining the effectiveness of other brachytherapy forms (i.e., low dose rate or pulsed dose rate). Numerous innovations have also been completed in the field of imaging, leading to a progress in treatment planning systems by switching from two-dimensional form to a three-dimensional one. Image-guided brachytherapy allows more precise target volume delineation as well as an optimized dosimetry permitting a better coverage of target volumes.

  1. Hormone replacement therapy and breast cancer mortality in Swedish women: results after adjustment for 'healthy drug-user' effect.

    PubMed

    Yuen, J; Persson, I; Bergkvist, L; Hoover, R; Schairer, C; Adami, H O

    1993-07-01

    No change of breast cancer mortality has been reported previously after long-term hormone replacement therapy. A conceivable explanation for the apparent discrepancy between incidence and mortality may be selection bias due to lower prevalence of breast cancer in women who receive replacement hormones, compared with nonexposed women. We used a new approach to correct for bias due to this 'healthy drug-user effect,' by adjusting the external, population-based, mortality rates for such cases prevalent during the recruitment period of our cohort. In this cohort of some 23,000 Swedish women, who were prescribed various hormone replacement regimens, breast cancer mortality was analyzed after follow-up to 12 years. External analyses revealed overall standardized mortality ratios for breast cancer rising from 0.71 to 0.81, but not significantly different from unity, after adjustment procedures. In multivariate regression models, excluding prevalent cases in the cohort, women prescribed estradiol, conjugated estrogens, or an estrogen-progestin combination were not at a higher risk relative to those given other and weak estrogens, relative risks being 0.81 and 0.68, respectively. On the basis of the present analytical approach, we conclude that breast cancer mortality does not appear to be changed overall or in subgroups, despite increased incidence.

  2. 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

    ... 25 Indians 1 2012-04-01 2011-04-01 true Procedures for adjusting electric power rates to reflect..., DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN ELECTRIC POWER UTILITIES Service Fees, Electric Power Rates and Revenues § 175.13 Procedures for adjusting electric power rates to reflect changes in the cost...

  3. 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

    ... 25 Indians 1 2011-04-01 2011-04-01 false Procedures for adjusting electric power rates to reflect..., DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN ELECTRIC POWER UTILITIES Service Fees, Electric Power Rates and Revenues § 175.13 Procedures for adjusting electric power rates to reflect changes in the cost...

  4. 25 CFR 175.13 - Procedures for adjusting electric power rates to reflect changes in the cost of purchased power...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false Procedures for adjusting electric power rates to reflect..., DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN ELECTRIC POWER UTILITIES Service Fees, Electric Power Rates and Revenues § 175.13 Procedures for adjusting electric power rates to reflect changes in the cost...

  5. 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

    ... 25 Indians 1 2010-04-01 2010-04-01 false Procedures for adjusting electric power rates to reflect..., DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN ELECTRIC POWER UTILITIES Service Fees, Electric Power Rates and Revenues § 175.13 Procedures for adjusting electric power rates to reflect changes in the cost...

  6. 25 CFR 175.13 - Procedures for adjusting electric power rates to reflect changes in the cost of purchased power...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false Procedures for adjusting electric power rates to reflect..., DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN ELECTRIC POWER UTILITIES Service Fees, Electric Power Rates and Revenues § 175.13 Procedures for adjusting electric power rates to reflect changes in the cost...

  7. 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

    ... the fee rates under Sections 31(b) and (c) of the Exchange Act in fiscal years 2002 through 2011. II... 14(g)(5) of the Exchange Act require the Commission to adjust the fee rates under Sections 13(e) and... adjustment to the fee rates under Sections 13(e) and 14(g) of the Exchange Act. \\7\\ The annual...

  8. Effect of gender on psychosocial adjustment of colorectal cancer survivors with ostomy

    PubMed Central

    Poudel, Anju

    2016-01-01

    Background Stoma can pose extensive challenges for colorectal cancer survivors. Identifying the psychological and social adjustment among them and how it differs by gender will aid in identifying those particularly at risk of having poor adjustment and in planning programs to improve their adjustment. The purpose of this study was to determine the effect of gender on psychosocial adjustment of colorectal cancer survivors with ostomy. Methods A descriptive cross sectional study was carried out in the stoma clinic of B.P. Koirala Memorial Cancer Hospital, Bharatpur, Nepal. A purposive sample of 122 patients with ostomy was taken from the above mentioned setting. Selection criteria included colorectal cancer survivors having ostomy for at least 6 months. Data on socio-demographic and clinical variables were collected. Psychosocial adjustment was measured using Ostomy Adjustment Inventory-23 (OAI-23). Results A total of 122 patients were included in the study. Mean time since ostomy surgery was 2.53 and 1.98 years for men and women respectively. Both men and women had significant impairment in the psychosocial adjustment, however, men had significantly lower psychosocial adjustment score (37.68±12.96 vs. 43.45±12.81, t=−2.47, P=0.015) at 95% CI as compared to women and they reported more negative emotions. Furthermore, men significantly predicted low acceptance {β=−3.078, P=0.023, ΔR2=0.036, F [4,117] =7.90, P<0.001} and social engagement score {β=−2.501, P<0.001, ΔR2=0.098, F [4,117] =6.03, P<0.001}. Conclusions Colorectal cancer survivors with ostomy should be monitored for psychosocial concerns in regular basis and health care providers should tailor care based on their need. Approaches of survivorship care and psychosocial interventions in colorectal cancer survivors with ostomy should take into account gender specific concerns and requirements to aid adjustment. PMID:28078117

  9. Pathways for psychological adjustment in breast cancer: a longitudinal study on coping strategies and posttraumatic growth.

    PubMed

    Silva, Sónia Martins; Crespo, Carla; Canavarro, Maria Cristina

    2012-01-01

    This longitudinal study examined the role of coping strategies and posttraumatic growth (PTG) on the psychological adjustment to breast cancer trajectory. The participants were 50 women assessed at the time of surgery (T1), during adjuvant treatment (T2) and six months after the end of treatment (T3). Women completed questionnaires assessing coping strategies, PTG and psychological adjustment (psychological quality of life, anxiety and depression). Results showed that the greatest impact of breast cancer on women's adjustment occurred at T1, when patients were significantly more anxious than in the other phases of the disease. The type of surgery and adjuvant treatment did not account for the course of PTG and adjustment. Coping through seeking social support and using cognitive strategies at T1 were linked to psychological quality of life and depression at T3 via PTG dimension of personal resources and skills at T2. Findings emphasise the value of promoting adaptive coping strategies and PTG in order to improve psychological adjustment in breast cancer patients.

  10. Apparent exchange rate for breast cancer characterization.

    PubMed

    Lasič, Samo; Oredsson, Stina; Partridge, Savannah C; Saal, Lao H; Topgaard, Daniel; Nilsson, Markus; Bryskhe, Karin

    2016-05-01

    Although diffusion MRI has shown promise for the characterization of breast cancer, it has low specificity to malignant subtypes. Higher specificity might be achieved if the effects of cell morphology and molecular exchange across cell membranes could be disentangled. The quantification of exchange might thus allow the differentiation of different types of breast cancer cells. Based on differences in diffusion rates between the intra- and extracellular compartments, filter exchange spectroscopy/imaging (FEXSY/FEXI) provides non-invasive quantification of the apparent exchange rate (AXR) of water between the two compartments. To test the feasibility of FEXSY for the differentiation of different breast cancer cells, we performed experiments on several breast epithelial cell lines in vitro. Furthermore, we performed the first in vivo FEXI measurement of water exchange in human breast. In cell suspensions, pulsed gradient spin-echo experiments with large b values and variable pulse duration allow the characterization of the intracellular compartment, whereas FEXSY provides a quantification of AXR. These experiments are very sensitive to the physiological state of cells and can be used to establish reliable protocols for the culture and harvesting of cells. Our results suggest that different breast cancer subtypes can be distinguished on the basis of their AXR values in cell suspensions. Time-resolved measurements allow the monitoring of the physiological state of cells in suspensions over the time-scale of hours, and reveal an abrupt disintegration of the intracellular compartment. In vivo, exchange can be detected in a tumor, whereas, in normal tissue, the exchange rate is outside the range experimentally accessible for FEXI. At present, low signal-to-noise ratio and limited scan time allows the quantification of AXR only in a region of interest of relatively large tumors.

  11. 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,…

  12. 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…

  13. 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…

  14. Trajectories of Anxiety Among Women with Breast Cancer: A Proxy for Adjustment from Acute to Transitional Survivorship.

    PubMed

    Saboonchi, Fredrik; Petersson, Lena-Marie; Wennman-Larsen, Agneta; Alexanderson, Kristina; Vaez, Marjan

    2015-01-01

    Anxiety is one of the main components of distress among women with breast cancer (BC), particularly in the early stages of the disease. Changes in anxiety over time may reflect the process of adjustment or lack thereof. The process of adjustment in the traverse of acute to transitional stages of survivorship warrants further examination. To examine the trajectory of anxiety and the specific patterns that may indicate a lack of adjustment within 2 years following BC surgery, survey data from a 2-year prospective cohort study of 725 women with BC were analyzed by Mixture Growth Modelling and logistic regression and Analysis of Variance. A piece-wise growth curve displayed the best fit to the data, indicating a significant decrease in anxiety in the first year, followed by a slower rate of change during the second year. Four classes of trajectories were identified: High Stable, High Decrease, Mild Decrease, and Low Decrease. Of these, High Stable anxiety showed the most substantive indications of lack of adjustment. This subgroup was predominantly characterized by sociodemographic variables such as financial difficulties. Our results support an emphasis on the transitional nature of the stage that follows the end of primary active treatment and imply a need for supportive follow up care for those who display lack of adjustment at this stage.

  15. Contrast material injection protocol with the flow rate adjusted to the heart rate for dual source CT coronary angiography.

    PubMed

    Zhu, Xiaomei; Chen, Wenping; Li, Mei; Xu, Yi; Xu, Hai; Zhu, Yinsu; Wang, Dehang; Tang, Lijun

    2012-08-01

    To investigate the effect on coronary arterial attenuations of contrast material flow rate adjusted to a patient's heart rate during dual source CT coronary angiography (DSCT-CCTA). A total of 296 consecutive patients (mean age: 58.7 years) undergoing DSCT-CCTA without previous coronary stent placement, bypass surgery, congenital or valvular heart disease were included. The image acquisition protocol was standardized (120 kV, 380 mAs) and retrospective electrocardiograph (ECG) gating was used. Patients were randomly assigned to one of three groups [flow rate: G1: dosage/16, G2: dosage/(scan time +8), G3: fixed flow rate]. The groups were compared with respect to the attenuations of the ascending aorta (AA) above coronary ostia, the left main coronary artery (LM), the proximal right coronary artery (RCA), the left anterior descending artery (LAD), the left circumflex artery (LCX), and the contrast to noise ratio of the LM (LM(CNR)) and the proximal RCA (RCA(CNR)). Correlations between heart rate and attenuation of the coronary arteries were evaluated in three groups with linear regression. There was no significant difference in the three groups among the mean attenuations of AA (P = 0.141), LM (P = 0.068), RCA (P = 0.284), LM(CNR) (P = 0.598) and RCA(CNR) (P = 0.546). The attenuations of the LAD and the LCX in group 1 were slightly higher than those in group 2 and 3 (P < 0.05). In group 1, the attenuations of the AA (P < 0.01), LM (P < 0.01), RCA (P < 0.01), LAD (P = 0.02) and LCX (P < 0.01) decreased, respectively, with an increasing heart rate. A similar finding was detected in group 3 (AA: P < 0.01, LM: P < 0.01, RCA: P < 0.01, LAD: P < 0.01 and LCX: P < 0.01). In contrast, the attenuations of the AA (P = 0.55), LM (P = 0.27), RCA (P = 0.77), LAD (P = 0.22) and LCX (P = 0.74) had no significant correlation with heart rate in group 2. In all three groups, LM(CNR) (P = 0.77, 0.69 and 0.73 respectively) and RCA(CNR) (P = 0.75, 0.39 and 0.61 respectively) had no

  16. 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…

  17. Designing and Psychometric Evaluation of Adjustment to Illness Measurement Inventory for Iranian Women With Breast Cancer

    PubMed Central

    Hajian, Sepideh; Mehrabi, Esmat; Simbar, Masoumeh; Houshyari, Mohammad; Zayeri, Farid; Hajian, Parastoo

    2016-01-01

    Background Cancer diagnosis for everybody may be perceived as crisis and breast cancer, as the most common malignancy in women, can influence their well-being and multiple aspects of their health. So understanding that how women in various contexts and communities adjust to the illness is necessary to facilitate this adjustment and improve their quality of life. Objectives The aim of this study was to: 1) identify the core components of coping strategies to adjust to the illness in Iranian women with breast cancer perspective, 2) to develop and determine psychometric properties of a native self-report instrument to assess coping behaviors and measure the degree of adjustment with the breast cancer. Methods The present exploratory mixed method study was conducted in two consecutive stages: 1) the hermeneutic phenomenological study was done to explore the life experiences of coping styles to adjust with the breast cancer using in-depth interviews with patients that lead to item generation; 2) psychometric properties (validity and reliability) of the instrument were evaluated recruiting 340 eligible women. The item pool was reduced systematically and resulted in a 49-item instrument. Results From the qualitative stage, item pool containing 78 items related to coping strategies to adjust with the breast cancer. After eliminating unwanted statements from the results, qualitative and quantitative face and content validity, the 10 factors extracted employing construct validity were: feeling of guilt, abstention-diversion, role preservation and seeking support, efforts for threat control, confronting, fear and anxiety, role wasting, maturation and growth, isolation, and fatalism. These factors accounted for the 59.1% of variance observed. The Cronbach reliability test was carried out and alpha value of 10 factors was calculated from 0.78 to 0.87 confirming all factors were internally consistent. The scale’s stability was tested using the test-retest method. Conclusions

  18. 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...

  19. Convergent Validity of the IPAT Children's Personality Questionnaire and Teacher's Ratings of the Adjustment of Elementary School Children

    ERIC Educational Resources Information Center

    Lessing, Elise E.; Barbera, Linda

    1974-01-01

    The IPAT Children's Personality Questionnaire was administered to two samples of white American school children. Both samples were divided into well-adjusted and maladjusted subgroups on the basis of teacher ratings. The CPQ Neuroticism score and the teacher ratings of adjustment status yielded biserial correlations of 0.12 and 0.22. (Author)

  20. Convergent Validity of the IPAT Children's Personality Questionnaire and Teachers' Ratings of the Adjustment of Elementary School Children.

    ERIC Educational Resources Information Center

    Lessing, Elise E.; And Others

    The IPAT Children's Personality Questionnaire was administered to two samples of white, middle-class, suburban school children. Both samples were divided into well-adjusted and maladjusted subgroups on the basis of teacher ratings. The CPQ Neuroticism score and the teacher ratings of adjustment status yielded biserial correlations of .12 and .22,…

  1. Returning to work: The cancer survivor’s transformational journey of adjustment and coping

    PubMed Central

    Barnard, Antoni; Clur, Loraine; Joubert, Yvonne

    2016-01-01

    The aim of this study was to explore cancer survivors’ return to work (RTW) experience with a specific focus on the adjustment and coping process underlying their journey. The study was conducted in the Southern Cape, South Africa, with eight cancer survivors having returned to work following successful treatment of various types of cancer. Unstructured interviews were conducted and data were analysed following the principles of hermeneutic phenomenological reflection and analysis. Four themes emerged, representing the changing adjustment responses and coping during the RTW journey. Participants evolve from being overwhelmed with emotions and applying avoidant coping to seeking understanding and positive affectivity in their attempt to comprehend the reality of their situation. Participants’ external locus of control change to a more active approach and problem-solving orientation, demonstrating a need to take control and responsibility. Ultimately, adjustment and coping become most constructive when cancer survivors resolve to re-assess life and self through meaning-making, resulting in renewed appreciation of life, appropriate life style changes, and regained confidence in their relational role. A process perspective is proposed to facilitate an understanding of, and working with, cancer survivors’ transition through the RTW journey towards optimal coping phases. PMID:27852419

  2. Capture-recapture-adjusted prevalence rates of type 2 diabetes are related to social deprivation.

    PubMed

    Ismail, A A; Beeching, N J; Gill, G V; Bellis, M A

    1999-12-01

    We examined the prevalence of type 2 diabetes and social deprivation in one urban district in Liverpool from October 1995 to September 1996 inclusive. This area has a stable Caucasian population of 176, 682. Lists were made of all known diabetics attending six different medical points of contact during the year, and were condensed and aggregated to eliminate duplicates. From postcode data, each patient was assigned to residence in one of the 14 electoral wards in the district, for which demographic structure and standardized measures of social deprivation were known (Townsend index). The crude period prevalences of type 1 and type 2 diabetes were estimated for each ward. Crude prevalence data were then corrected by applying capture-recapture (CR) techniques to the different patient datasets to allow for undercount. The crude period prevalence (95%CI) of diabetes was 1.5% (1.4-1.5%), or 2585/176, 682. The mean age of people with diabetes was not significantly different between electoral wards. The crude period prevalence of type 2 diabetes within individual wards ranged from 0.4% (0.3-0.6%) in the least deprived area to 4.1% (3.6-4.6%) in the most deprived area. The corresponding range of CR-adjusted period prevalence rates of type 2 diabetes was from 3.2% (2.8-3.6%) to 6.7% (6.1-7.4%), and there was strong correlation between both crude and CR-adjusted prevalence and social deprivation in each ward (r=0.76, p<0.001 for crude; and r=0. 49, p<0.005 for CR-adjusted prevalence). There was no correlation between the crude or CR-adjusted period prevalence rates of type 1 diabetes and Townsend index (r=0.14, p=NS). This strong correlation between the prevalence of type 2 diabetes and social deprivation has important implications for the planning of health-care delivery.

  3. 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

    ... Mortgages (ARMs) Rates AGENCY: Office of Single Family Program Development, HUD. ACTION: Notice. SUMMARY... FURTHER INFORMATION CONTACT: Joanne Kuzma, Director, Office of Single Family Program Development... adjustable- rate mortgage ARM consistent with the disclosure requirements applicable to variable...

  4. Coping with early breast cancer: couple adjustment processes and couple-based intervention.

    PubMed

    Naaman, Sandra; Radwan, Karam; Johnson, Susan

    2009-01-01

    Early breast cancer affects one in every nine women along with their families. Advances in screening and biomedical interventions have changed the face of breast cancer from a terminal condition to a chronic disease with biopsychosocial features. The present review surveyed the nature and extent of psychological morbidity experienced by the breast cancer survivor and her spouse during the post-treatment phase, with particular focus on the impact of disease on the marital relationship. Interpersonal processes shown to unfold in couples facing breast cancer, as well as risk factors associated with greater psychological morbidity, were reviewed. Moreover, interpersonal processes central to coping with chronic illness and adjustment were reconceptualized from the point of view of attachment theory. Attachment theory was also used as the grounding framework for an empirically supported couples-based intervention, Emotionally Focused Therapy, which is advanced as a potentially useful treatment option for couples experiencing unremitting psychological and relational distress following diagnosis and treatment for breast cancer.

  5. 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.

  6. Radial and tangential gravity rates from GRACE in areas of glacial isostatic adjustment

    NASA Astrophysics Data System (ADS)

    van der Wal, Wouter; Kurtenbach, Enrico; Kusche, Jürgen; Vermeersen, Bert

    2011-11-01

    In areas dominated by Glacial Isostatic Adjustment (GIA), the free-air gravity anomaly rate can be converted to uplift rate to good approximation by using a simple spectral relation. We provide quantitative comparisons between gravity rates derived from monthly gravity field solutions (GFZ Potsdam, CSR Texas, IGG Bonn) from the Gravity Recovery and Climate Experiment (GRACE) satellite mission with uplift rates measured by GPS in these areas. The band-limited gravity data from the GRACE satellite mission can be brought to very good agreement with the point data from GPS by using scaling factors derived from a GIA model (the root-mean-square of differences is 0.55 mm yr-1 for a maximum uplift rate signal of 10 mm yr-1). The root-mean-square of the differences between GRACE derived uplift rates and GPS derived uplift rates decreases with increasing GRACE time period to a level below the uncertainty that is expected from GRACE observations, GPS measurements and the conversion from gravity rate to uplift rate. With the current length of time-series (more than 8 yr) applying filters and a hydrology correction to the GRACE data does not reduce the root-mean-square of differences significantly. The smallest root-mean-square was obtained with the GFZ solution in Fennoscandia and with the CSR solution in North America. With radial gravity rates in excellent agreement with GPS uplift rates, more information on the GIA process can be extracted from GRACE gravity field solutions in the form of tangential gravity rates, which are equivalent to a rate of change in the deflection of the vertical scaled by the magnitude of gravity rate vector. Tangential gravity rates derived from GRACE point towards the centre of the previously glaciated area, and are largest in a location close to the centre of the former ice sheet. Forward modelling showed that present day tangential gravity rates have maximum sensitivity between the centre and edge of the former ice sheet, while radial gravity

  7. 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.

  8. Psychosocial adjustment and marital intimacy among partners of patients with breast cancer: a comparison study with partners of healthy women.

    PubMed

    Moreira, Helena; Canavarro, Maria Cristina

    2013-01-01

    This cross-sectional study investigated the psychosocial adjustment of 70 partners of patients with breast cancer by comparing their emotional adjustment and quality of life (QoL) with 70 partners of women without cancer. The role of marital intimacy in their adjustment and the moderating effect of group type were analyzed. The partners of patients with breast cancer presented higher levels of anxious and depressive symptomatology; poor social, psychological, general and physical QoL; and higher levels of intimacy. The moderation analysis showed that higher levels of intimacy predicted lower levels of depression and anxiety and greater QoL only among the partners of cancer patients.

  9. Maryland's high cancer mortality rate: a review of contributing demographic factors.

    PubMed

    Freedman, D M

    1999-01-01

    For many years, Maryland has ranked among the top states in cancer mortality. This study analyzed mortality data from the National Center for Health Statistics (CDC-Wonder) to help explain Maryland's cancer rate and rank. Age-adjusted rates are based on deaths per 100,000 population from 1991 through 1995. Rates and ranks overall, and stratified by age, are calculated for total cancer mortality, as well as for four major sites: lung, breast, prostate, and colorectal. Because states differ in their racial/gender mix, race/gender rates among states are also compared. Although Maryland ranks seventh in overall cancer mortality, its rates and rank by race and gender subpopulation are less high. For those under 75, white men ranked 26th, black men ranked 20th, and black and white women ranked 12th and 10th, respectively. Maryland's overall rank, as with any state, is a function of the rates of its racial and gender subpopulations and the relative size of these groups in the state. Many of the disparities between Maryland's overall high cancer rank and its lower rank by subpopulation also characterize the major cancer sites. Although a stratified presentation of cancer rates and ranks may be more favorable to Maryland, it should not be used to downplay the attention cancer mortality in Maryland deserves.

  10. Negative support of significant others affects psychological adjustment in breast cancer patients.

    PubMed

    Shiozaki, Mariko; Hirai, Kei; Koyama, Atsuko; Inui, Hiroki; Yoshida, Rika; Tokoro, Akihiro

    2011-11-01

    Significant others play an important role in providing support in patients' lives, but some types of support negatively affect the patients. This study was conducted in early-stage breast cancer patients to examine the structure of support, which was provided by their significant others and assessed negatively by the patients, and to identify negative support relating to the psychological adjustment of these patients. Thus, we first conducted interviews among 28 breast cancer patients to identify these support items assessed as negative; next, we conducted a questionnaire survey using the resulting items in 109 postoperative patients who had early-stage breast cancer. We performed exploratory and confirmatory factor analyses and obtained a valid second-order factor structure, including superordinate factors (excessive engagement, avoidance of problems and underestimation) and subordinate factors (overprotection, encouragement and management). Among these factors, the avoidance of problems was the only factor to be negatively associated with psychological adjustment of the patients, suggesting that these patients receive problem-avoiding support. The results of our study suggest that such problem-avoiding support from significant others can be counter-productive and potentially worsen the psychological adjustment of breast cancer patients.

  11. Stress and self-efficacy predict psychological adjustment at diagnosis of prostate cancer

    PubMed Central

    Curtis, Ruth; Groarke, AnnMarie; Sullivan, Frank

    2014-01-01

    Prostate cancer is the most frequently non-skin cancer diagnosed among men. Diagnosis, a significant burden, generates many challenges which impact on emotional adjustment and so warrants further investigation. Most studies to date however, have been carried out at or post treatment with an emphasis on functional quality of life outcomes. Men recently diagnosed with localised prostate cancer (N = 89) attending a Rapid Access Prostate Clinic to discuss treatment options completed self report questionnaires on stress, self-efficacy, and mood. Information on age and disease status was gathered from hospital records. Self-efficacy and stress together explained more than half of the variance on anxiety and depression. Self-efficacy explained variance on all 6 emotional domains of the POMS (ranging from 5–25%) with high scores linked to good emotional adjustment. Perceived global and cancer specific stress also explained variance on the 6 emotional domains of the POMS (8–31%) with high stress linked to poor mood. These findings extend understanding of the role of efficacy beliefs and stress appraisal in predicting emotional adjustment in men at diagnosis and identify those at risk for poor adaptation at this time. Such identification may lead to more effective patient management. PMID:24993798

  12. Interdependent Psychological Quality of Life in Dyads Adjusting to Prostate Cancer

    PubMed Central

    Segrin, Chris; Badger, Terry A.; Harrington, Joanne

    2013-01-01

    Objective Prostate cancer negatively influences quality of life (QOL) in survivors and the people with whom they are close. The purpose of this investigation was to assess the degree of dyadic interdependence in psychological QOL in dyads adjusting to prostate cancer and its treatment. Method Participants were 70 prostate cancer survivors and their partners, most of whom were spouses. Assessments of psychological QOL (i.e., depression, anxiety, fatigue, and positive affect) were made at three points in time, each separated by 8 weeks. Results Survivors’ prostate specific function was associated with both their own and their partners’ psychological QOL. There was evidence of longitudinal dyadic interdependence for psychological QOL, particularly from partners to survivors between the T2 and T3 assessments. Conclusions Prostate cancer survivors’ psychological QOL is affected substantially by their partners’ psychological QOL, consistent with theories of emotional contagion. PMID:21895374

  13. Health-related quality of life and life satisfaction in colorectal cancer survivors: trajectories of adjustment

    PubMed Central

    2013-01-01

    Background This longitudinal study describes the five year trajectories of health-related quality of life (HR-QOL) and life satisfaction in long term colorectal cancer survivors. Patients and methods A population-based sample of 1966 colorectal cancer survivors were surveyed at six time points from five months to five years post-diagnosis. Predictor variables were: socio-demographic variables, optimism; cancer threat appraisal; perceived social support. Quality of life was assessed with the Functional Assessment of Cancer Therapy-Colorectal (HR-QOL); and the Satisfaction with Life Scale. Growth mixture models were applied to identify trajectory classes and their predictors. Results Distinct adjustment trajectories were identified for HR-QOL and life satisfaction. Lower optimism, poorer social support, a more negative cognitive appraisal, and younger age were associated with poorer life satisfaction, while survivors with less than 8 years of education had higher life satisfaction. This pattern was similar for overall HR-QOL except that educational level was not a significant predictor and later stage disease and female gender emerged as related to poorer outcomes. One in five survivors reported poorer constant HR-QOL (19.2%) and a small group had poor life satisfaction (7.2%); 26.2% reported constant high HR-QOL and 48.8% had high constant life satisfaction. Socioeconomic disadvantage and remoteness of residence uniquely predicted poorer outcomes in the colorectal cancer specific HR-QOL sub domain. Conclusion Although HR-QOL and subjective cognitive QOL share similar antecedents their trajectory patterns suggested they are distinct adjustment outcomes; with life satisfaction emerging as temporally stable phenomenon. Unique patterns of risk support suggest the need to account for heterogeneity in adjustment in longitudinal QOL studies with cancer survivors. PMID:23497387

  14. 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

  15. Race Adjustment for Estimating Glomerular Filtration Rate Is Not Always Necessary

    PubMed Central

    Zanocco, Juliana A.; Nishida, Sonia K.; Passos, Michelle Tiveron; Pereira, Amélia Rodrigues; Silva, Marcelo S.; Pereira, Aparecido B.; Kirsztajn, Gianna Mastroianni

    2012-01-01

    Background Estimated glomerular filtration rate (eGFR) is very important in clinical practice, although it is not adequately tested in different populations. We aimed at establishing the best eGFR formulas for a Brazilian population with emphasis on the need for race correction. Methods We evaluated 202 individuals with chronic kidney disease (CKD) and 42 without previously known renal lesions that were additionally screened by urinalysis. Serum creatinine and plasma clearance of iohexol were measured in all cases. GFR was estimated by the Mayo Clinic, abbreviated Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formulas, and creatinine clearance was estimated by the Cockcroft-Gault (CG) formula. Plasma clearance of iohexol was used as the gold standard for GFR determination and for the development of a Brazilian formula (BreGFR). Results Measured and estimated GFR were compared in 244 individuals, 57% female, with a mean age of 41 years (range 18–82). Estimates of intraclass correlation coefficients among the plasma clearance of iohexol and eGFR formulas were all significant (p < 0.001) and corresponded to the following scores: CG 0.730; obesity-adjusted CG 0.789; Mayo Clinic 0.804; MDRD 0.848; MDRD1 (without race adjustment) 0.846; CKD-EPI 0.869; CKD-EPI1 (without race adjustment) 0.876, and BreGFR 0.844. Conclusions All cited eGFR formulas showed a good correlation with the plasma clearance of iohexol in the healthy and diseased conditions. The formulas that best detected reduced eGFR were the BreGFR, CKD-EPI, and CKD-EPI1 formulas. Notably, the race correction included in the MDRD and CKD-EPI formulas was not necessary for this population, as it did not contribute to more accurate results. PMID:23243414

  16. Age adjustment in ecological studies: using a study on arsenic ingestion and bladder cancer as an example

    PubMed Central

    2011-01-01

    Background Despite its limitations, ecological study design is widely applied in epidemiology. In most cases, adjustment for age is necessary, but different methods may lead to different conclusions. To compare three methods of age adjustment, a study on the associations between arsenic in drinking water and incidence of bladder cancer in 243 townships in Taiwan was used as an example. Methods A total of 3068 cases of bladder cancer, including 2276 men and 792 women, were identified during a ten-year study period in the study townships. Three methods were applied to analyze the same data set on the ten-year study period. The first (Direct Method) applied direct standardization to obtain standardized incidence rate and then used it as the dependent variable in the regression analysis. The second (Indirect Method) applied indirect standardization to obtain standardized incidence ratio and then used it as the dependent variable in the regression analysis instead. The third (Variable Method) used proportions of residents in different age groups as a part of the independent variables in the multiple regression models. Results All three methods showed a statistically significant positive association between arsenic exposure above 0.64 mg/L and incidence of bladder cancer in men and women, but different results were observed for the other exposure categories. In addition, the risk estimates obtained by different methods for the same exposure category were all different. Conclusions Using an empirical example, the current study confirmed the argument made by other researchers previously that whereas the three different methods of age adjustment may lead to different conclusions, only the third approach can obtain unbiased estimates of the risks. The third method can also generate estimates of the risk associated with each age group, but the other two are unable to evaluate the effects of age directly. PMID:22014275

  17. Modelling the rate of change in a longitudinal study with missing data, adjusting for contact attempts.

    PubMed

    Akacha, Mouna; Hutton, Jane L

    2011-05-10

    The Collaborative Ankle Support Trial (CAST) is a longitudinal trial of treatments for severe ankle sprains in which interest lies in the rate of improvement, the effectiveness of reminders and potentially informative missingness. A model is proposed for continuous longitudinal data with non-ignorable or informative missingness, taking into account the nature of attempts made to contact initial non-responders. The model combines a non-linear mixed model for the outcome model with logistic regression models for the reminder processes. A sensitivity analysis is used to contrast this model with the traditional selection model, where we adjust for missingness by modelling the missingness process. The conclusions that recovery is slower, and less satisfactory with age and more rapid with below knee cast than with a tubular bandage do not alter materially across all models investigated. The results also suggest that phone calls are most effective in retrieving questionnaires.

  18. Assessment of pain, acceptance of illness, adjustment to life with cancer, and coping strategies in colorectal cancer patients

    PubMed Central

    Religioni, Urszula; Deptała, Andrzej; Walewska-Zielecka, Bożena

    2015-01-01

    Introduction Every year more than 15,000 newly diagnosed cases of colorectal carcinoma are recorded in Poland. Aim The objective of the study was an assessment of coping strategies and pain management, acceptance of illness, and adjustment to cancer in patients diagnosed with colorectal carcinoma. The analysis was extended to include the effect of socioeconomic variables on the above-mentioned issues. Material and methods The study included 238 colorectal cancer patients treated on an outpatient basis at the Centre of Oncology, the Maria Skłodowska-Curie Institute in Warsaw in the year 2013. The questionnaire interview comprised demographic questions (socioeconomic variables) and the following four psychometric tests: BPCQ (Beliefs about Pain Control Questionnaire), CSQ (Coping Strategies Questionnaire), AIS questionnaire (Acceptance of Illness Scale), and the Mini-Mac scale (Mental Adjustment to Cancer). Results The source of pain control depends on the respondent's level of education. An increase in patient income was associated with a lower mean result in the “power of doctors” subscale. The coping self-statements and increased behavioural activity are the two most frequently selected strategies of coping with pain. The most commonly followed ways of mental adjustment to cancer in the study group were a fighting spirit (23.42) and positive re-evaluation (22.31). Conclusions Colorectal cancer patients believe that the greatest role in pain management is played by internal factors. The locus of pain control depends on the level of education. The study patients feature a constructive way of struggling with disease differentiated by the place of residence, professional status, and income. PMID:27350836

  19. Contextual, Ecological and Organizational Variations in Risk-Adjusted COPD and Asthma Hospitalization Rates of Rural Medicare Beneficiaries.

    PubMed

    Wan, Thomas T H; Lin, Yi-Ling; Ortiz, Judith

    2016-01-01

    The purpose of this study is to examine what factors contributing to the variability in chronic obstructive pulmonary disorder (COPD) and asthma hospitalization rates when the influence of patient characteristics is being simultaneously considered by applying a risk adjustment method. A longitudinal analysis of COPD and asthma hospitalization of rural Medicare beneficiaries in 427 rural health clinics (RHCs) was conducted utilizing administrative data and inpatient and outpatient claims from Region 4. The repeated measures of risk-adjusted COPD and asthma admission rate were analyzed by growth curve modeling. A generalized estimating equation (GEE) method was used to identify the relevance of selected predictors in accounting for the variability in risk-adjusted admission rates for COPD and asthma. Both adjusted and unadjusted rates of COPD admission showed a slight decline from 2010 to 2013. The growth curve modeling showed the annual rates of change were gradually accentuated through time. GEE revealed that a moderate amount of variance (marginal R(2) = 0.66) in the risk-adjusted hospital admission rates for COPD and asthma was accounted for by contextual, ecological, and organizational variables. The contextual, ecological, and organizational factors are those associated with RHCs, not hospitals. We cannot infer how the variability in hospital practices in RHC service areas may have contributed to the disparities in admissions. Identification of RHCs with substantially higher rates than an average rate can portray the need for further enhancement of needed ambulatory or primary care services for the specific groups of RHCs. Because the risk-adjusted rates of hospitalization do not very by classification of rural area, future research should address the variation in a specific COPD and asthma condition of RHC patients. Risk-adjusted admission rates for COPD and asthma are influenced by the synergism of multiple contextual, ecological, and organizational factors

  20. 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

    ... 48 Federal Acquisition Regulations System 2 2014-10-01 2014-10-01 false Construction Wage Rate... PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 52.222-30 Construction Wage Rate Requirements... clause: Construction Wage Rate Requirements—Price Adjustment (None or Separately Specified Method)...

  1. 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

  2. 12 CFR 747.1001 - Adjustment of civil money penalties by the rate of inflation.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Inflation Adjustment Act of 1990 (Pub. L. 101-410, 104 Stat. 890, as amended (28 U.S.C. 2461 note)) to... 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...

  3. Breast Cancer Rates by Race and Ethnicity

    MedlinePlus

    ... black, Hispanic, Asian/Pacific Islander (A/PI), and American Indian/Alaska Native (AI/AN) women. Sources: CDC’s National Program of Cancer Registries and National Cancer Institute’s Surveillance, ...

  4. 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

  5. Trends in Gastrointestinal Cancer Mortality Rate in Hungary.

    PubMed

    Farkas, Klaudia; Szűcs, Mónika; Nyári, Tibor András

    2016-10-01

    The aim of this study was to investigate the annual death trends for gastrointestinal cancer in Hungary between 1963 and 2012. Data on the numbers of cancer deaths were obtained from the published nationwide population register. Numbers of deaths from esophageal, gastric and colorectal cancer were available during the study period. However, the mortality data for hepatic, pancreatic and gallbladder cancer have been published only since 1979. Joinpoint regression was applied to investigate the annual trends in the rates of cancer mortality. The annual mortality rates of gastric and gallbladder cancer decreased throughout the study period. Furthermore, declines in mortality from esophageal and hepatic cancers have been observed since 1998 and 1995, respectively. However, the rates of colorectal and pancreatic cancer mortality have been increasing in the past few years. Nevertheless, the mortality rates of colorectal and pancreatic cancers have increased in males aged 40-59 years during the study period. Moreover, significantly higher risks of gastrointestinal cancer-related deaths have been observed in males as compared with females except for death related to cancer of the gallbladder. The presented data suggest that the Hungarian mortality rates are particularly high. The detection of gastrointestinal cancers at an early stage would significantly improves the outcome of these malignancies.

  6. ‘I–We’ boundary fluctuations in couple adjustment to rectal cancer and life with a permanent colostomy

    PubMed Central

    McCarthy, Molly; Fergus, Karen; Miller, Debbie

    2016-01-01

    This study investigates couples’ adjustment to rectal cancer and a colostomy using the ‘Classification System of Couple Adjustment to Cancer’, a framework delineating fluctuations in couples’ sense of ‘I’ and ‘We’ in response to cancer. Nine couples affected by rectal cancer and adjusting to life with a colostomy were interviewed. A theoretical thematic analysis of the transcripts was conducted; nearly all ‘I–We’ shifts of the Classification System of Couple Adjustment to Cancer were observed – often in unique ways in response to rectal cancer–specific challenges – and one new shift was described. The results provide a novel and experientially grounded means of conceptualizing complex dyadic coping processes. PMID:28070388

  7. Anger toward God: social-cognitive predictors, prevalence, and links with adjustment to bereavement and cancer.

    PubMed

    Exline, Julie J; Park, Crystal L; Smyth, Joshua M; Carey, Michael P

    2011-01-01

    Many people see themselves as being in a relationship with God and see this bond as comforting. Yet, perceived relationships with God also carry the potential for experiencing anger toward God, as shown here in studies with the U.S. population (Study 1), undergraduates (Studies 2 and 3), bereaved individuals (Study 4), and cancer survivors (Study 5). These studies addressed 3 fundamental issues regarding anger toward God: perceptions and attributions that predict anger toward God, its prevalence, and its associations with adjustment. Social-cognitive predictors of anger toward God paralleled predictors of interpersonal anger and included holding God responsible for severe harm, attributions of cruelty, difficulty finding meaning, and seeing oneself as a victim. Anger toward God was frequently reported in response to negative events, although positive feelings predominated. Anger and positive feelings toward God showed moderate negative associations. Religiosity and age correlated negatively with anger toward God. Reports of anger toward God were slightly lower among Protestants and African Americans in comparison with other groups (Study 1). Some atheists and agnostics reported anger involving God, particularly on measures emphasizing past experiences (Study 2) and images of a hypothetical God (Study 3). Anger toward God was associated with poorer adjustment to bereavement (Study 4) and cancer (Study 5), particularly when anger remained unresolved over a 1-year period (Study 5). Taken together, these studies suggest that anger toward God is an important dimension of religious and spiritual experience, one that is measurable, widespread, and related to adjustment across various contexts and populations.

  8. Situational and dispositional goal adjustment in the context of metastatic cancer.

    PubMed

    Thompson, Elizabeth; Stanton, Annette L; Bower, Julienne E

    2013-10-01

    Striving toward goals is associated with higher levels of subjective well-being; however, many potential roadblocks to goal achievement exist. The current study extends the understanding of goal regulation processes in its examination of the relationships between dispositional and situational goal adjustment to a profound stressor and their associations with psychological adjustment. Women (N = 103; M age = 57.2 years; 82% Caucasian) with metastatic breast cancer completed semistructured interviews and self-report measures at study entry and 3 months later. Measures of dispositional and situational goal reengagement were significantly correlated, but dispositional and situational goal disengagement were unrelated. Greater dispositional and situational goal disengagement abilities were associated with fewer cancer-related intrusive thoughts at Time 1. Dispositional and situational reengagement were positively associated with life satisfaction and sense of purpose and negatively associated with depressive symptoms at Time 1. However, greater initial situational goal disengagement predicted an increase in depressive symptoms over time. Both how an individual typically responds to goal blockage, as well as how an individual is currently responding to a specific blocked goal, appear related to psychological adjustment.

  9. 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…

  10. The Role of Coping and Temperament in the Adjustment of Children with Cancer

    PubMed Central

    Miller, Kimberly S.; Vannatta, Kathryn; Compas, Bruce E.; Vasey, Michael; McGoron, Katie D.; Salley, Christina G.

    2009-01-01

    Objective To examine the extent to which stress, coping, and temperament accounted for variability in adjustment among children with cancer. Methods Seventy-five mothers of children with cancer (ages 5–17) completed questionnaires regarding their child's cancer-related stress; coping; temperament characteristics including positive affect (PA), negative affect (NA), and effortful control (EC); and symptoms of anxiety and depression. Assessments occurred within one year of initial diagnosis or relapse (M = 5.74 months; SD = 4.72). Results Cancer-related stress was positively associated with symptoms of depression in children. NA was positively associated with symptoms of anxiety and depression. Primary control coping moderated the association between NA and depression, and primary and secondary control coping mediated this association. Conclusion Results partially support the utility of an integrated model including cancer-related stress, coping, and NA in identifying children at risk for internalizing symptoms during treatment. Additional research is needed to inform interventions for this population. PMID:19451171

  11. 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

  12. 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

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

    PubMed

    2016-07-01

    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.

  14. 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.

  15. 39 CFR 3010.13 - Proceedings for Type 1-A and Type 1-B rate adjustment filings.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... rate adjustments are found consistent with applicable law by the Commission, they may take effect... with applicable law by the Commission, the Postal Service will submit an amended notice of rate... 39 Postal Service 1 2012-07-01 2012-07-01 false Proceedings for Type 1-A and Type 1-B...

  16. 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

    ... 6 Adjustment of Appendices to the Dairy Tariff-Rate Import Quota Licensing Regulation for the 2011... sets forth the revised appendices to the Dairy Tariff-Rate Import Quota Licensing Regulation for the... dairy product import licenses permanently surrendered by licensees or revoked by the Licensing...

  17. 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

    ... 6 Adjustment of Appendices to the Dairy Tariff-Rate Import Quota Licensing Regulation for the 2010... sets forth the revised appendices to the Dairy Tariff-Rate Import Quota Licensing Regulation for the... dairy product import licenses permanently surrendered by licensees or revoked by the Licensing...

  18. 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...

  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. State-level Uterine Corpus Cancer Incidence Rates Corrected for Hysterectomy Prevalence, 2004-2008

    PubMed Central

    Siegel, Rebecca L.; Devesa, Susan S.; Cokkinides, Vilma; Ma, Jiemin; Jemal, Ahmedin

    2012-01-01

    Background The interpretation of uterine cancer rates is hindered by the inclusion of women whose uterus has been surgically removed in the population at risk. Hysterectomy prevalence varies widely by state and race/ethnicity, exacerbating this issue. Methods We estimated hysterectomy-corrected, age-adjusted uterine corpus cancer incidence rates by race/ethnicity for 49 states and the District of Columbia during 2004-2008 using case counts obtained from population-based cancer registries; population data from the U.S. Census Bureau; and hysterectomy prevalence data from the Behavioral Risk Factor Surveillance System. Corrected and uncorrected incidence rates were compared with regard to geographic and racial/ethnic disparity patterns and the association with obesity. Results Among non-Hispanic whites, uterine cancer incidence rates (per 100,000 woman-years) uncorrected for hysterectomy prevalence ranged from 17.1 in Louisiana to 32.1 in New Jersey, mirrored regional hysterectomy patterns, and were not correlated with obesity prevalence (Pearson’s correlation coefficient, r = 0.06, two-sided p = 0.68). In comparison, hysterectomy-corrected rates were higher by 30% (District of Columbia) to more than 100% (Mississippi, Louisiana, Alabama, and Oklahoma), displayed no discernible geographic pattern, and were moderately associated with obesity (r = 0.37, two-sided p = 0.009). For most states, hysterectomy correction diminished or reversed the black/white deficit and accentuated the Hispanic/white deficit. Conclusion Failure to adjust uterine cancer incidence rates for hysterectomy prevalence distorts true geographic and racial patterns and substantially underestimates the disease burden, particularly for Southern states. Impact Correction for hysterectomy is necessary for the accurate evaluation of uterine cancer rates. PMID:23125334

  1. Partner's adjustment to breast cancer: a critical analysis of intervention studies.

    PubMed

    Cochrane, Barbara B; Lewis, Frances Marcus

    2005-05-01

    Partners of breast cancer patients do not have resources available for dealing with their concerns. An analysis of intervention studies with partners was conducted, spanning research published from 1966 to 2004. Although there is considerable descriptive research documenting the need for partner interventions in the context of breast cancer, only 4 studies met criteria for inclusion in this analysis. Two studies reported limited intervention efficacy, but none incorporated all characteristics of a rigorous clinical trial with adequate power to fully test the intervention. Future intervention research should incorporate randomized, controlled clinical trial designs; have adequate statistical power; clearly report eligibility criteria; delineate theoretically based, fully explicated, and consistently delivered interventions; and use outcome measures that are sensitive to empirically derived partner-adjustment issues.

  2. 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

  3. Adjusted and unadjusted energy usage rates both determine body fat and plasma leptin in male Fischer 344 rats.

    PubMed

    Greenberg, J A; Rahman, S; Saint-Preux, S; Owen, D R; Boozer, C N

    1999-10-01

    Previous studies of the relationship between plasma leptin and energy usage have yielded contradictory findings. The present study was therefore conducted to clearly distinguish and measure the energy usage rate and the energy usage rate adjusted for a surrogate of metabolically active tissue mass. We investigated the simultaneous relationships between these two measures of energy usage, leptin, and body fat in 21-month-old adult male Fischer 344 rats on three different long-term dietary regimens: (1) continuous ad libitum feeding (Ad-lib); (2) ad libitum feeding until early adulthood, and then continuous 60% caloric restriction (CR); and (3) ad libitum feeding until early adulthood, then 60% caloric restriction until 16 months, and then ad libitum feeding for 5 months (CR/Ad-lib). Two versions of the daily usage rate were measured: daily dietary caloric intake (DCI), and daily energy expenditure (EE) based on indirect calorimetry. Two versions of the metabolically active tissue mass were also measured: fat-free mass (FFM), and the sum of the weight of the heart, brain, liver, and kidneys. Energy usage rates were adjusted for these measures of metabolically active tissue mass to yield measures of the energy metabolic rate. Correlation, regression, and path analyses showed that both the energy usage rate and adjusted energy usage rate played important independent roles in determining body fat and plasma leptin, but only after multivariate techniques were used to account for the simultaneous interactions between variables. Increases in the energy usage rate were associated with increases in body fat and the adjusted energy usage rate. Increases in the adjusted energy usage rate were associated with decreases in body fat and plasma leptin. These findings suggest that differences in subjects adjusted energy usage rate could explain some of the apparently contradictory findings concerning the relationship between energy usage and plasma leptin in previously published

  4. 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.

  5. 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.

  6. Primary Health Care and Cervical Cancer Mortality Rates in Brazil

    PubMed Central

    Rocha, Thiago Augusto Hernandes; da Silva, Núbia Cristina; Thomaz, Erika Bárbara Abreu Fonseca; Queiroz, Rejane Christine de Sousa; de Souza, Marta Rovery; Lein, Adriana; Alvares, Viviane; de Almeida, Dante Grapiuna; Barbosa, Allan Claudius Queiroz; Thumé, Elaine; Staton, Catherine; Vissoci, João Ricardo Nickenig; Facchini, Luiz Augusto

    2017-01-01

    Cervical cancer is a common neoplasm that is responsible for nearly 230 000 deaths annually in Brazil. Despite this burden, cervical cancer is considered preventable with appropriate care. We conducted a longitudinal ecological study from 2002 to 2012 to examine the relationship between the delivery of preventive primary care and cervical cancer mortality rates in Brazil. Brazilian states and the federal district were the unit of analysis (N = 27). Results suggest that primary health care has contributed to reducing cervical cancer mortality rates in Brazil; however, the full potential of preventive care has yet to be realized. PMID:28252500

  7. Rapid rise and subsequent decline in prostate cancer incidence rates for New Mexico, 1989-1993.

    PubMed

    Gilliland, F D; Welsh, D J; Hoffman, R M; Key, C R

    1995-01-01

    Beginning in the late 1980s, a large increase in incidence rates for prostate cancer occurred in association with increased prostate-specific antigen (PSA) screening. In New Mexico, the increased screening was associated with earlier detection of cancers and decreased prostate cancer mortality, suggesting that PSA screening may be effective. PSA screening has become a controversial topic of public debate, and anecdotal reports from physicians indicated that prostate cancer screening practice patterns were changing in New Mexico. To assess whether PSA-associated trends in prostate cancer incidence were continuing, we examined incidence rates from 1989 to 1993 among men in New Mexico. From 1989 to 1992, age-adjusted rates increased substantially for non-Hispanic whites (77%), Hispanics (50%), and American Indians (27%). Although rates increased for all stages combined, incidence rates decreased for distant-stage disease, especially for non-Hispanic whites, indicating a continuing trend toward earlier detection. In 1993, incidence rates unexpectedly decreased from 203 to 158/100,000 in non-Hispanic whites, largely as a result of changes in rates in men over age 65 years. Although incidence rates decreased, the trend toward earlier detection was maintained for non-Hispanic whites. In contrast, among Hispanic and American Indians, rates did not change substantially between 1992 and 1993. Because the epidemic in prostate cancer was associated with increased PSA screening, it is likely that the trends for non-Hispanic whites are also related to PSA screening. We suggest that the decrease in rates and the continued stage shift are consistent with repeated screening of men in the population at risk.

  8. Lung Cancer Rates by Race and Ethnicity

    MedlinePlus

    ... and ethnicity. Incidence Rates by Race/Ethnicity and Sex “Incidence rate” means how many people out ... individual years. Death Rates by Race/Ethnicity and Sex From 1999–2013, the rate of people dying ...

  9. Colorectal Cancer Rates by Race and Ethnicity

    MedlinePlus

    ... and ethnicity. Incidence Rates by Race/Ethnicity and Sex “Incidence rate” means how many people out ... individual years. Death Rates by Race/Ethnicity and Sex From 1999–2013, the rate of people dying ...

  10. Supplementary documentation for an Environmental Impact Statement regarding the Pantex Plant: a comparison of county and state cancer mortality rates

    SciTech Connect

    Wiggs, L.D.; Wilkinson, G.S.; Tietjen, G.L.; Acquavella, J.F.

    1982-12-01

    This report documents work performed in support of preparation of an Environmental Impact Statement (EIS) regarding the Department of Energy's Pantex Plant near Amarillo, Texas. This report considers cancer mortality rates in the region surrounding the Pantex nuclear weapons facility. The working hypothesis was that increased cancer mortality rates would exist in counties proximal to the Pantex Plant. To evaluate this hypothesis, we compared age-adjusted cancer mortality rates for the six surrounding counties with Texas state rates for three time periods: 150 to 1959, 1960 to 1969, and 1970 to 1978. These comparisons showed that cancer mortality rates for Carson County (where the plant is located) and the five adjacent and downwind counties were not significantly different from rates for the State of Texas.

  11. 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.

  12. Correlation of mutagenic assessment of Houston air particulate extracts in relation to lung cancer mortality rates

    SciTech Connect

    Walker, R.D.; Connor, T.H.; MacDonald, E.J.; Trieff, N.M.; Legator, M.S.; MacKenzie, K.W. Jr.; Dobbins, J.G.

    1982-08-01

    Air particulate extracts from a series of solvents were tested in the Ames mutagen detection system and were found to be mutagenic in varying degrees as a function of the particulate collection site in Houston, Texas. The mutagenicity level at seven sites was compared with age-adjusted mortality rates in the same areas. Significant correlation was found with the lung cancer mortality rates but not with mortality rates for other causes. These findings support the hypothesis of a contribution of urban air particulate to the lung cancer rates. Furthermore, these findings suggest that an index of the mutagenicity of air particulate is a more powerful measure of the human health hazard of air pollution than the traditional indices of particulate concentration.

  13. 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....

  14. 17 CFR Appendix B to Part 4 - Adjustments for Additions and Withdrawals in the Computation of Rate of Return

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 17 Commodity and Securities Exchanges 1 2011-04-01 2011-04-01 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....

  15. 17 CFR Appendix B to Part 4 - Adjustments for Additions and Withdrawals in the Computation of Rate of Return

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 17 Commodity and Securities Exchanges 1 2013-04-01 2013-04-01 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....

  16. 17 CFR Appendix B to Part 4 - Adjustments for Additions and Withdrawals in the Computation of Rate of Return

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 17 Commodity and Securities Exchanges 1 2012-04-01 2012-04-01 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....

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

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 17 Commodity and Securities Exchanges 1 2014-04-01 2014-04-01 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....

  18. Measuring water accumulation rates using GRACE data in areas experiencing glacial isostatic adjustment: The Nelson River basin

    NASA Astrophysics Data System (ADS)

    Lambert, A.; Huang, J.; Kamp, G.; Henton, J.; Mazzotti, S.; James, T. S.; Courtier, N.; Barr, A. G.

    2013-12-01

    Recovery and Climate Experiment (GRACE) satellite-derived total water storage can be obscured by glacial isostatic adjustment. In order to solve this problem for the Nelson River drainage basin in Canada, a gravity rate map from 110 months (June 2002 to October 2011) of GRACE gravity data was corrected for glacial isostatic adjustment using an independent gravity rate map derived from updated GPS vertical velocities. The GPS-based map was converted to equivalent gravity rate using a transfer function developed from GPS and absolute-g data at colocated sites. The corrected GRACE gravity rate map revealed a major positive anomaly within the drainage basin, which was independently shown by hydrological data to be due to changes in water storage. The anomaly represents a cumulative increase at its center of about 340 mm of water, reflecting a progression from extreme drought to extremely wet conditions.

  19. 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

  20. A direct algorithm for convective adjustment of the vertical temperature profile for an arbitrary critical lapse rate

    NASA Technical Reports Server (NTRS)

    Akmaev, Rashid A.

    1991-01-01

    An efficient direct algorithm of convective adjustment for an arbitrary critical value of the vertical temperature lapse rate gamma is proposed. The algorithm provides an exact and unique solution of a standard convective adjustment problem for models with temperature specified either on nonuniformly spaced levels or for layers of different thicknesses in pressure, sigma, or other vertical coordinate related to pressure. The algorithm may be recommended for use either directly in atmospheric models not explicitly including a hydrologic cycle with prescribed gamma, or as a part of more complicated parameterizations of moist convection, where gamma may be calculated depending on relative humidity.

  1. Colon Cancer Rates, Deaths Drop in Americans Over 50

    MedlinePlus

    ... gov/news/fullstory_163856.html Colon Cancer Rates, Deaths Drop in Americans Over 50 Report suggests higher ... over 50 fell 32 percent since 2000, while deaths from the disease fell by 34 percent. Those ...

  2. 42 CFR 422.308 - Adjustments to capitation rates, benchmarks, bids, and payments.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... specialized MA plans for special needs individuals. (i) Application of payment rules. For plan year 2011 and... plan described in this paragraph is a fully integrated dual-eligible special needs plan, as defined at.... (6) Improvements to risk adjustment for special needs individuals with chronic health...

  3. 76 FR 74703 - Cost of Living Adjustment to Satellite Carrier Compulsory License Royalty Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-01

    ... 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 COLA.... Telephone: (202) 707-7658. Email: crb@loc.gov . SUPPLEMENTARY INFORMATION: The satellite carrier...

  4. 77 FR 70373 - Cost of Living Adjustment to Satellite Carrier Compulsory License Royalty Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-26

    ... 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 COLA.... Telephone: (202) 707-7658. Email: crb@loc.gov . SUPPLEMENTARY INFORMATION: The satellite carrier...

  5. 75 FR 75624 - Cost of Living Adjustment to Satellite Carrier Compulsory License Royalty Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-06

    ... 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 COLA... INFORMATION: The satellite carrier compulsory license establishes a statutory copyright licensing scheme...

  6. Long-term survival rates of gravity-assisted, adjustable differential pressure valves in infants with hydrocephalus.

    PubMed

    Gebert, Anna-Felicitas; Schulz, Matthias; Schwarz, Karin; Thomale, Ulrich-Wilhelm

    2016-05-01

    OBJECTIVE The use of adjustable differential pressure valves with gravity-assisted units in shunt therapy of children with hydrocephalus was reported to be feasible and promising as a way to avoid chronic overdrainage. In this single-center study, the authors' experiences in infants, who have higher rates of shunt complications, are presented. METHODS All data were collected from a cohort of infants (93 patients [37 girls and 56 boys], less than 1 year of age [mean age 4.1 ± 3.1 months]) who received their first adjustable pressure hydrocephalus shunt as either a primary or secondary implant between May 2007 and April 2012. Rates of valve and shunt failure were recorded for a total of 85 months until the end of the observation period in May 2014. RESULTS During a follow-up of 54.2 ± 15.9 months (range 26-85 months), the Kaplan-Meier rate of shunt survival was 69.2% at 1 year and 34.1% at 85 months; the Kaplan-Meier rate of valve survival was 77.8% at 1 year and 56% at 85 months. Survival rates of the shunt were significantly inferior if the patients had previous shunt surgery. During follow-up, 44 valves were exchanged in cases of infection (n = 19), occlusion (n = 14), dysfunction of the adjustment unit (n = 10), or to change the gravitational unit (n = 1). CONCLUSIONS Although a higher shunt complication rate is observed in infant populations compared with older children, reasonable survival rates demonstrate the feasibility of using this sophisticated valve technology. The gravitational unit of this valve is well tolerated and its adjustability offers the flexible application of opening pressure in an unpredictable cohort of patients. This may adequately address overdrainage-related complications from early in treatment.

  7. 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

  8. [Pulsed-dose rate brachytherapy in cervical cancers: why, how?].

    PubMed

    Mazeron, R; Dumas, I; Martin, V; Martinetti, F; Benhabib-Boukhelif, W; Gensse, M-C; Chargari, C; Guemnie-Tafo, A; Haie-Méder, C

    2014-10-01

    The end of the production of 192 iridium wires terminates low dose rate brachytherapy and requires to move towards pulsed-dose rate or high-dose rate brachytherapy. In the case of gynecological cancers, technical alternatives exist, and many teams have already taken the step of pulsed-dose rate for scientific reasons. Using a projector source is indeed a prerequisite for 3D brachytherapy, which gradually installs as a standard treatment in the treatment of cervical cancers. For other centers, this change implies beyond investments in equipment and training, organizational consequences to ensure quality.

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

    PubMed

    2016-08-12

    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).

  10. Adjusting for temporal change in trophic position results in reduced rates of contaminant decline.

    PubMed

    Hebert, Craig E; Weseloh, D V Chip

    2006-09-15

    The development of ecological tracers to track the flow of energy and nutrients through food webs has provided new insights into the factors that are important in regulating diet composition in wildlife. The Great Lakes Herring Gull Monitoring Program has provided information regarding temporal trends in levels of bioaccumulative contaminants since the early 1970s. In recent years, data from this program have also been generated to examine ecological changes in the Great Lakes. Because the contaminants that are evaluated as part of this program biomagnify, food is the primary determinant of contaminant concentrations in the eggs that are analyzed annually. Fluctuations in diet composition could affect the interpretation of temporal trends by affecting exposure to contaminants. Retrospective analyses involving ecological tracers, i.e., stable nitrogen isotopes and fatty acids, have shown temporal change in the diets of Great Lakes herring gulls at some monitoring colonies. These dietary differences have led to temporal variation in the trophic position of herring gulls. Given that higher trophic level organisms incur greater exposure to biomagnifying contaminants, it is necessary to adjust for these temporal changes in trophic position to get an accurate indication of how contaminant burdens are changing within the Great Lakes ecosystem. Here, we outline a method to adjust for temporal changes in indicator species trophic position and discuss how these adjustments affect the interpretation of contaminant temporal trend monitoring data.

  11. Short-term heat stress exposure limits based on wet bulb globe temperature adjusted for clothing and metabolic rate.

    PubMed

    Bernard, Thomas E; Ashley, Candi D

    2009-10-01

    Most heat stress exposure assessments based on wet bulb globe temperature (WBGT) consider the environmental conditions, metabolic demands, and clothing requirements, and the exposure limit is for extended work periods (e.g., a typical workday). The U.S. Navy physiological heat exposure limit (PHEL) curves and rational models of heat stress also consider time as a job risk factor so that there is a limiting time for exposures above a conventional WBGT exposure limit. The PHEL charts have not been examined for different clothing and the rational models require personal computers. The current study examined the role of clothing in short-term (time limited) exposures and proposed a relationship between a Safe Exposure Time and WBGT adjusted for clothing and metabolic rate. Twelve participants worked at a metabolic rate of 380 W in three clothing ensembles [clothing adjustment factors]: (1) work clothes (0 degrees C-WBGT), (2) NexGen microporous coveralls (2.5 degrees C-WBGT), and (2) vapor-barrier coveralls (6.5 degrees C-WBGT) at five levels of heat stress (approximately at the clothing adjusted TLV plus 7.0, 8.0, 9.5, 11.5 and 15.0 degrees C-WBGT). The combinations of metabolic rate, clothing, and environment were selected in anticipation that the participants would reach a physiological limit in less than 120 min. WBGT-based clothing adjustment factors were used to account for different clothing ensembles, and no differences were found for ensemble, which meant that the clothing adjustment factor can be used in WBGT-based time limited exposures. An equation was proposed to recommend a Safe Exposure Time for exposures under 120 min. The recommended times were longer than the PHEL times or times from a rational model of heat stress.

  12. Historical cohort study of US man-made vitreous fiber production workers: VI. Respiratory system cancer standardized mortality ratios adjusted for the confounding effect of cigarette smoking.

    PubMed

    Marsh, G M; Buchanich, J M; Youk, A O

    2001-09-01

    To date, the US cohort study of man-made vitreous fiber workers has provided no consistent evidence of a relationship between man-made vitreous fiber exposure and mortality from malignant or non-malignant respiratory disease. Nevertheless, there have been small, overall excesses in respiratory system cancer (RSC) among workers from the fiberglass and rock/slag wool production plants included in the study that were unexplained by estimated worker exposures to respirable fiber or other agents present in the plants. The present investigation was designed to provide a quantitative estimate of the extent to which the overall excess in RSC mortality observed at the total cohort level among male fiberglass and rock/slag wool workers is a result of the positive confounding effects of cigarette smoking. Because cigarette-smoking data were neither available nor obtainable at the individual level for all members of the fiberglass and rock/slag wool cohorts, we used the "indirect" method to adjust RSC standardized mortality ratios (SMRs) at the group (cohort and plant) level. Our adjustment suggested that cigarette smoking accounts for all of the 7% and 24% excesses in RSC observed, respectively, for the male fiberglass and rock/slag wool cohorts in the latest mortality updates. The same conclusion was reached regardless of which of several alternative formulations were used to adjust local rate-based RSC SMRs. We found that our smoking adjustments were robust with respect to several alternative characterizations and (with the exception of one fiberglass plant) produced adjusted RSC SMRs that were lower than their unadjusted counterparts. Further, all statistically significantly elevated unadjusted SMRs were reduced to not statistically significant levels. These results reaffirm that RSC SMRs based on US and local rates must take into account the potential confounding effects of cigarette smoking. They also suggest that the use of local county mortality rate-based SMRs may not

  13. 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

    ...-Point (PTP) service. Network Integration Transmission (NT-12) rate--The NT rate applies to customers taking network integration service under the Open Access Transmission Tariff (OATT) and allows customers... rate that applies to customers taking point-to-point service on BPA's network facilities under the...

  14. 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…

  15. 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

  16. Molecular mechanism of prostate cancer cell apoptosis induced by busulfan via adjustment of androgen receptor phosphatization

    PubMed Central

    Liu, Jun; Jiang, Guojun; Yang, Aiping; Yang, Guohui; Yang, Wenjuan; Fang, Yi

    2016-01-01

    Objective: To probe killing effect of busulfan to prostate cancer cell without androgen and the influence of androgen receptor phosphatization and analyze its molecular mechanism. Methods: prostate cancer cell line 22RV1, LAPC4 and LNCaP treated with busulfan under androgen-free condition underwent CCK-8 examination to probe killing ability of the medicine. Flow cytometry was used to check the influence of busulfan on apoptosis rate of prostate cancer cell line LAPC4. Expression level of androgen receptor (AR), Src and Ack1 and change in phosphatization of AR after busulfan treatment were measured by RT-PCR and Western blotting. Finally, influence o proliferation ability and apoptosis of LAPC4 were measured using EGF-busulfan co-processing. Results: Significant dose-dependency was observed as killing ability rises with higher busulfan concentration (p<0.05). Significant improvement in prostate cancer cell inhibition ability of busulfan was also observed with prolonging of time (p<0.05). Then we discovered, as indicated by flow cytometry, that busulfan inhibits prostate cancer cell LAPC4 proliferation by strengthening its apoptosis (p<0.05), which showed significant dose- and time-dependency. Detection of AR expression and phosphatization level showed no significant influence on mRNA and protein expression level of AR made by busulfan. However, decline of phosphatization level at AR Y534 site was positively related to busulfan treatment time. Busulfan was found to be inhibitory to Src kinase induced by EGF and level of resulting AR phosphatization in our further probe into the mechanism of busulfan influence on phosphatization level at AR Y534 site. Nude mice experiment indicated that busulfan was inhibitory to protein expression of AR downstream target gene prostate specific antigen (PSA) and human tissue kallikrein2 (hk-2), thus inhibited in vivo tumorigenic ability of prostate cancer cells. Conclusion: Busulfan was significantly inhibitory to prostate cancer cell

  17. 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...

  18. Proposed Adjustments to PI-RADS Version 2 Decision Rules: Impact on Prostate Cancer Detection.

    PubMed

    Rosenkrantz, Andrew B; Babb, James S; Taneja, Samir S; Ream, Justin M

    2016-10-26

    Purpose To test the impact of existing Prostate Imaging Reporting and Data System (PI-RADS) version 2 (V2) decision rules, as well as of proposed adjustments to these decision rules, on detection of Gleason score (GS) 7 or greater (GS ≥7) prostate cancer. Materials and Methods Two radiologists independently provided PI-RADS V2 scores for the dominant lesion on 343 prostate magnetic resonance (MR) examinations. Diagnostic performance for GS ≥7 tumor was assessed by using MR imaging-ultrasonography fusion-targeted biopsy as the reference. The impact of existing PI-RADS V2 decision rules, as well as a series of exploratory proposed adjustments, on the frequency of GS ≥7 tumor detection, was evaluated. Results A total of 210 lesions were benign, 43 were GS 6, and 90 were GS ≥7. Lesions were GS ≥7 in 0%-4.1% of PI-RADS categories 1 and 2, 11.4%-27.1% of PI-RADS category 3, 44.4%-49.3% of PI-RADS category 4, and 72.1%-73.7% of PI-RADS category 5 lesions. PI-RADS category 4 or greater had sensitivity of 78.9%-87.8% and specificity of 75.5%-79.1 for detecting GS ≥7 tumor. The frequency of GS ≥7 tumor for existing PI-RADS V2 decision rules was 30.0%-33.3% in peripheral zone (PZ) lesions upgraded from category 3 to 4 based on dynamic contrast enhancement (DCE) score of positive; 50.0%-66.7% in transition zone (TZ) lesions upgraded from category 3 to 4 based on diffusion-weighted imaging (DWI) score of 5; and 71.7%-72.7% of lesions in both zones upgraded from category 4 to 5 based on size of 15 mm or greater. The frequency of GS ≥7 tumor for proposed adjustments to the decision rules was 30.0%-60.0% for TZ lesions upgraded from category 3 to 4 based on DWI score of 4; 33.3%-57.1% for TZ lesions upgraded from category 3 to 4 based on DCE score of positive when incorporating new criteria (unencapsulated sheetlike enhancement) for DCE score of positive in TZ; and 56.4%-61.9% for lesions in both zones upgraded from category 4 to 5 based on size of 10-14 mm. Other

  19. 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

    ... Appropriations Act, 2013 (Public Law 113-6), the rates of basic pay or salaries of the statutory pay systems (as... hereof. Sec. 3. Certain Executive, Legislative, and Judicial Salaries. The rates of basic pay or salaries... specified in section 7 of this order.Barack ObamaThe White House, April 5, 2013. ED11AP13.002...

  20. 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

    ...(Public Law 111-322; December 22, 2010), the rates of basic pay or salaries of the statutory pay systems... hereof. Sec. 3. Certain Executive, Legislative, and Judicial Salaries. The rates of basic pay or salaries... Order Superseded. Executive Order 13561 of December 22, 2010, is superseded.Barack ObamaThe White...

  1. 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

    ...: Section 1. Statutory Pay Systems. The rates of basic pay or salaries of the statutory pay systems (as... Salaries. The rates of basic pay or salaries for the following offices and positions are set forth on the... specified in section 7 of this order.Barack ObamaThe White House, December 23, 2013. ED31DE13.195...

  2. 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... proceeding and a significant interest in the outcome of that proceeding objects under clause (II... related to the programming on such stream. (b) Rates--(1) Private home viewing. The rates applicable...

  3. 75 FR 39891 - Rate Adjustment for the Satellite Carrier Compulsory License

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-13

    ... Owners'') and DIRECTV, Inc., DISH Network, LLC, and National Programming Service, LLC (collectively, the... proceeding and a significant interest in the outcome of that proceeding objects under clause ] (II).'' Any... programming on such stream. (b) Rates. (1) Private home viewing. The rates applicable to Satellite...

  4. 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.

  5. 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...

  6. The effects of hysterectomy on body image, self-esteem, and marital adjustment in Turkish women with gynecologic cancer.

    PubMed

    Pinar, Gul; Okdem, Seyda; Dogan, Nevin; Buyukgonenc, Lale; Ayhan, Ali

    2012-06-01

    The purpose of this research was to investigate the differences in the effect of hysterectomy on body image, self-esteem, and marital adjustment in Turkish women with gynecologic cancer based on specific independent variables, including age, education, employment, having or not having children, and income. This cross-sectional study compared a group of women who underwent a hysterectomy (n = 100) with a healthy control group (n = 100). The study findings indicate that women who had a hysterectomy were found in worse conditions in terms of body image, self-esteem, and dyadic adjustment compared to healthy women. In terms of dyadic adjustment and body image among women who had undergone a hysterectomy, those with lower levels of income and education were found in poorer conditions. The study's findings show that hysterectomies have negative effects on body image, self-esteem, and dyadic adjustment in women affected by gynecologic cancer. Nursing assessment of self-esteem and marital adjustment indicators and implementation of strategies to increase self-confidence and self-esteem are needed for high-risk women.

  7. 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

  8. 75 FR 8730 - Notice of Proposed Information Collection: Comment Request; FHA- Disclosure of Adjustable Rate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-25

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Notice of Proposed Information Collection: Comment Request; FHA- Disclosure of... applicable to variable rate mortgages secured by a principal dwelling under TILA. Regulation Z,'' at 15...

  9. 78 FR 48374 - Great Lakes Pilotage Rates-2014 Annual Review and Adjustment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-08

    ... consideration to the public interest and the costs of providing the services.'' 46 U.S.C. 9303(f). Rates must be... pilotage systems that has existed since 2008. Based on historic traffic levels, we believe this weighting... for pilotage services, giving consideration to the public interest and the costs of providing...

  10. 77 FR 45539 - Great Lakes Pilotage Rates-2013 Annual Review and Adjustment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-01

    ... public interest and the costs of providing the services.'' Rates must be established or reviewed and... 1 Area 2 Reported expenses for 2010 St. Lawrence Total River Lake Ontario Pilot Costs: Other pilotage costs: Pilot subsistence/Travel $212,715 $167,880 $380,595 License insurance 23,880 18,847...

  11. 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.

  12. 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

  13. 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

  14. The Impact of Extreme-Risk Cases on Hospitals’ Risk-Adjusted Percutaneous Coronary Intervention Mortality Ratings

    PubMed Central

    Sherwood, Matthew W.; Brennan, J. Matthew; Ho, Kalon K.; Masoudi, Frederick A.; Messenger, John C.; Weaver, W. Douglas; Dai, David; Peterson, Eric D.

    2017-01-01

    OBJECTIVES The goal of this study was to examine the calibration of a validated risk-adjustment model in very high-risk percutaneous coronary intervention (PCI) cases and assess whether sites’ case mix affects their performance ratings. BACKGROUND There are concerns that treating PCI patients with particularly high-risk features such as cardiogenic shock or prior cardiac arrest may adversely impact hospital performance ratings. However, there is little investigation on the validity of these concerns. METHODS We examined 624,286 PCI procedures from 1,168 sites that participated in the CathPCI Registry in 2010. Procedural risk was estimated using the recently published Version 4 National Cardiovascular Data Registry (NCDR) PCI risk-adjusted mortality (RAM) model. We calculated observed/expected mortality using several risk classification methods, and simulated hospital performance after combining their highest risk cases over 2 years into a single year. RESULTS In 2010, crude in-hospital PCI mortality was 1.4%. The NCDR model was generally well calibrated among high risk, however there was slight overprediction of risk in extreme cases. Hospitals treating the highest overall expected risk PCI patients or those treating the top 20% of high-risk cases had lower (better) RAM ratings than centers treating lower-risk cases (1.25% vs. 1.51%). The observed/expected ratio for top-risk quintile versus low-risk quintile was 0.91 (0.87 to 0.96) versus 1.10 (1.03 to 1.17). Combining all the high-risk patients over a 2-year period into a single year also did not negatively impact the site’s RAM ratings. CONCLUSIONS Evaluation of a contemporary sample of PCI cases across the United States showed no evidence that treating high-risk PCI cases adversely affects hospital RAM rates. PMID:25499301

  15. 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

  16. The use of estimated glomerular filtration rate for dose adjustment of medications in the elderly.

    PubMed

    Elinder, Carl-Gustaf; Bárány, Peter; Heimbürger, Olof

    2014-07-01

    Adverse drug effects as a consequence of inappropriate dosage are a common cause of hospitalization among the elderly. Older individuals are at a particular risk of overdosing because their kidney function decreases with advancing age and the elderly are often prescribed several pharmaceutical drugs. In addition, serum creatinine levels decrease owing to a reduction in muscle mass with age. Therefore, drug dosing based on the serum creatinine level only, instead of using assessment of the renal function, may result in overdosing of frail elderly patients. Renal function, i.e., the glomerular filtration rate can, with simple formulas, be estimated from analysis of creatinine and/or plasma cystatin C (eGFR). Such estimations performed with modern and validated formulas, as a rule present renal function normalized to the body surface area (mL/min/1.73 m(2)). A good estimation of how much the normal dosing interval should be prolonged, or the dose reduced, to obtain a desired plasma concentration of drugs that are mainly eliminated by glomerular filtration can be obtained by calculating the ratio between the patient's eGFR and the normal renal function (about 90-125 mL/min/1.73 m(2)). Increased knowledge and use of eGFR by prescribing physicians will reduce the risk of overdosing drugs in the elderly.

  17. Long-Term Ambient Residential Traffic–Related Exposures and Measurement Error–Adjusted Risk of Incident Lung Cancer in the Netherlands Cohort Study on Diet and Cancer

    PubMed Central

    Spiegelman, Donna; Beelen, Rob; Hoek, Gerard; Brunekreef, Bert; Schouten, Leo J.; van den Brandt, Piet

    2015-01-01

    Background The International Agency for Research on Cancer (IARC) recently declared air pollution carcinogenic to humans. However, no study of air pollution and lung cancer to date has incorporated adjustment for exposure measurement error, and few have examined specific histological subtypes. Objectives Our aim was to assess the association of air pollution and incident lung cancer in the Netherlands Cohort Study on Diet and Cancer and the impact of measurement error on these associations. Methods The cohort was followed from 1986 through 2003, and 3,355 incident cases were identified. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals, for long-term exposures to nitrogen dioxide (NO2), black smoke (BS), PM2.5 (particulate matter with diameter ≤ 2.5 μm), and measures of roadway proximity and traffic volume, adjusted for potential confounders. Information from a previous validation study was used to correct the effect estimates for measurement error. Results We observed elevated risks of incident lung cancer with exposure to BS [hazard ratio (HR) = 1.16; 95% CI: 1.02, 1.32, per 10 μg/m3], NO2 (HR = 1.29; 95% CI: 1.08, 1.54, per 30 μg/m3), PM2.5 (HR = 1.17; 95% CI: 0.93, 1.47, per 10 μg/m3), and with measures of traffic at the baseline address. The exposures were positively associated with all lung cancer subtypes. After adjustment for measurement error, the HRs increased and the 95% CIs widened [HR = 1.19 (95% CI: 1.02, 1.39) for BS and HR = 1.37 (95% CI: 0.86, 2.17) for PM2.5]. Conclusions These findings add support to a growing body of literature on the effects of air pollution on lung cancer. In addition, they highlight variation in measurement error by pollutant and support the implementation of measurement error corrections when possible. Citation Hart JE, Spiegelman D, Beelen R, Hoek G, Brunekreef B, Schouten LJ, van den Brandt P. 2015. Long-term ambient residential traffic–related exposures and

  18. Calculating disability-adjusted life years (DALY) as a measure of excess cancer risk following radiation exposure.

    PubMed

    Shimada, K; Kai, M

    2015-12-01

    This paper has proposed that disability-adjusted life year (DALY) can be used as a measure of radiation health risk. DALY is calculated as the sum of years of life lost (YLL) and years lived with disability (YLD). This multidimensional concept can be expressed as a risk index without a probability measure to avoid the misuse of the current radiation detriment at low doses. In this study, we calculated YLL and YLD using Japanese population data by gender. DALY for all cancers in Japan per 1 Gy per person was 0.84 year in men and 1.34 year in women. The DALY for all cancers in the Japanese baseline was 4.8 in men and 3.5 in women. When we calculated the ICRP detriment from the same data, DALYs for the cancer sites were similar to the radiation detriment in the cancer sites, excluding leukemia, breast and thyroid cancer. These results suggested that the ICRP detriment overestimate the weighting fraction of leukemia risk and underestimate the weighting fraction of breast and thyroid cancer. A big advantage over the ICRP detriment is that DALY can calculate the risk components for non-fatal diseases without the data of lethality. This study showed that DALY is a practical tool that can compare many types of diseases encountered in public health.

  19. Bayesian bias adjustments of the lung cancer SMR in a cohort of German carbon black production workers

    PubMed Central

    2010-01-01

    Background A German cohort study on 1,528 carbon black production workers estimated an elevated lung cancer SMR ranging from 1.8-2.2 depending on the reference population. No positive trends with carbon black exposures were noted in the analyses. A nested case control study, however, identified smoking and previous exposures to known carcinogens, such as crystalline silica, received prior to work in the carbon black industry as important risk factors. We used a Bayesian procedure to adjust the SMR, based on a prior of seven independent parameter distributions describing smoking behaviour and crystalline silica dust exposure (as indicator of a group of correlated carcinogen exposures received previously) in the cohort and population as well as the strength of the relationship of these factors with lung cancer mortality. We implemented the approach by Markov Chain Monte Carlo Methods (MCMC) programmed in R, a statistical computing system freely available on the internet, and we provide the program code. Results When putting a flat prior to the SMR a Markov chain of length 1,000,000 returned a median posterior SMR estimate (that is, the adjusted SMR) in the range between 1.32 (95% posterior interval: 0.7, 2.1) and 1.00 (0.2, 3.3) depending on the method of assessing previous exposures. Conclusions Bayesian bias adjustment is an excellent tool to effectively combine data about confounders from different sources. The usually calculated lung cancer SMR statistic in a cohort of carbon black workers overestimated effect and precision when compared with the Bayesian results. Quantitative bias adjustment should become a regular tool in occupational epidemiology to address narrative discussions of potential distortions. PMID:20701747

  20. Risk assessment of diesel exhaust and lung cancer: combining human and animal studies after adjustment for biases in epidemiological studies

    PubMed Central

    2011-01-01

    Background Risk assessment requires dose-response data for the evaluation of the relationship between exposure to an environmental stressor and the probability of developing an adverse health effect. Information from human studies is usually limited and additional results from animal studies are often needed for the assessment of risks in humans. Combination of risk estimates requires an assessment and correction of the important biases in the two types of studies. In this paper we aim to illustrate a quantitative approach to combining data from human and animal studies after adjusting for bias in human studies. For our purpose we use the example of the association between exposure to diesel exhaust and occurrence of lung cancer. Methods Firstly, we identify and adjust for the main sources of systematic error in selected human studies of the association between occupational exposure to diesel exhaust and occurrence of lung cancer. Evidence from selected animal studies is also accounted for by extrapolating to average ambient, occupational exposure concentrations of diesel exhaust. In a second stage, the bias adjusted effect estimates are combined in a common effect measure through meta-analysis. Results The random-effects pooled estimate (RR) for exposure to diesel exhaust vs. non-exposure was found 1.37 (95% C.I.: 1.08-1.65) in animal studies and 1.59 (95% C.I.: 1.09-2.10) in human studies, whilst the overall was found equal to 1.49 (95% C.I.: 1.21-1.78) with a greater contribution from human studies. Without bias adjustment in human studies, the pooled effect estimate was 1.59 (95% C.I.: 1.28-1.89). Conclusions Adjustment for the main sources of uncertainty produced lower risk estimates showing that ignoring bias leads to risk estimates potentially biased upwards. PMID:21481231

  1. Prior event rate ratio adjustment for hidden confounding in observational studies of treatment effectiveness: a pairwise Cox likelihood approach.

    PubMed

    Lin, Nan Xuan; Henley, William Edward

    2016-12-10

    Observational studies provide a rich source of information for assessing effectiveness of treatment interventions in many situations where it is not ethical or practical to perform randomized controlled trials. However, such studies are prone to bias from hidden (unmeasured) confounding. A promising approach to identifying and reducing the impact of unmeasured confounding is prior event rate ratio (PERR) adjustment, a quasi-experimental analytic method proposed in the context of electronic medical record database studies. In this paper, we present a statistical framework for using a pairwise approach to PERR adjustment that removes bias inherent in the original PERR method. A flexible pairwise Cox likelihood function is derived and used to demonstrate the consistency of the simple and convenient alternative PERR (PERR-ALT) estimator. We show how to estimate standard errors and confidence intervals for treatment effect estimates based on the observed information and provide R code to illustrate how to implement the method. Assumptions required for the pairwise approach (as well as PERR) are clarified, and the consequences of model misspecification are explored. Our results confirm the need for researchers to consider carefully the suitability of the method in the context of each problem. Extensions of the pairwise likelihood to more complex designs involving time-varying covariates or more than two periods are considered. We illustrate the application of the method using data from a longitudinal cohort study of enzyme replacement therapy for lysosomal storage disorders. © 2016 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd.

  2. Multiple confidence intervals for selected parameters adjusted for the false coverage rate in monotone dose-response microarray experiments.

    PubMed

    Peng, Jianan; Liu, Wei; Bretz, Frank; Shkedy, Ziv

    2016-12-26

    Benjamini and Yekutieli () introduced the concept of the false coverage-statement rate (FCR) to account for selection when the confidence intervals (CIs) are constructed only for the selected parameters. Dose-response analysis in dose-response microarray experiments is conducted only for genes having monotone dose-response relationship, which is a selection problem. In this paper, we consider multiple CIs for the mean gene expression difference between the highest dose and control in monotone dose-response microarray experiments for selected parameters adjusted for the FCR. A simulation study is conducted to study the performance of the method proposed. The method is applied to a real dose-response microarray experiment with 16, 998 genes for illustration.

  3. Aspiration-related organizing pneumonia complicating laparoscopic adjustable gastric banding: A lung cancer mimicker

    PubMed Central

    Aljohaney, Ahmed A.; Ajlan, Amr M.; Alghamdi, Fahad A.

    2016-01-01

    There are several described pulmonary complications due to laparoscopic adjustable gastric banding. We report a rare case of a 32-year-old male who presented with pulmonary symptoms and a solitary lung mass 12 years after laparoscopic adjustable gastric banding. A bronchoscopic lung biopsy showed organizing pneumonia that was induced by aspiration pneumonia. The atypical radiological appearance of the aspiration pneumonia may pose a diagnostic challenge, and clinicians' awareness regarding such an entity is needed to avoid unnecessary intervention. PMID:27803757

  4. Aspiration-related organizing pneumonia complicating laparoscopic adjustable gastric banding: A lung cancer mimicker.

    PubMed

    Aljohaney, Ahmed A; Ajlan, Amr M; Alghamdi, Fahad A

    2016-01-01

    There are several described pulmonary complications due to laparoscopic adjustable gastric banding. We report a rare case of a 32-year-old male who presented with pulmonary symptoms and a solitary lung mass 12 years after laparoscopic adjustable gastric banding. A bronchoscopic lung biopsy showed organizing pneumonia that was induced by aspiration pneumonia. The atypical radiological appearance of the aspiration pneumonia may pose a diagnostic challenge, and clinicians' awareness regarding such an entity is needed to avoid unnecessary intervention.

  5. Incidence and mortality rates of colorectal cancer in Malaysia

    PubMed Central

    2016-01-01

    OBJECTIVES This is the first study that estimates the incidence and mortality rate for colorectal cancer (CRC) patients in Malaysia by sex and ethnicity. METHODS The 4,501 patients were selected from National Cancer Patient Registry-Colorectal Cancer data. Patient survival status was cross-checked with the National Registration Department. The age-standardised rate (ASR) was calculated as the proportion of CRC cases (incidence) and deaths (mortality) from 2008 to 2013, weighted by the age structure of the population, as determined by the Department of Statistics Malaysia and the World Health Organization world standard population distribution. RESULTS The overall incidence rate for CRC was 21.32 cases per 100,000. Those of Chinese ethnicity had the highest CRC incidence (27.35), followed by the Malay (18.95), and Indian (17.55) ethnicities. The ASR incidence rate of CRC was 1.33 times higher among males than females (24.16 and 18.14 per 100,000, respectively). The 2011 (44.7%) CRC deaths were recorded. The overall ASR of mortality was 9.79 cases, with 11.85 among the Chinese, followed by 9.56 among the Malays and 7.08 among the Indians. The ASR of mortality was 1.42 times higher among males (11.46) than females (8.05). CONCLUSIONS CRC incidence and mortality is higher in males than females. Individuals of Chinese ethnicity have the highest incidence of CRC, followed by the Malay and Indian ethnicities. The same trends were observed for the age-standardised mortality rate. PMID:26971697

  6. Colorectal cancer incidence rates have decreased in central Italy.

    PubMed

    Crocetti, Emanuele; Buzzoni, Carlotta; Zappa, Marco

    2010-11-01

    We analyzed colorectal cancer incidence data from the Tuscany Cancer Registry, central Italy, for the period 1985-2005. We carried out a trend analysis through a Joinpoint regression analysis, and summarized trends as annual percent change (APC) of the standardized (European standard) rates. Colorectal incidence rates increased until 1996 (APC=+1.4, 95% CI: 0.8-1.9), then decreased significantly (APC=-1.1, 95% CI: -0.8 to -0.4). The change was detected as statistically significant in the age group of 54+ years. Among younger individuals, we observed an increasing incidence until 2003. In the same geographical area, a colorectal screening programme has been active from 1982; it was initially based on guaiac faecal occult blood testing (GFOBT) and on immunological testing (IFOBT) since the mid 1990s. The decline in colorectal cancer incidence since 1996, in the whole population and especially among individuals older than 54 years, may suggest the effect of FOBT screening in terms of precancerous polyps removal.

  7. 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…

  8. 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.

  9. How Elephant Seals (Mirounga leonina) Adjust Their Fine Scale Horizontal Movement and Diving Behaviour in Relation to Prey Encounter Rate

    PubMed Central

    Jouma’a, Joffrey; Picard, Baptiste; Guinet, Christophe

    2016-01-01

    Understanding the diving behaviour of diving predators in relation to concomitant prey distribution could have major practical applications in conservation biology by allowing the assessment of how changes in fine scale prey distribution impact foraging efficiency and ultimately population dynamics. The southern elephant seal (Mirounga leonina, hereafter SES), the largest phocid, is a major predator of the southern ocean feeding on myctophids and cephalopods. Because of its large size it can carry bio-loggers with minimal disturbance. Moreover, it has great diving abilities and a wide foraging habitat. Thus, the SES is a well suited model species to study predator diving behaviour and the distribution of ecologically important prey species in the Southern Ocean. In this study, we examined how SESs adjust their diving behaviour and horizontal movements in response to fine scale prey encounter densities using high resolution accelerometers, magnetometers, pressure sensors and GPS loggers. When high prey encounter rates were encountered, animals responded by (1) diving and returning to the surface with steeper angles, reducing the duration of transit dive phases (thus improving dive efficiency), and (2) exhibiting more horizontally and vertically sinuous bottom phases. In these cases, the distance travelled horizontally at the surface was reduced. This behaviour is likely to counteract horizontal displacement from water currents, as they try to remain within favourable prey patches. The prey encounter rate at the bottom of dives decreased with increasing diving depth, suggesting a combined effect of decreased accessibility and prey density with increasing depth. Prey encounter rate also decreased when the bottom phases of dives were spread across larger vertical extents of the water column. This result suggests that the vertical aggregation of prey can regulate prey density, and as a consequence impact the foraging success of SESs. To our knowledge, this is one of

  10. 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

  11. Estimating the personal cure rate of cancer patients using population-based grouped cancer survival data.

    PubMed

    Binbing Yu; Tiwari, Ram C; Feuer, Eric J

    2011-06-01

    Cancer patients are subject to multiple competing risks of death and may die from causes other than the cancer diagnosed. The probability of not dying from the cancer diagnosed, which is one of the patients' main concerns, is sometimes called the 'personal cure' rate. Two approaches of modelling competing-risk survival data, namely the cause-specific hazards approach and the mixture model approach, have been used to model competing-risk survival data. In this article, we first show the connection and differences between crude cause-specific survival in the presence of other causes and net survival in the absence of other causes. The mixture survival model is extended to population-based grouped survival data to estimate the personal cure rate. Using the colorectal cancer survival data from the Surveillance, Epidemiology and End Results Programme, we estimate the probabilities of dying from colorectal cancer, heart disease, and other causes by age at diagnosis, race and American Joint Committee on Cancer stage.

  12. 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.

  13. Prognostic significance of K-Ras mutation rate in metastatic colorectal cancer patients

    PubMed Central

    Vincenzi, Bruno; Cremolini, Chiara; Sartore-Bianchi, Andrea; Russo, Antonio; Mannavola, Francesco; Perrone, Giuseppe; Pantano, Francesco; Loupakis, Fotios; Rossini, Daniele; Ongaro, Elena; Bonazzina, Erica; Dell'Aquila, Emanuela; Imperatori, Marco; Zoccoli, Alice; Bronte, Giuseppe; De Maglio, Giovanna; Fontanini, Gabriella; Natoli, Clara; Falcone, Alfredo; Santini, Daniele; Onetti-Muda, Andrea; Siena, Salvatore; Tonini, Giuseppe; Aprile, Giuseppe

    2015-01-01

    Introduction: Activating mutations of K-Ras gene have a well-established role as predictors of resistance to anti-EGFR monoclonal antibodies in metastatic colorectal cancer (mCRC) patients. Their prognostic value is controversial, and no data regarding the prognostic value of mutation rate, defined as the percentage of mutated alleles/tumor sample, are available. We aimed to evaluate the prognostic value of K-Rasmutation rate in a homogenous cohort of mCRC patients receiving first-line doublet plus bevacizumab. Patients and Methods: This retrospective study enrolled 397 K-Ras mutant mCRC patients from 6 Italian centers, and 263 patients were fully evaluable for our analysis. K-Ras mutation rate was assessed by pyrosequencing. Patients with less than 60% of cancer cells in tumor tissue were excluded. No patients received anti-EGFR containing anticancer therapy, at any time. Median mutation rate was 40% and was adopted as cut-off. The primary and secondary endpoints were PFS and OS respectively. Results: At univariate analysis, K-Ras mutation rate higher than 40% was significantly associated with lower PFS (7.3 vs 9.1 months; P < 0.0001) and OS (21 vs 31 months; P = 0.004). A multivariate model adjusted for age at diagnosis, site of origin of tumor tissue (primary vs metastases), referral center, number of metastatic sites, and first-line chemotherapy backbone, showed that K-Ras mutation rate remained a significant predictor of PFS and OS in the whole population. Discussion: Our data demonstrate an association between K-Ras mutation rate and prognosis in mCRC patients treated with bevacizumab-containing first-line therapy. These data deserve to be verified in an independent validation set. PMID:26384309

  14. Bayesian adjustment for over-estimation and under-estimation of gastric cancer incidence across Iranian provinces

    PubMed Central

    Hajizadeh, Nastaran; Pourhoseingholi, Mohamad Amin; Baghestani, Ahmad Reza; Abadi, Alireza; Zali, Mohammad Reza

    2017-01-01

    AIM To correct the misclassification in registered gastric cancer incidence across Iranian provinces in cancer registry data. METHODS Gastric cancer data is extracted from Iranian annual of national cancer registration report 2008. A Bayesian method with beta prior is implemented to estimate the rate of misclassification in registering patient’s permanent residence in neighboring province. Each time two neighboring provinces with lower and higher than 100% expected coverage of cancer cases are selected to be entered in the model. The expected coverage of cancerous patient is reported by medical university of each province. It is assumed that some cancer cases from a province with a lower than 100% expected coverage are registered in their neighboring province with more than 100% expected coverage. RESULTS The condition was true for 21 provinces from a total of 30 provinces of Iran. It was estimated that 43% of gastric cancer cases of North and South Khorasan provinces in north-east of Iran was registered in Razavi Khorasan as the neighboring facilitate province; also 72% misclassification was estimated between Sistan and balochestan province and Razavi Khorasan. The misclassification rate was estimated to be 36% between West Azerbaijan province and East Azerbaijan province, 21% between Ardebil province and East Azerbaijan, 63% between Hormozgan province and Fars province, 8% between Chaharmahal and bakhtyari province and Isfahan province, 8% between Kogiloye and boyerahmad province and Isfahan, 43% Golestan province and Mazandaran province, 54% between Bushehr province and Khozestan province, 26% between Ilam province and Khuzestan province, 32% between Qazvin province and Tehran province (capital of Iran), 43% between Markazi province and Tehran, and 37% between Qom province and Tehran. CONCLUSION Policy makers should consider the regional misclassification in the time of programming for cancer control, prevention and resource allocation. PMID:28255430

  15. High-dose-rate and pulsed-dose-rate brachytherapy for oral cavity cancer and oropharynx cancer

    PubMed Central

    2010-01-01

    Interstitial brachytherapy represents the treatment of choice for small tumours, regionally localized in the oral cavity and the oropharynx. In the technical setting, continuous low-dose-rate (LDR) brachytherapy represented for many years the gold standard for administering radiation in head and neck brachytherapy. Large series of head and neck cancer patients treated with LDR brachytherapy have been reported, constituting an invaluable source of clinical data and the gold standard to compare results of new techniques. Nowadays, LDR brachytherapy competes with fractionated HDR and hyperfractionated PDR. In the paper an overview of the different time-dose-fraction alternatives to LDR brachytherapy in head and neck cancer is presented, as well as the radiobiological basis of different dose-rate schedules, the linear-quadratic model, interconversion of fractionation schedules and the repair half-times for early- and late-responding tissues. In subsequent sections essentials of switching from LDR to HDR and from LDR to PDR are discussed. Selected clinical results using HDR and PDR brachytherapy in oral cavity and oropharynx cancer are presented. PMID:28050175

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

    PubMed

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

    2015-04-20

    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.

  17. Temporal changes in liver cancer incidence rates in Japan: accounting for death certificate inaccuracies and improving diagnostic techniques.

    PubMed

    Sharp, G B; Cologne, J B; Fukuhara, T; Itakura, H; Yamamoto, M; Tokuoka, S

    2001-09-01

    Primary liver cancer (PLC) rates have risen dramatically during the past few decades in some regions, particularly in Japan, where PLC is now the third major cause of cancer death. PLC is one of the most difficult tumors to diagnose correctly, because (i) the liver is a frequent site of cancer metastasis and (ii) death from PLC is often attributed to cirrhosis or chronic hepatitis. Also, because the disease is often rapidly fatal, a large proportion of liver cancer cases are identified based on death certificates alone without confirmation by clinical records. Thus, worldwide differences in published incidence rates for this disease reflect regional or national differences in both the accuracy of death certificates and the sensitivity of diagnostic methods. By comparing death certificate causes of death with those based on pathology review, we were able to adjust 1958--1994 incidence rates for a large Japanese cohort for these errors. Although the death certificate false-positive error rate declined, the false-negative error rate remained high throughout the study. The introduction of improved liver cancer diagnostic methods in Japan in the early 1980s was associated with a sharp increase in PLC incidence. We conclude that errors in death certificate causes of death and changes in liver cancer diagnostic techniques have had an important impact on the reported incidence of this disease. Taking these factors into account, rates of hepatocellular carcinoma rose between 2.4- and 4.3-fold in our Japanese cohort from 1960 to 1985, peaked about 1993 and declined thereafter. Incidence rates of cholangiocarcinoma remained stable through 1987.

  18. TACImager: a high frame rate 320 x 256 SPAD time to amplitude converter array with adjustable time zoom

    NASA Astrophysics Data System (ADS)

    Finlayson, Neil; Parmesan, Luca; Dutton, Neale A. W.; Calder, Neil J.; Henderson, Robert K.

    2016-10-01

    Single-photon avalanche diodes (SPADs) in the form of high-resolution imaging pixel arrays are used in 3D cameras, motion-tracking, biomedical and time-correlated single photon counting (TCSPC) applications. Rapid spatial and temporal zoom onto objects of interest is an attractive feature. We present here novel high-speed time-zoom functionality achieved with the digital readout mode of the TACImager, a 256 x 256 TCSPC image sensor array based on sample and hold Time to Amplitude Converter (TAC) pixels. A column-parallel flash Analogue to Digital Converter (ADC) is implemented in the TACImager to support fast digital readout, allowing per-pixel, 3-bin TCSPC histogramming at frame rates of 4 kfps. New results related to this high-speed mode of operation are presented. The TACImager utilises a global ramp voltage as a timing reference, allowing time-zoom to be achieved through dynamic adjustment of comparator voltages, ramp offset voltages and ramp waveforms. We demonstrate the influence of fixed pattern noise in the pixels and column parallel ADCs on the results.

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

    PubMed Central

    Purnell, Jason Q.; Andersen, Barbara L.; Wilmot, James P.

    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 included 130 women assessed 2 years following diagnosis. Using hierarchical multiple regression analysis, the authors found that spiritual well-being was significantly associated with QoL and traumatic stress, whereas religious practice was not significantly associated with these variables. The results suggest that it may be helpful for clinicians to address spirituality, in particular with survivors of breast cancer. PMID:20098664

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

    NASA Astrophysics Data System (ADS)

    Sun, Xiaoqiang; Bao, Jiguang; Shao, Yongzhao

    2016-03-01

    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.

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

    PubMed

    Sun, Xiaoqiang; Bao, Jiguang; Shao, Yongzhao

    2016-03-01

    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.

  2. 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

  3. 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.

  4. 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.

  5. Medicare program; changes to the hospital inpatient prospective payment systems and fiscal year 2007 rates; fiscal year 2007 occupational mix adjustment to wage index; health care infrastructure improvement program; selection criteria of loan program for qualifying hospitals engaged in cancer-related health care and forgiveness of indebtedness; and exclusion of vendor purchases made under the competitive acquisition program (CAP) for outpatient drugs and biologicals under part B for the purpose of calculating the average sales price (ASP). Final rules and interim final rule with comment period.

    PubMed

    2006-08-18

    We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs to implement changes arising from our continuing experience with these systems, and to implement a number of changes made by the Deficit Reduction Act of 2005 (Pub. L. 109-171). In addition, in the Addendum to this final rule, we describe the changes to the amounts and factors used to determine the rates for Medicare hospital inpatient services for operating costs and capital-related costs. We also are setting forth rate-of-increase limits as well as policy changes for hospitals and hospital units excluded from the IPPS that are paid in full or in part on a reasonable cost basis subject to these limits. These changes are applicable to discharges occurring on or after October 1, 2006. In this final rule, we discuss public comments we received on our proposals to refine the diagnosis-related group (DRG) system under the IPPS to better recognize severity of illness among patients--to use a hospital-specific relative value (HSRV) cost center weighting methodology to adjust DRG relative weights; and to implement consolidated severity-adjusted DRGs or alternative severity adjustment methods. Among the other policy changes that we are making are those changes related to: limited revisions of the reclassification of cases to DRGs; the long-term care (LTC)-DRGs and relative weights; the wage data, including the occupational mix data, used to compute the wage index; applications for new technologies and medical services add-on payments; payments to hospitals for the direct and indirect costs of graduate medical education; submission of hospital quality data; payments to sole community hospitals and Medicare-dependent, small rural hospitals; and provisions governing emergency services under the Emergency Medical Treatment and Labor Act of 1986 (EMTALA). We are responding to requested public comments on a number of other issues that include performance

  6. QuickStats: Age-Adjusted Rate* for Suicide,(†) by Sex - National Vital Statistics System, United States, 1975-2015.

    PubMed

    2017-03-17

    There was an overall decline of 24% in the age-adjusted suicide rate from 1977 (13.7 per 100,000) to 2000 (10.4). The rate increased in most years from 2000 to 2015. The 2015  suicide rate (13.3) was 28% higher than in 2000. The rates for males and females  followed the overall pattern; however, the rate for males was approximately 3-5 times higher than the rate for females throughout the study period.

  7. Facilitating Treatment Decision Making, Adjustment, and Coping in Men Newly Diagnosed with Prostate Cancer. Addendum

    DTIC Science & Technology

    2005-05-01

    expectations), to facilitate treatment decision-making for localized prostate cancer ( PrCa ). Methods: CARE identified treatment-related values and goals...information. Couples (N=300) were enrolled after diagnosis with PrCa , but before a definite treatment decision was made. Data were assessed

  8. Follow‐up care in cancer: adjusting for referral targets and extending choice

    PubMed Central

    Wilson, Kate; Lydon, Anne; Amir, Ziv

    2011-01-01

    Abstract Background  Over recent years, several initiatives have impacted on the referral of patients to secondary care, most notably targets for urgent referral in suspected cancer and the patient choice agenda. At the same time, improved long‐term survival in cancer has increased numbers attending follow‐up, doubts about the effectiveness of specialist follow‐up have emerged, and alternative models of follow‐up have been tested. Aim  The aim of the study was to explore patient and carer perspectives on the flexibility and responsiveness of cancer services. This article focuses on findings relating to referral, subsequent outpatient appointments and cessation of outpatient follow‐up. Methods  Issues were explored in a qualitative study using face‐to‐face interviews with a purposive sample of 54 people affected by cancer. Data were analysed concurrently with data collection, using qualitative analysis software. Findings  The study gave rise to a number of salient themes. Links were identified between three of these: choice and responsiveness during referral; the flexibility and responsiveness of outpatient appointment systems; and negotiating cessation of follow‐up. It appeared that policy on urgent referrals might be adversely affecting practice relating to appointment systems and the continuance of follow‐up. Discussion and conclusions  Hospital‐based cancer follow‐up is being given decreasing priority because of doubts about effectiveness and a target‐driven focus on referral. This is impacting on patients, who may value outpatient follow‐up as a ‘safety net’ but have difficulties in obtaining appointments, and may be discharged without negotiation or adequate support. For these reasons, new forms of flexible/responsive aftercare are urgently needed. PMID:21615642

  9. Cancer risk assessment on trihalomethanes and haloacetic acids in drinking water of China using disability-adjusted life years.

    PubMed

    Pan, Shenling; An, Wei; Li, Hongyan; Su, Ming; Zhang, Jinliang; Yang, Min

    2014-09-15

    The cancer risks from exposure to trihalomethanes (THMs) and haloacetic acids (HAAs) through multiple pathways were assessed based on the result of a water quality survey in 35 major cities of China. To express the risks in disability-adjusted life years (DALYs), the excess cancer incidence estimates were combined with a two-stage disease model for calculation. The median total cancer risk of THMs and HAAs was calculated as 7.34 × 10(-7) DALYs per person-year (ppy), lower than the reference level of risk (10(-6)DALYsppy) set by WHO. The risk from ingestion and inhalation exposures contributed 93.6% and 6.3% of the total risk respectively, while dermal contact made a negligible contribution. The median risk of trichloroacetic acid (TCAA) (2.12 × 10(-7)DALYsppy) was highest among the disinfection by-products (DBPs) considered. The risk ratio of total HAAs (THAA) to total THMs (TTHM) was 1.12. The risk was highest in northeast China while lowest in northwest China. As for the 35 cities, Tianjin had the highest risk while Yinchuan had the lowest. This study attempted to use DALYs for the risk assessment of DBPs, which will provide useful information for risk comparison and prioritization of hazards in drinking water.

  10. Quantifying trade-offs: quality of life and quality-adjusted survival in a randomised trial of chemotherapy in postmenopausal patients with lymph node-negative breast cancer.

    PubMed

    Bernhard, J; Zahrieh, D; Coates, A S; Gelber, R D; Castiglione-Gertsch, M; Murray, E; Forbes, J F; Perey, L; Collins, J; Snyder, R; Rudenstam, C-M; Crivellari, D; Veronesi, A; Thürlimann, B; Fey, M F; Price, K N; Goldhirsch, A; Hürny, C

    2004-11-29

    We evaluated quality of life (QL) and quality-adjusted survival in International Breast Cancer Study Group Trial IX, a randomised trial including 1669 eligible patients receiving tamoxifen for 5 years or three prior cycles of cyclophosphamide, methotrexate and 5-fluorouracil (CMF) followed by 57 months tamoxifen. During the time with CMF toxicity (Tox), without symptoms and toxicity (TWiST), and following relapse (Rel), patients scored their QL indicators and a utility indicator for subjective health estimation between 'perfect' and 'worst' health. Scores were averaged within Tox, TWiST and Rel and transformed to utilities. Mean durations for the three transition times were weighted with utilities to obtain mean quality-adjusted TWiST (Q-TWiST). Patients receiving CMF reported significantly worse scores for most QL domains at month 3, but less hot flushes. After completing chemotherapy, there were no differences by treatment groups. Benefits evaluated by Q-TWiST favoured the additional chemotherapy. CMF provided 3 more months of Q-TWiST for patients with ER-negative tumours, but CMF provided no benefit in Q-TWiST for patients with ER-positive tumours. Q-TWiST analysis based on patient ratings is feasible in large-scale cross-cultural clinical trials.

  11. 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,

  12. 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

  13. 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

  14. 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

  15. Reduction of Deterministic Thinking Among Cancer Patients as a New Method to Increase Psychosocial Adjustments

    PubMed Central

    Younesi, Seyyed Jalal; Mirafzal, Akramsadat; Tooyserkani, Mahdieh

    2012-01-01

    Background Deterministic thinking is one of the major cognitive distortions. This type of thinking ignores any possibility in making a conclusion about events. Any consequence of an event may be thought as: 2×2= 4. Equality is a dominant factor among all conclusions of this kind of distortion. Distortion emerges in cognitive rigidity in the mind and could be the source of all distortions. Cognitive rigidity is a main reason for depression and other psychosocial maladjustments. Methods Challenging distortion was discussed as a new method for improving psychological conditions of cancer patients. Adapting the cultural base of the method, distortion is explained as a destructive factor which ruins the balance of fear and hope, the two important signs of faith in Islamic perspective. Results The consequence of challenging distortion to reduce depression and anxiety has been explained based on the Islamic Culture. Conclusion For the first time, in this study, it was proposed that how this method can be used in the treatment of psychological disorders of cancer patients. PMID:25628825

  16. A Case for Adjusting Subjectively Rated Scores in the Advanced Placement Tests. Program Statistics Research. Technical Report No. 94-5.

    ERIC Educational Resources Information Center

    Longford, Nicholas T.

    A case is presented for adjusting the scores for free response items in the Advanced Placement (AP) tests. Using information about the rating process from the reliability studies, administrations of the AP test for three subject areas, psychology, computer science, and English language and composition, are analyzed. In the reliability studies, 299…

  17. 42 CFR 484.220 - Calculation of the adjusted national prospective 60-day episode payment rate for case-mix and...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Calculation of the adjusted national prospective 60-day episode payment rate for case-mix and area wage levels. 484.220 Section 484.220 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED)...

  18. 42 CFR 484.220 - Calculation of the adjusted national prospective 60-day episode payment rate for case-mix and...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Calculation of the adjusted national prospective 60-day episode payment rate for case-mix and area wage levels. 484.220 Section 484.220 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED)...

  19. Adjustment for gas exchange threshold enhances precision of heart rate-derived VO2 estimates during heavy exercise.

    PubMed

    Pettitt, Robert W; Symons, J David; Taylor, Julie E; Eisenman, Patricia A; White, Andrea T

    2008-02-01

    Overestimates of oxygen uptake (VO2) are derived from the heart rate reserve-VO2 reserve (HRR-VO2R) model. We tested the hypothesis that adjusting for differences above and below gas exchange threshold (HRR-GET model) would tighten the precision of HR-derived VO2 estimates during heavy exercise. Seven men and 7 women of various VO2 max levels, on 2 separate days, cycled for 6 min at intensities equal to power at GET, 15% the difference between GET and VO2 max (15% above), and at 30% above GET. A second bout at 15% above GET (15% above (bout 2)) after 3 min of recovery was performed to assess estimates during interval training. Actual VO2 was compared with estimates derived from the HRR-VO2R and the HRR-GET. VO2 values were summed over the 6 min duration of data collection (6 min LO2) and compared with Bland-Altman plots. HRR-VO2R yielded 6 min LO2 (+/-2 SD) overestimates of 2.0 (+/-2.5), 1.9 (+/-2.7), and 1.3 (+/-3.3) for GET, 15% over, and 30% over, respectively, whereas corresponding 6 min LO2 difference values for the HRR-GET model were -0.42 (+/-1.6), -0.23 (+/-1.1), and -0.55 (+/-1.8), respectively. For 15% above (bout 2), the 6 min LO2 difference for HRR-VO2R was 1.8 (+/-2.9), whereas the difference for HRR-GET was 0.17 (+/-1.4). The 6 min LO2 values relative to the subjects' VO2 max did not vary (r=0.05 to 0.36); therefore, fitness level did not affect estimates. Sex did not affect accuracy of either estimate model (sex X estimate model interaction, p>0.95). We observed accurate estimates from the HRR-GET model during heavy exercise.

  20. Survival rate after emergency diagnosis of cancer is 'shocking'.

    PubMed

    2015-12-01

    ONE QUARTER of patients diagnosed with cancer after attending a London emergency department will die within two months, latest research suggests. Study author Kathy Pritchard-Jones, chief medical officer for London Cancer, said the 'shocking figures' confirm that early diagnosis makes a huge difference to the chances of surviving cancer.

  1. 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

  2. Personalized Prediction of Proliferation Rates and Metabolic Liabilities in Cancer Biopsies.

    PubMed

    Diener, Christian; Resendis-Antonio, Osbaldo

    2016-01-01

    Cancer is a heterogeneous disease and its genetic and metabolic mechanism may manifest differently in each patient. This creates a demand for studies that can characterize phenotypic traits of cancer on a per-sample basis. Combining two large data sets, the NCI60 cancer cell line panel, and The Cancer Genome Atlas, we used a linear interaction model to predict proliferation rates for more than 12,000 cancer samples across 33 different cancers from The Cancer Genome Atlas. The predicted proliferation rates are associated with patient survival and cancer stage and show a strong heterogeneity in proliferative capacity within and across different cancer panels. We also show how the obtained proliferation rates can be incorporated into genome-scale metabolic reconstructions to obtain the metabolic fluxes for more than 3000 cancer samples that identified specific metabolic liabilities for nine cancer panels. Here we found that affected pathways coincided with the literature, with pentose phosphate pathway, retinol, and branched-chain amino acid metabolism being the most panel-specific alterations and fatty acid metabolism and ROS detoxification showing homogeneous metabolic activities across all cancer panels. The presented strategy has potential applications in personalized medicine since it can leverage gene expression signatures for cell line based prediction of additional metabolic properties which might help in constraining personalized metabolic models and improve the identification of metabolic alterations in cancer for individual patients.

  3. Personalized Prediction of Proliferation Rates and Metabolic Liabilities in Cancer Biopsies

    PubMed Central

    Diener, Christian; Resendis-Antonio, Osbaldo

    2016-01-01

    Cancer is a heterogeneous disease and its genetic and metabolic mechanism may manifest differently in each patient. This creates a demand for studies that can characterize phenotypic traits of cancer on a per-sample basis. Combining two large data sets, the NCI60 cancer cell line panel, and The Cancer Genome Atlas, we used a linear interaction model to predict proliferation rates for more than 12,000 cancer samples across 33 different cancers from The Cancer Genome Atlas. The predicted proliferation rates are associated with patient survival and cancer stage and show a strong heterogeneity in proliferative capacity within and across different cancer panels. We also show how the obtained proliferation rates can be incorporated into genome-scale metabolic reconstructions to obtain the metabolic fluxes for more than 3000 cancer samples that identified specific metabolic liabilities for nine cancer panels. Here we found that affected pathways coincided with the literature, with pentose phosphate pathway, retinol, and branched-chain amino acid metabolism being the most panel-specific alterations and fatty acid metabolism and ROS detoxification showing homogeneous metabolic activities across all cancer panels. The presented strategy has potential applications in personalized medicine since it can leverage gene expression signatures for cell line based prediction of additional metabolic properties which might help in constraining personalized metabolic models and improve the identification of metabolic alterations in cancer for individual patients. PMID:28082911

  4. Neighborhood foreclosures and self-rated health among breast cancer survivors

    PubMed Central

    Deshpande, Anjali D.; Pruitt, Sandi L.; Jeffe, Donna B.

    2011-01-01

    Purpose We determined the association of neighborhood foreclosure risk on the health status of a statewide sample of breast cancer survivors (n = 1047) and the extent to which covariates accounted for observed associations. Methods Measures of self-rated health and several covariates were obtained by telephone interview 1 year after diagnosis. We used the federal Housing and Urban Development agency's estimated census-tract foreclosure-abandonment-risk score and multilevel, logistic regression to determine the association of foreclosure risk (high, moderate versus low) with self-rated health (fair-poor versus good, very good, excellent) and whether covariates could explain the observed association. Results Women who resided in high-foreclosure-risk (HFR) areas were 2.39 times (95% CI: 1.83–3.13) more likely to report being in fair-poor health than women who lived in low-foreclosure-risk areas. The odds ratio (OR) was reduced for women who lived in high-foreclosure-risk versus low-foreclosure-risk areas after adjusting for income (HFR OR: 1.78; 95% CI: 1.01–3.15), physical activity (HFR OR: 1.74; 95% CI: 0.98–3.08), and perceived neighborhood conditions (HFR OR: 1.76; 95% CI: 1.02–3.05). Conclusions Breast cancer survivors who lived in census tracts with high- versus low-foreclosure risk reported poorer health status. This association was explained by differences in household income, physical activity, and perceived neighborhood conditions. PMID:21590510

  5. Ultraviolet B Irradiance and Incidence Rates of Bladder Cancer in 174 Countries

    DTIC Science & Technology

    2010-03-01

    Schistosoma hemato- bium is highly prevalent in Egypt, 35 and chronic infection with it has been shown to substantially increase risk of bladder cancer ...rates of bladder cancer in a few European countries may be due in part to the extremely high prevalence of cigarette smok- ing in those countries in the...Ferlay J, Bray F, Pisani P, Parkin D. GLOHOCAN 2002: cancer inci- dence, mortality and prevalence worldwide. IARC Cancer Base No.5. version 2.0. www

  6. 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

  7. Comparison of social support content within online communities for high- and low-survival-rate cancers.

    PubMed

    Buis, Lorraine R; Whitten, Pamela

    2011-08-01

    People experiencing cancer use the Internet for many reasons, particularly for social support. This study sought to determine how social support content within online support communities for different cancers varied according to cancer survival rate. A quantitative content analysis was conducted on 3717 posts from eight online communities focused on cancers with high and low 5-year relative survival rates. Using Optimal Matching Theory, we predicted that low-survival-rate communities would have more emotional support content than high-survival-rate communities, and high-survival-rate communities would have more informational support content than low-survival-rate communities. Emotional support content was consistently more common than informational support. Overall, high-survival-rate communities had a greater proportion of posts containing emotional support content (75%) than low-survival-rate communities (66%) (χ1 = 20.89 [n = 2235], P < .001). Furthermore, low-survival-rate communities had a greater proportion of posts containing informational support content (46%) than high-survival-rate communities (36%) (χ1 = 21.13 [n = 2235], P< .001). Although the relationships between survival rate and support types were significant, they were not as hypothesized. Deviations from theoretically predicted results suggest that individuals experiencing low-survival-rate cancers may have a greater desire for informational support online than individuals experiencing high-survival-rate cancers.

  8. The association between self-consciousness about appearance and psychological adjustment among newly diagnosed breast cancer patients and survivors: the moderating role of appearance investment.

    PubMed

    Moreira, Helena; Canavarro, Maria Cristina

    2012-03-01

    This study examined the moderating role of two facets of appearance investment (self-evaluative salience (SES) and motivational salience (MS)) in the relationship between self-consciousness about appearance and psychological adjustment (depression, anxiety and psychological quality of life (QoL)) in a sample of 134 breast cancer patients (68 newly diagnosed patients and 66 survivors). No significant differences were found between groups on body image variables. Among survivors, the associations between self-consciousness about appearance and the outcome variables were only significant at high (depression, psychological QoL) levels and at moderate (psychological QoL) levels of SES. Self-consciousness about appearance contributed to poor adjustment in both groups. This study demonstrates that appearance investment plays a key role in patients' adjustment and highlights the SES-MS distinction. SES seems to be a vulnerability factor for poor adjustment, and MS seems to be a protective factor that helps women cope with changes in appearance.

  9. 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.

  10. County-level socioeconomic status and cancer rates in Texas, 2001-2005.

    PubMed

    Risser, David R; Miller, Eric A; Williams, Melanie A; Foxhall, Lewis E

    2010-10-01

    Previous studies have shown that a person's socioeconomic status (SES) (a proxy measure that can incorporate income, wealth, education, and occupation) is associated with cancer incidence and mortality. Examining variation in cancer rates by SES can help identify health disparities and target areas for cancer control activities. The Texas Cancer Registry (TCR) collects data on every newly diagnosed case of cancer in Texas, including personal and demographic data, but does not collect data related directly to SES. Using a county-level measure of SES determined by the 2000 US Census, we compared cancer incidence and mortality rates for selected cancer sites by counties categorized into Low, Intermediate, and High SES. The cancers examined in this analysis included lung, colorectal, female breast, prostate, cervical, and all cancers collected by TCR combined. Consistent with other studies, most incidence and mortality rates were lowest in the High SES counties. However, in general, the highest incidence and mortality rates were found in counties categorized as Intermediate SES, but patterns differed by cancer site and by race and ethnicity. This study provides additional evidence that geographically related SES is associated with cancer incidence and mortality.

  11. 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

  12. Cancer incidence rates in the Kurdistan region/Iraq from 2007-2009.

    PubMed

    Othman, Ramadhan T; Abdulljabar, Rezvan; Saeed, Abdullah; Kittani, Sarwar Sadiq; Sulaiman, Hushyar M; Mohammed, Sami A; Rashid, Rekawt M; Hussein, Nawfal R

    2011-01-01

    Cancer is a disease of gradual increase in incidence overall the world. Kurdistan Region in Iraq has been exposed to several carcinogenic hazards. There are few reports about the increased risk of cancer in different cities in Iraq. These reports did not cover Kurdistan region. The aim of this paper was to study cancer incidence and to identify possible risks of cancer in this region. Cancer registries from 9 hospitals in three cities of Kurdistan were used as a source of data. Information on these cases was subjected to careful verification regarding repetition, place of residence and other possible errors. Overall registered cases in 2007, 2008 and 2009 were 1444, 2081, 2356 respectively. 49% of registered cases were males and 51% were female. The Age Standardized Rate of cancer was 89.83/100 000 among male and 83.93/100 000 among female. The results showed major variation in incidence rates of different types of cancer in the three governorates of Kurdistan. Furthermore, there was evidence of increased risks of cancer in Kurdistan Region in Iraq. Hematological malignancies were the most common cancer among male (21.13% of all cancer in males) and second most common in female (18.8% of all cancer in female), only exceeded by breast cancer. To reach sound conclusions about extent and determinants of cancer in Kurdistan, enormous multi-spectrum efforts are now needed.

  13. 48 CFR 252.216-7008 - Economic price adjustment-wage rates or material prices controlled by a foreign government...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...-wage rates or material prices controlled by a foreign government-representation. 252.216-7008 Section... Clauses 252.216-7008 Economic price adjustment—wage rates or material prices controlled by a foreign... Adjustment—Wage Rates or Material Prices Controlled by a Foreign Government—Representation (MAR 2012) (a)...

  14. Test facility for advanced electric adjustable frequency drives and generators of typical industrial ratings. Final technical report

    SciTech Connect

    1997-12-01

    A test facility has been developed, for electric adjustable-speed motors and variable-speed generators, that is unique in US universities in terms of its range (5 to 300 hp currently with 0.1 to 1,000 hp final capability) and flexibility (standard NEMA frame and novel geometry machines can be accommodated). The basic facility was constructed with funding from the Electric Power Research Institute. The instrumentation obtained under this DOE grant has been integrated into the facility which was completed in Fall 1997. The facility has already provided useful studies for DOE, EPRI, as well as several West Coast industries and electric energy utilities.

  15. Adjustable Nyquist-rate System for Single-Bit Sigma-Delta ADC with Alternative FIR Architecture

    NASA Astrophysics Data System (ADS)

    Frick, Vincent; Dadouche, Foudil; Berviller, Hervé

    2016-09-01

    This paper presents a new smart and compact system dedicated to control the output sampling frequency of an analogue-to-digital converters (ADC) based on single-bit sigma-delta (ΣΔ) modulator. This system dramatically improves the spectral analysis capabilities of power network analysers (power meters) by adjusting the ADC's sampling frequency to the input signal's fundamental frequency with a few parts per million accuracy. The trade-off between straightforwardness and performance that motivated the choice of the ADC's architecture are preliminary discussed. It particularly comes along with design considerations of an ultra-steep direct-form FIR that is optimised in terms of size and operating speed. Thanks to compact standard VHDL language description, the architecture of the proposed system is particularly suitable for application-specific integrated circuit (ASIC) implementation-oriented low-power and low-cost power meter applications. Field programmable gate array (FPGA) prototyping and experimental results validate the adjustable sampling frequency concept. They also show that the system can perform better in terms of implementation and power capabilities compared to dedicated IP resources.

  16. Five-Year Cancer Survival Rates in Oklahoma from 1997 to 2008

    PubMed Central

    Campbell, Janis; Gandhi, Krupa; Pate, Anne; Janitz, Amanda; Anderson, Amber; Kinnard, Robin; Ding, Kai

    2016-01-01

    Introduction This study evaluated the five-year observed survival rates of American Indians/Alaskan Native, African American, and white cancer patients among various demographic characteristics in Oklahoma focusing on lung and bronchus, colon and rectum, female breast, and prostate for the cancer patients diagnosed between 1997 and 2008. Methods The five-year observed survival rates were calculated for overall cancer and specific cancer sites, using Kaplan-Meier method with data from the Oklahoma Central Cancer Registry. Results Overall, 51.5% patients diagnosed with cancer survived for five years. For specific sites we found: 79.2% for female breast cancer survived; 77.5% for prostate cancer; 12.9% for lung and bronchus cancer; and 49.9% for colorectal cancer. Conclusions The five-year observed survival rates in Oklahoma were consistent with national trends. Overall, cancer survival seems to be improving over time, but there remains disparity with the AA and AI/AN populations in contrast to whites in Oklahoma. PMID:27890941

  17. 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

  18. 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.

  19. Stomach cancer incidence rates among Americans, Asian Americans and Native Asians from 1988 to 2011.

    PubMed

    Kim, Yeerae; Park, Jinju; Nam, Byung-Ho; Ki, Moran

    2015-01-01

    Stomach cancer is the second most common cancer in Eastern Asia, accounting for approximately 50% of all new cases of stomach cancer worldwide. Our objective was to compare the stomach cancer incidence rates of Asian Americans in Los Angeles with those of native Asians to assess the etiology of stomach cancer from 1988 to 2011. To examine these differences, Asian Americans (Korean, Japanese, Chinese, and Filipino Americans living in Los Angeles, California, USA) and native Asians (from Korea, Japan, China, and the Philippines) were selected for this study. Using the Cancer Incidence in Five Continents database, stomach cancer incidence rates were examined. Data from the National Cancer Registry of Korea were used for native Koreans. Between native countries, the incidence rates in Japan, China, the Philippines, and the US declined over time, but the incidence in Korea has remained constant. The incidences among Asian immigrants were lower than those among native Asians. The incidence rates of males were approximately 2 times higher than those among females in Asian countries were. The effect of immigration on stomach cancer incidence suggests that lifestyle factors are a significant determinant of stomach cancer risk. However, the incidence in Korea remains the highest of these countries.

  20. 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.

  1. 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

    ...-wage rates or material prices controlled by a foreign government. 252.216-7003 Section 252.216-7003... Economic price adjustment—wage rates or material prices controlled by a foreign government. As prescribed... Prices Controlled by a Foreign Government (MAR 2012) (a) As represented by the Contractor in its...

  2. 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

    ... 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 Prices... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Economic price...

  3. 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

    ... Assistance Percentage Rates for Federal Matching Shares for Medicaid and Title IV-E Foster Care, Adoption... of the ARRA provides for a temporary increase in FMAP rates for Medicaid and title IV-E Foster Care... (including Foster Care, Adoption Assistance and Guardianship Assistance programs) only to the extent of...

  4. External Validation of a Case-Mix Adjustment Model for the Standardized Reporting of 30-Day Stroke Mortality Rates in China

    PubMed Central

    Yu, Ping; Pan, Yuesong; Wang, Yongjun; Wang, Xianwei; Liu, Liping; Ji, Ruijun; Meng, Xia; Jing, Jing; Tong, Xu; Guo, Li; Wang, Yilong

    2016-01-01

    Background and Purpose A case-mix adjustment model has been developed and externally validated, demonstrating promise. However, the model has not been thoroughly tested among populations in China. In our study, we evaluated the performance of the model in Chinese patients with acute stroke. Methods The case-mix adjustment model A includes items on age, presence of atrial fibrillation on admission, National Institutes of Health Stroke Severity Scale (NIHSS) score on admission, and stroke type. Model B is similar to Model A but includes only the consciousness component of the NIHSS score. Both model A and B were evaluated to predict 30-day mortality rates in 13,948 patients with acute stroke from the China National Stroke Registry. The discrimination of the models was quantified by c-statistic. Calibration was assessed using Pearson’s correlation coefficient. Results The c-statistic of model A in our external validation cohort was 0.80 (95% confidence interval, 0.79–0.82), and the c-statistic of model B was 0.82 (95% confidence interval, 0.81–0.84). Excellent calibration was reported in the two models with Pearson’s correlation coefficient (0.892 for model A, p<0.001; 0.927 for model B, p = 0.008). Conclusions The case-mix adjustment model could be used to effectively predict 30-day mortality rates in Chinese patients with acute stroke. PMID:27846282

  5. Delay Adjusted Incidence

    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. Does childhood cancer affect parental divorce rates? A population-based study.

    PubMed

    Syse, Astri; Loge, Jon H; Lyngstad, Torkild H

    2010-02-10

    PURPOSE Cancer in children may profoundly affect parents' personal relationships in terms of psychological stress and an increased care burden. This could hypothetically elevate divorce rates. Few studies on divorce occurrence exist, so the effect of childhood cancers on parental divorce rates was explored. PATIENTS AND METHODS Data on the entire Norwegian married population, age 17 to 69 years, with children age 0 to 20 years in 1974 to 2001 (N = 977,928 couples) were retrieved from the Cancer Registry, the Central Population Register, the Directorate of Taxes, and population censuses. Divorce rates for 4,590 couples who were parenting a child with cancer were compared with those of otherwise similar couples by discrete-time hazard regression models. Results Cancer in a child was not associated with an increased risk of parental divorce overall. An increased divorce rate was observed with Wilms tumor (odds ratio [OR], 1.52) but not with any of the other common childhood cancers. The child's age at diagnosis, time elapsed from diagnosis, and death from cancer did not influence divorce rates significantly. Increased divorce rates were observed for couples in whom the mothers had an education greater than high school level (OR, 1.16); the risk was particularly high shortly after diagnosis, for CNS cancers and Wilms tumors, for couples with children 0 to 9 years of age at diagnosis, and after a child's death. CONCLUSION This large, registry-based study shows that cancer in children is not associated with an increased parental divorce rate, except with Wilms tumors. Couples in whom the wife is highly educated appear to face increased divorce rates after a child's cancer, and this may warrant additional study.

  7. p53 mutations associated with aging-related rise in cancer incidence rates.

    PubMed

    Richardson, Richard B

    2013-08-01

    TP53's role as guardian of the genome diminishes with age, as the probability of mutation increases. Previous studies have shown an association between p53 gene mutations and cancer. However, the role of somatic TP53 mutations in the steep rise in cancer rates with aging has not been investigated at a population level. This relationship was quantified using the International Agency for Research on Cancer (IARC) TP53 and GLOBOCAN cancer databases. The power function exponent of the cancer rate was calculated for 5-y age-standardized incidence or mortality rates for up to 25 cancer sites occurring in adults of median age 42 to 72 y. Linear regression analysis of the mean percentage of a cancer's TP53 mutations and the corresponding cancer exponent was conducted for four populations: worldwide, Japan, Western Europe, and the United States. Significant associations (P ≤ 0.05) were found for incidence rates but not mortality rates. Regardless of the population studied, positive associations were found for all cancer sites, with more significant associations for solid tumors, excluding the outlier prostate cancer or sex-related tumors. Worldwide and Japanese populations yielded P values as low as 0.002 and 0.005, respectively. For the United States, a significant association was apparent only when analysis utilized the Surveillance, Epidemiology, and End Results (SEER) database. This study found that TP53 mutations accounts for approximately one-quarter and one-third of the aging-related rise in the worldwide and Japanese incidence of all cancers, respectively. These significant associations between TP53 mutations and the rapid rise in cancer incidence with aging, considered with previously published literature, support a causal role for TP53 according to the Bradford-Hill criteria. However, questions remain concerning the contribution of TP53 mutations to neoplastic development and the role of factors such as genetic instability, obesity, and gene deficiencies other

  8. 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.

  9. Doubly robust estimator for net survival rate in analyses of cancer registry data.

    PubMed

    Komukai, Sho; Hattori, Satoshi

    2017-03-01

    Cancer population studies based on cancer registry databases are widely conducted to address various research questions. In general, cancer registry databases do not collect information on cause of death. The net survival rate is defined as the survival rate if a subject would not die for any causes other than cancer. This counterfactual concept is widely used for the analyses of cancer registry data. Perme, Stare, and Estève (2012) proposed a nonparametric estimator of the net survival rate under the assumption that the censoring time is independent of the survival time and covariates. Kodre and Perme (2013) proposed an inverse weighting estimator for the net survival rate under the covariate-dependent censoring. An alternative approach to estimating the net survival rate under covariate-dependent censoring is to apply a regression model for the conditional net survival rate given covariates. In this article, we propose a new estimator for the net survival rate. The proposed estimator is shown to be doubly robust in the sense that it is consistent at least one of the regression models for survival time and for censoring time. We examine the theoretical and empirical properties of our proposed estimator by asymptotic theory and simulation studies. We also apply the proposed method to cancer registry data for gastric cancer patients in Osaka, Japan.

  10. 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

    ... 5 Administrative Personnel 3 2013-01-01 2013-01-01 false Treatment of employees whose rate of pay... a result of that rating, DHS must— (1) If the employee demonstrates performance that meets or... action procedures established in subpart F of this part. (b) If DHS fails to initiate a removal...

  11. Age-adjusted charlson comorbidity index score as predictor of prolonged postoperative ileus in patients with colorectal cancer who underwent surgical resection.

    PubMed

    Tian, Yaohua; Xu, Beibei; Yu, Guopei; Li, Yan; Liu, Hui

    2017-02-11

    Comorbidities had considerable effects on the development of postoperative ileus (POI). The primary aim of the present study was to determine the influence of the age-adjusted Charlson comorbidity index (ACCI) score on the risk of prolonged POI in patients with colorectal cancer who underwent surgical resection. Using the electronic Hospitalization Summary Reports, we identified 11,397 patients with colorectal cancer who underwent surgical resection from 2013 through 2015. Logistic regression models were applied to evaluate the effect of the ACCI score on the risk of prolonged POI. The ACCI score had a positive graded association with the risk of prolonged POI in both colon and rectal cancer (P for trend < 0.05). Among patients with rectal cancer, after adjusting for potential confounders, those with an ACCI score of 4-5 had a 108% higher risk of prolonged POI than those with an ACCI score of 0-1 (odds ratio [OR], 2.08; 95% confidence interval [CI], 1.09-3.98), and those with an ACCI score of ≥ 6 had a 130% higher risk (OR, 2.30; 95% CI, 1.08-4.89). Among patients with colon cancer, those with an ACCI score of ≥ 6 had a 47% greater risk of prolonged POI than those with an ACCI score of 0-1 (OR, 1.47; 95% CI, 1.07-2.02). These findings suggested that a higher ACCI score was an independent predictor of the development of prolonged POI.

  12. 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

  13. Association Between Air Temperature and Cancer Death Rates in Florida: An Ecological Study.

    PubMed

    Hart, John

    2015-01-01

    Proponents of global warming predict adverse events due to a slight warming of the planet in the last 100 years. This ecological study tests one of the possible arguments that might support the global warming theory - that it may increase cancer death rates. Thus, average daily air temperature is compared to cancer death rates at the county level in a U.S. state, while controlling for variables of smoking, race, and land elevation. The study revealed that lower cancer death rates were associated with warmer temperatures. Further study is indicated to verify these findings.

  14. U.S. Cancer Death Rates Continue to Fall

    MedlinePlus

    ... cancer death. Similarly, the report found that for black women those same figures fell from 20 percent in 1998 to 13 percent by 2014. As to why, the study authors suggested that ... percentage of black Americans who remain uninsured plummeted from 21 percent ...

  15. What is being done about Delaware's high cancer death rate? (1988 through June 1997).

    PubMed

    Frelick, R W

    1997-12-01

    After more than ten years of studies of Delaware's high cancer death rates by Delaware's Division of Public Health, few of the recommendations to reduce the excessive number of cancer deaths have been understood or adopted. Although rural Sussex County's cancer death rate is higher than the other two counties (except for lung cancer), and Delaware has only a few more cancers per population than the national average, industrial toxins commonly continue to be blamed for the State's high cancer mortality rate. People are still not persuaded that over the long run, cancer deaths would be cut by adopting healthy life styles to: 1. Reduce exposures to tobacco (by far the most significant intervention), 2. Stick to low fat, high fiber diets, 3. Have regular screening for cancers with appropriate tests 4. Seek medical attention for early symptoms of cancer. This review is seeking to emphasize the importance of implementing the repeated recommendations to reduce cancer mortality in Delaware without asking for another study, and to stress that health behavior education at home and in the schools is a cost effective way to initiate the adoption of healthy life styles to reduce the risk of getting cancer and dying from it. Efforts in the schools should be continued by extending health promotion activities to workplaces, doctors' offices, and to the general public with a focus on senior citizens. Universal access to health care will be needed especially for the poorly educated with limited fiscal resources who are most at risk. Delaware needs action, not more studies, to reduce its high cancer death rate.

  16. 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

    ... customers with Contract High Water Mark (CHWM) contracts from proposing changes to the TRM's ratesetting... Water Mark (RHWM) Process Under the Tiered Rate Methodology (TRM), BPA has established FY 2014-2015... service to their load above high water mark. About 75 percent of BPA's power revenues are paid under...

  17. 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...

  18. Worldwide Cancer Rates Up More Than One-Third in Past Decade: Report

    MedlinePlus

    ... One-Third in Past Decade: Report Researchers cite population aging and growth To use the sharing features on this page, ... rise in cancer cases was mainly due to population aging and growth, along with changes in age-specific cancer rates, ...

  19. Differences in cancer mortality rates in Ohio communities with respect to uraniferous geology

    SciTech Connect

    Dzik, A.J.

    1989-07-01

    Populations in areas of uraniferous geology may be at risk from radon emissions. Twenty-eight municipalities were examined as to their location with respect to uraniferous geology. Communities with possible radon risk had higher rates for all cancers and cancer of the respiratory system, but differences were not statistically significant. Some possible reasons for the results are discussed.

  20. 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.

  1. 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.

  2. Trends in 5-year survival rates among breast cancer patients by hormone receptor status and stage

    PubMed Central

    Chen, Lu; Linden, Hannah M.; Anderson, Benjamin O.; Li, Christopher I.

    2014-01-01

    Purpose Improvement in breast cancer survival has been observed in recent decades in the U.S., but it is unclear if similar survival gains are consistent across breast cancer subtypes, especially with regards to more advanced stages of the disease. Methods Data were from 13 population-based cancer registries participating in the Surveillance, Epidemiology and End Results (SEER) program, consisting of women between 20–79 years of age diagnosed with invasive breast cancer between 1992 and 2008. 2-year (1992–2008) and 5-year (1992–2006) breast cancer cause-specific survival rates were calculated and stratified by estrogen receptor (ER)/progesterone receptor (PR) status, stage and race. Annual percent changes in survival rates were assessed. Results From 1992 through 1998–1999, 5-year and 2-year cause specific survival rates significantly improved across ER+/PR+, ER−/PR− and ER+/PR− subtypes, with an annual increase ranging from 0.5%–1.0%. From 1998–1999 to 2006, different patterns were observed by ER/PR subtypes with survival rates slightly improving for ER+/PR+, continuing to improve at a rate of 0.5% per year for ER−/PR−, and dropping 0.3% annually for ER+/PR− No significant survival gains were experienced by patients with ER−/PR+ cancer during the study period. In terms of advanced diseases, greatest annual increases in survival rates were seen for patients with stage III–IV ER+/PR+ and ER−/PR− tumors but less progress was observed for advanced ER+/PR− breast cancers. Conclusion Steady improvements in survival rates for breast cancer have been achieved over the past several decades. However, 5-year survival rates for stage IV disease remained dismally below 20% for most ER/PR subtypes. PMID:25164974

  3. Statistical methods to adjust for date and age misreporting to improve estimates of vital rates in Pakistan.

    PubMed

    Pullum, T W

    1991-02-01

    Misreporting of dates and ages poses serious difficulties for the estimation of the age distribution and birth and death rates in many developing countries. The pervasiveness of these problems is illustrated with data from a well-designed on-going survey in Pakistan, the Pakistan Demographic Survey. Methods for reconciling discrepancies, based on the assumptions of constant misreporting and survivorship patterns, are presented. The reasoning behind these methods could be applied much more generally. Research into the cultural interpretations of age and dates, and the nature of possible biases, is called for.

  4. Improving preemptive transplant education to increase living donation rates: reaching patients earlier in their disease adjustment process.

    PubMed

    Hays, Rebecca; Waterman, Amy D

    2008-12-01

    Patients who receive a preemptive kidney transplant before starting dialysis avoid the medical complications related to dialysis and have the highest graft success and lowest mortality rates. Because only 2.5% of incident patients receive kidney transplants preemptively, improved psychosocial education may assist more patients in accessing preemptive transplant. This article outlines (1) unique psychosocial issues affecting patients with chronic kidney disease stage 4 (glomerular filtration rates > 20 mL/min per 1.73 m2) and (2) how an educational program about preemptive living donor transplant should be designed and administered to increase access to this treatment option. Early referral patients may be overwhelmed in coping with and learning about their disease and, therefore, not ready to make a treatment decision, or they may be highly motivated to obtain a transplant to avoid dialysis and return to a normal life. An education program that defines the quality-of-life and health benefits possible with early transplant is outlined. The program is focused on minimizing the disruption of starting 2 treatment techniques and maximizing early transplant health, graft survival, employability, and retention of insurance coverage. Once the benefits of preemptive living donor transplant are outlined, educators can focus on demystifying the living donor evaluation process and assisting interested patients in planning how to find a living donor. To reach all patients, especially racial minorities, education about preemptive transplant should be available in primary-care physicians' and community nephrologists' offices, at dialysis centers, and through other kidney organizations.

  5. An age adjustment of very young children of India, 1981 and reappraisal of fertility and mortality rates--A model approach.

    PubMed

    Mukhopadhyay, B K

    1986-01-01

    Several approaches were made by actuaries and demographers to correct and smooth the Indian age distribution with special emphasis on population in age group 0-4 at different points of time. The present analysis conceives the life table stationary population (using the West Model) as 'reference standard'. 2 parameters were estimated from a regression equation using the proportion of population in age groups 5-14 and 60-plus as independent variables and that in 0-4 as the dependent variable. The corrected census proportions in age group 0-4 obtained from the regression model under certain assumptions for the 14 major states and India seem to be consistent and to have slightly lower values than those of the 1971 adjusted data. Moreover, unadjusted and adjusted proportions in 5-14 and 60 plus do not show any significant difference between the predicted values. Using the corrected population aged 0-4 years, the average annual birth and death rates during the 5 year period preceeding the 1981 census have been estimated for those 14 states and India as well. The estimated birth rates so obtained were further adjusted using an appropriate factor from the West Model and Indian life table survival ratios. The final estimates seem to be consistent, except for a few, and to have slightly higher values than those of earlier estimates. As the present analysis is based on a 5% sample and confined to only 14 states, it is proposed to study the same for all the states and India in greater detail using full count data on age distribution and actul life tables as and when available.

  6. 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

  7. Trends in Cancer Screening Rates among Korean Men and Women: Results from the Korean National Cancer Screening Survey (KNCSS), 2004-2010

    PubMed Central

    Lee, Eun-Ha; Lee, Hoo-Yeon; Choi, Kui Son; Park, Eun-Cheol; Lee, Jin Soo

    2011-01-01

    Purpose The Korean National Cancer Screening Survey (KNCSS) is a continuous nationwide survey implemented by the National Cancer Center in Korea since 2004. The purpose of the present study was to report trends in cancer screening rates for the five major cancers (stomach, liver, colorectal, breast, and cervix uteri) in Korean men and women. Materials and Methods The study used KNCSS data collected between 2004 and 2010. The survey was conducted on Korean men aged 40-74 years and Korean women aged 30-74 years with no history of cancer diagnosis. The annual percentage change and corresponding 95% confidence intervals were used to examine changes in annual screening rates. Results Screening rates with recommendation increased by 4.4% annually for stomach cancer, 1.5% for liver cancer, 2.8% per year for colorectal cancer, 4.5% for breast cancer, and 1.2% for cervix uteri cancer. The increasing trend in cancer screening rates, with the exception of liver cancer, was significant. Conclusion Cancer screening rates have increased consistently from 2004 to 2010 among Korean men and women. Stomach and breast cancer screening rates in particular have increased markedly. PMID:22022290

  8. Prostate cancer incidence rates have started to decrease in central Italy.

    PubMed

    Crocetti, Emanuele; Ciatto, Stefano; Buzzoni, Carlotta; Zappa, Marco

    2010-01-01

    The widespread use of prostate-specific antigen (PSA) testing has dramatically changed the epidemiology of prostate cancer. Growing incidence rates have been documented in almost all western countries following the increased usage of PSA screening. In the United States after a period of huge increase in incidence, rates have decreased to values lower than those of the pre-PSA era. Similar changes have been documented also in the area of the Tuscany Cancer Registry, central Italy, where prostate cancer incidence rates doubled from the early 1990s to 2003 and afterwards decreased. This is the first evidence, to our knowledge, of a decline in prostate cancer incidence in Italy following the screening-related increase.

  9. 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.

  10. A higher incidence rate of acute coronary syndrome following radiation therapy in patients with breast cancer and a history of coronary artery diseases.

    PubMed

    Lee, Yen-Chien; Chuang, Jen-Pin; Hsieh, Pi-Ching; Chiou, Meng-Jiun; Li, Chung-Yi

    2015-07-01

    This study aims to investigate whether patients with breast cancer and a history of cardiovascular diseases (CADs) are at an increased incidence of acute coronary syndrome (ACS) after receiving radiation therapy (RT). In Taiwan, 5828 patients who had a history of CAD were newly diagnosed of breast cancer and received mastectomy between 1999 and 2009. Among these patients, 1851 also received RT. The study cohort was prospectively followed to the end of 2010 for estimating the incidence of ACS in association with exposure to RT. A Cox proportional hazard model that was adjusted for covariates was used to estimate the hazard ratio (HR) of ACS. Over the study period, the incident rates of ACS for RT and control patients were estimated at 1.51 and 1.77 per 100 person-years, respectively. Covariate-adjusted regression analysis indicated that the hazard of ACS significantly increased in RT patients at an adjusted HR of 1.48 [95% confidence interval (CI) 1.18-1.87]. Both hypertension and diabetes significantly increased the hazard of ACS in this patient cohort, with adjusted HRs of 3.31 (95% CI 1.94-5.66) and 1.50 (95% CI 1.19-1.89), respectively. This 12-year follow-up study suggested excess of ACS events in association with RT exposure in patients with breast cancer who had a higher cardiovascular risk. In consideration of the benefit associated with RT, intensive cardiac care should be given to patients with breast cancer and high cardiovascular risk.

  11. Survival rate of breast cancer patients in Malaysia: a population-based study.

    PubMed

    Abdullah, Nor Aini; Wan Mahiyuddin, Wan Rozita; Muhammad, Nor Asiah; Ali, Zainudin Mohamad; Ibrahim, Lailanor; Ibrahim Tamim, Nor Saleha; Mustafa, Amal Nasir; Kamaluddin, Muhammad Amir

    2013-01-01

    Breast cancer is the most common cancer among Malaysian women. Other than hospital-based results, there are no documented population-based survival rates of Malaysian women for breast cancers. This population- based retrospective cohort study was therefore conducted. Data were obtained from Health Informatics Centre, Ministry of Health Malaysia, National Cancer Registry and National Registration Department for the period from 1st Jan 2000 to 31st December 2005. Cases were captured by ICD-10 and linked to death certificates to identify the status. Only complete data were analysed. Survival time was calculated from the estimated date of diagnosis to the date of death or date of loss to follow-up. Observed survival rates were estimated by Kaplan- Meier method using SPSS Statistical Software version 17. A total of 10,230 complete data sets were analysed. The mean age at diagnosis was 50.6 years old. The overall 5-year survival rate was 49% with median survival time of 68.1 months. Indian women had a higher survival rate of 54% compared to Chinese women (49%) and Malays (45%). The overall 5-year survival rate of breast cancer patient among Malaysian women was still low for the cohort of 2000 to 2005 as compared to survival rates in developed nations. Therefore, it is necessary to enhance the strategies for early detection and intervention.

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

    PubMed

    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.

  13. 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.

  14. Rate of phosphoantimonylmolybdenum blue complex formation in acidic persulfate digested sample matrix for total dissolved phosphorus determination: importance of post-digestion pH adjustment.

    PubMed

    Huang, Xiao-Lan; Zhang, Jia-Zhong

    2008-10-19

    Acidic persulfate oxidation is one of the most common procedures used to digest dissolved organic phosphorus compounds in water samples for total dissolved phosphorus determination. It has been reported that the rates of phosphoantimonylmolybdenum blue complex formation were significantly reduced in the digested sample matrix. This study revealed that the intermediate products of persulfate oxidation, not the slight change in pH, cause the slowdown of color formation. This effect can be remedied by adjusting digested samples pH to a near neural to decompose the intermediate products. No disturbing effects of chlorine on the phosphoantimonylmolybdenum blue formation in seawater were observed. It is noted that the modification of mixed reagent recipe cannot provide near neutral pH for the decomposition of the intermediate products of persulfate oxidation. This study provides experimental evidence not only to support the recommendation made in APHA standard methods that the pH of the digested sample must be adjusted to within a narrow range of sample, but also to improve the understanding of role of residue from persulfate decomposition on the subsequent phosphoantimonylmolybdenum blue formation.

  15. 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. PMID:27635340

  16. 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…

  17. 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…

  18. 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.

  19. Lung cancer risk at low radon exposure rates in German uranium miners

    PubMed Central

    Kreuzer, M; Fenske, N; Schnelzer, M; Walsh, L

    2015-01-01

    Background: A determination of the risk of lung cancer at low levels of radon exposure is important for occupational radiation protection. Methods: The risk of death from lung cancer at low radon exposure rates was investigated in the subcohort of 26 766 German uranium miners hired in 1960 or later. Results: A clear association between lung cancer mortality (n=334 deaths) and cumulative exposure to radon in working level months (WLM) was found. The excess relative risk per WLM was 0.013 (95% confidence intervals: 0.007; 0.021). Conclusions: The present findings provide strong evidence for an increased lung cancer risk after long-term exposure to low radon exposure rates among Wismut miners. The results are compatible to those from residential radon studies and miner studies restricted to low levels. PMID:26393888

  20. 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.

  1. Can high dose rates used in cancer radiotherapy change therapeutic effectiveness?

    PubMed Central

    Konopacka, Maria; Sochanik, Aleksander; Ślosarek, Krzysztof

    2017-01-01

    Current cancer radiotherapy relies on increasingly high dose rates of ionising radiation (100–2400 cGy/min). It is possible that changing dose rates is not paralleled by treatment effectiveness. Irradiating cancer cells is assumed to induce molecular alterations that ultimately lead to apoptotic death. Studies comparing the efficacy of radiation-induced DNA damage and apoptotic death in relation to varying dose rates do not provide unequivocal data. Whereas some have demonstrated higher dose rates (single dose) to effectively kill cancer cells, others claim the opposite. Recent gene expression studies in cells subject to variable dose rates stress alterations in molecular signalling, especially in the expression of genes linked to cell survival, immune response, and tumour progression. Novel irradiation techniques of modern cancer treatment do not rely anymore on maintaining absolute constancy of dose rates during radiation emission: instead, timing and exposure areas are regulated temporally and spatially by modulating the dose rate and beam shape. Such conditions may be reflected in tumour cells’ response to irradiation, and this is supported by the references provided. PMID:28239281

  2. Correlation between HLA-A2 gene frequency, latitude, ovarian and prostate cancer mortality rates.

    PubMed

    De Petris, Luigi; Bergfeldt, Kjell; Hising, Christina; Lundqvist, Andreas; Tholander, Bengt; Pisa, Pavel; van der Zanden, Henk G M; Masucci, Giuseppe

    2004-01-01

    Molecular-target therapies are novel approaches to the treatment of prostate and ovarian cancer, but to ensure the best response, a very careful selection of patients, based on immunological characteristics, must be performed. We screened for HLA type, 24 patients with advanced ovarian cancer and 26 patients with hormone-refractory prostate cancer, in order to be recruited to vaccine protocols. HLA typing was performed with PCR in ovarian cancer patients and with serological assay in prostate cancer patients. The results were then extended to a population level, comparing the HLA genotype frequencies in Europe with ovarian and prostate cancer mortality rates. An overrepresentation of HLA-A2 phenotype was observed in both patient groups compared to the normal Swedish population (p = 0.01). As it is already known, the higher phenotype frequency of this allele found in Scandinavian countries decreases significantly as one moves further south in Europe. Ovarian and prostate cancer mortality rates decrease as well as the demographic changes in HLA-A2. These observations have to be confirmed by more extended investigations in order to elucidate if HLA-A2 higher frequency is already present at the diagnosis (risk factor) or is selected during the course of the disease (prognostic factor). Moreover, this fact would suggest different strategies for specific immunotherapy in addition to first line conventional treatments.

  3. 78 FR 62712 - Rate Adjustment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-22

    ... Service in Response to Commission Order No. 1059, September 26, 2013 (Exigent Request). See also Docket...,'' is ``premised on the recent recession as an exigent event.'' Id. at 1, 2. In Order No. 1059, the..., December 20, 2011, at 6 (Order No. 1059). If the Postal Service wishes to pursue its Exigent Request,...

  4. Statistical modelling of breast cancer incidence and mortality rates in Scotland.

    PubMed

    Robertson, C; Boyle, P

    1997-01-01

    The interpretation of time trends in disease rates can be facilitated using estimable contrasts from age-period-cohort models. Cohort and period trends in breast cancer incidence and mortality rates in Scotland were investigated using contrasts that measure the changes in the linear trends. These contrasts were compared with estimates obtained from mortality rates in the USA and Japan. A significant moderation of both breast cancer incidence and mortality rates was observed in Scotland, associated with cohorts of women born after the Second World War compared with women born between the two world wars. The moderation of breast cancer mortality among cohorts born after 1925 compared with cohorts born before 1925 that was observed in the USA and Japan was also observed in this study. This moderation is not present in the incidence rates. The relative decline in the risk of breast cancer seen in younger cohorts seems to be contradictory to the temporal pattern present among breast cancer risk factors. It may well be that the alteration of eating patterns as a result of rationing in the wartime and immediate post-war period, and the subsequent influence on certain breast cancer risk factors probably produced by such changes, may have had some influence on the development of healthier girls and women. Such speculation could be addressed in a well-designed epidemiological study. There have been no changes in the mortality rate trends with period in Scotland, although the changes in the incidence rate trends with period are consistent with an increase in registration coverage.

  5. 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

  6. 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.

  7. Incidence and survival rates of ovarian cancer in low-income women in Sudan

    PubMed Central

    Abuidris, Dafalla O.; Weng, Hsin-Yi; Elhaj, Ahmed M.; Eltayeb, Elgaylani Abdallah; Elsanousi, Mohamed; Ibnoof, Rehab S.; Mohammed, Sulma I.

    2016-01-01

    Ovarian cancer is the second most common gynecological cancer worldwide. Little is known about the disease in Sudan. The objective of the present study was to evaluate the incidence rate, age and stage at diagnosis, and median survival time of patients presenting at the National Cancer Institute-University of Gezira (NCI-UG), Sudan. Data were collected in a prospective study of women with ovarian cancer over a period of eleven years of follow-up (between 2000 and 2011). Descriptive statistics were used to summarize the distribution of the demographics of the sample. The direct method was used to compute the age-standardized rate (ASR) using data from the 1966 and 2000 World Standard Populations (WSPs). The Kaplan-Meier method was used to estimate survival functions and the median survival time. Log-rank tests were used to statistically compare between the survival functions. There were steady increases in ovarian cancer incidence rates between 2000 and 2009, with a slight decline noted in 2010 and 2011. The patients' age range was 9–90. The age-specific incidence rate increased greatly in women aged 55 years or older. The majority of the patients had stage III or IV disease. The annual ASR using WSPs 1966 and 2000 as standard populations were 3.3 and 3.7 per 100,000 women, respectively. The median survival time was 31 months (95% confidence interval, 19–43). The 5-year cumulative survival rate was 38%. In Sudan, ovarian cancer affects postmenopausal women, akin to what is reported in the developed world with high incidence rates. Presenting with advanced stage disease is the predominant factor that results in a short survival time for women. PMID:28105363

  8. Incidence rate of female breast cancer in urban Shijiazhuang in 2012 and modifiable risk factors

    PubMed Central

    Wen, Denggui; He, Yutong; Wei, Lizhen; Zhang, Nan; Li, Shumei; Wen, Xiaoduo; Yang, Yi; Wang, Guiying; Wang, Shijie; Geng, Cuizhi; Liu, Yunjiang

    2016-01-01

    Background Breast cancer is diagnosed more frequently among urban than rural women in China; however, the incidence among women in Shijiazhuang is unknown. Methods As registered Chinese citizens are entitled to complete public medical insurance coverage, the incidence rate was estimated using reimbursement records of first hospitalization. Results Breast cancer is the most common cancer among women in Shijiazhuang. The crude rate and age‐standardized incidence rates by China (ASRC) and world (ASRW) standards were 59.6, 48.5 and 45.5/100 000 in 2012. Mean age at diagnosis was 55.1 years. Incidence increased with age, peaking at 165.1 at 70–74. In comparison with urban women in other Chinese cities, incidence in Shijiazhuang was similar to Shanghai (ASRC 46.6) and Suzhou (ASRW 45). When compared with 31 other Chinese cities, Shijiazhuang ranked second highest behind Guangzhou (ASRW 46.6), and the ASRW correlated significantly with gross domestic product per capita among the 32 cities. The breast cancer ASRW in Shijiazhuang was 2.7 times the rate of 41 rural Chinese counties (17). When compared with GLOBOCAN 2012 data according to the Human Development Index, breast cancer incidence in Shijiazhuang matched countries with a high human development index (ASRW 45.2). Conclusion Breast cancer incidence in Shijiazhuang in 2012 was the highest in China, matching the rate in countries with high social economic development. This rate may continue to rise, parallel with urbanization, and may be associated with changing reproductive patterns and Westernization. Prevention methods need to be incorporated. PMID:27766774

  9. 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

  10. Chromatin organization is a major influence on regional mutation rates in human cancer cells.

    PubMed

    Schuster-Böckler, Benjamin; Lehner, Ben

    2012-08-23

    Cancer genome sequencing provides the first direct information on how mutation rates vary across the human genome in somatic cells. Testing diverse genetic and epigenetic features, here we show that mutation rates in cancer genomes are strikingly related to chromatin organization. Indeed, at the megabase scale, a single feature—levels of the heterochromatin-associated histone modification H3K9me3—can account for more than 40% of mutation-rate variation, and a combination of features can account for more than 55%. The strong association between mutation rates and chromatin organization is upheld in samples from different tissues and for different mutation types. This suggests that the arrangement of the genome into heterochromatin- and euchromatin-like domains is a dominant influence on regional mutation-rate variation in human somatic cells.

  11. 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

  12. 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.

  13. Use of Glucose Rate of Change Arrows to Adjust Insulin Therapy Among Individuals with Type 1 Diabetes Who Use Continuous Glucose Monitoring

    PubMed Central

    Pettus, Jeremy

    2016-01-01

    Abstract Objective: This study was performed to understand and to compare differences in utilization of continuous glucose monitoring (CGM) and the rate of change (ROC) arrow to adjust insulin therapy among individuals with type 1 diabetes (T1D), comparing those treated with multiple daily insulin injections (MDI) with those treated with continuous subcutaneous insulin infusion (CSII). Research Design and Methods: We surveyed 222 T1D individuals who regularly used real-time CGM to obtain information about general CGM use and response to glucose ROC arrows in managing their diabetes. Results: The survey was completed by 222 T1D individuals. Respondents included CSII (n = 166) and MDI (n = 56) users. MDI and CSII respondents reported similar substantial increases in correction dosages (from 220 mg/dL to 120 mg/dL) in response to increasing glucose (one ROC arrow up: rising 2–3 mg/dL/min): +120% and +108%, respectively (P = 0.13). MDI and CSII respondents reported similar substantial increases in correction dosages in response to rapidly increasing glucose (two arrows up: rising >3 mg/dL/min): +146% and +138%, respectively (P = 0.72). When correcting from 220 mg/dL to 120 mg/dL, MDI respondents reported larger correction dosage reductions than CSII respondents in response to decreasing glucose (one ROC down arrow: decreasing 2–3 mg/dL/min) and rapidly decreasing glucose (two ROC down arrows: decreasing >3 mg/dL/min): −50% versus −37%, respectively (P = 0.024) and −52% versus 38%, respectively (P = 0.034). Similar between-group differences were observed in mealtime dosage adjustments. Conclusions: CGM users often rely on ROC information when determining insulin doses and tend to make larger changes than current recommendations suggest regardless of insulin delivery method. PMID:26784128

  14. Age and double product (systolic blood pressure x heart rate) reserve-adjusted modification of the Duke Treadmill Score nomogram in men.

    PubMed

    Sadrzadeh Rafie, Amir H; Dewey, Frederick E; Sungar, Gannon W; Ashley, Euan A; Hadley, David; Myers, Jonathan; Froelicher, Victor F

    2008-11-15

    The Duke Treadmill Score (DTS) is an established clinical tool for risk stratification. Our aim was to determine if other variables could improve the prognostic power of the DTS and if so, to modify the DTS nomogram. From a total of 1,959 patients referred for exercise testing at the Palo Alto VA Medical Center from 1997 to 2006 (a mean follow-up of 5.4 years), we studied 1,759 male veterans (age 57 +/- 12 years) free of heart failure. Double product (DP) was calculated by multiplying systolic blood pressure and heart rate; variables and their products were subtracted to obtain the differences between at rest and maximal exercise (reserve) and recovery. Of all the hemodynamic measurements, DP reserve was the strongest predictor of cardiovascular death (CVD) (Wald Z-score -3.84, p <0.001) after adjustment for potential confounders. When the components of DTS were entered in the Cox hazard model with DP reserve and age, only DP reserve and age were chosen (p <0.00001). Using the Cox coefficients, a score calculated by [age - DTS - 3 x (DP reserve/1,000)] yielded an area under the curve of 0.84 compared with 0.76 for the DTS. Using this equation, a nomogram was constructed by adding age and DP reserve to the original DTS nomogram improving estimation of annual CVD. In conclusion, we propose an age and DP reserve-adjusted DTS nomogram that improves the prognostic estimates of average annual CVD over the DTS alone.

  15. Pharmacokinetic evaluation of doxorubicin plasma levels in normal and overweight patients with breast cancer and simulation of dose adjustment by different indexes of body mass.

    PubMed

    Barpe, Deise Raquel; Rosa, Daniela Dornelles; Froehlich, Pedro Eduardo

    2010-11-20

    Although being used for decades in the treatment of several types of cancer, either alone or in association, only a few data about the pharmacokinetics of doxorubicin (DOX) in humans are available. DOX is frequently used in association with other anticancer drugs in the management of breast cancer. Pharmacokinetic data available in the literature show that after i.v. administration DOX follows a two-compartment open model, with a fast distribution phase followed by a very slow elimination phase. The objective of this work is to perform a pilot study in order to verify if the usual dose adjustment based on body surface area (BSA) would be producing the same plasma concentration-time profiles in patients with normal (<25) and above normal (>25) body mass index (BMI). In order to assess the pharmacokinetics of DOX after a short-term i.v. infusion of 60mg/m(2) of BSA, an experimental design using only five plasma samples of each patient was applied. Samples were collected at 0.00, 0.66 (right after the end of infusion), 1.66, 8.66, and 24.66h. DOX pharmacokinetic profiles were evaluated after quantification of DOX using a new HPLC method developed and validated. Pharmacokinetic parameters (AUC(0-24.66) and C(max)) were analyzed by non-compartmental and compartmental approaches. Significant differences (α=0.05) between overweight and normal weight groups were found with respect to AUC and C(max). After adjustment of dose by weight and by BMI, the compartmental model was used to simulate plasma concentrations and new values for C(max) and AUC(0-24.66) were calculated. The new values obtained using both body weight (BW) and BMI were closer to the normal group than those obtained with BSA. According to the simulation, the differences of AUC and C(max) between the overweight group and the group of patients with normal weight were lower when the dose was adjusted by BW and BMI. These results suggest that more studies must be conducted, with more patients, in order to

  16. Application of Artificial Neural Network in Predicting the Survival Rate of Gastric Cancer Patients

    PubMed Central

    Biglarian, A; Hajizadeh, E; Kazemnejad, A; Zali, MR

    2011-01-01

    Background: The aim of this study was to predict the survival rate of Iranian gastric cancer patients using the Cox proportional hazard and artificial neural network models as well as comparing the ability of these approaches in predicting the survival of these patients. Methods: In this historical cohort study, the data gathered from 436 registered gastric cancer patients who have had surgery between 2002 and 2007 at the Taleghani Hospital (a referral center for gastrointestinal cancers), Tehran, Iran, to predict the survival time using Cox proportional hazard and artificial neural network techniques. Results: The estimated one-year, two-year, three-year, four-year and five-year survival rates of the patients were 77.9%, 53.1%, 40.8%, 32.0%, and 17.4%, respectively. The Cox regression analysis revealed that the age at diagnosis, high-risk behaviors, extent of wall penetration, distant metastasis and tumor stage were significantly associated with the survival rate of the patients. The true prediction of neural network was 83.1%, and for Cox regression model, 75.0%. Conclusion: The present study shows that neural network model is a more powerful statistical tool in predicting the survival rate of the gastric cancer patients compared to Cox proportional hazard regression model. Therefore, this model recommended for the predicting the survival rate of these patients. PMID:23113076

  17. 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

  18. The trail of the development of high-dose-rate brachytherapy for cervical cancer in Japan.

    PubMed

    Inoue, Toshihiko

    2003-07-01

    The differences in radiotherapeutic treatment systems for cervical cancer between the United States and Japan can be attributed either to the tolerance of high-risk organs, or dosimetry itself. High-dose-rate (HDR) brachytherapy is the standard treatment for uterine cervix carcinoma in Japan. In addition, HDR Co-60 afterloading machines have been gradually replaced with Ir-192 micro-source afterloading machines during the past ten years. This implies that it has now become impossible to conduct a prospective comparative study of HDR versus low-dose-rate (LDR) brachytherapy for cervical cancer in Japan. An examination of the history of HDR intracavitary radiotherapy for uterine cervix carcinoma in Japan led us to the conclusion that HDR intracavitary brachytherapy for the treatment of cervical cancer is as effective as LDR intracavitary brachytherapy in terms of both survival and complications. In Japan, studies on the former can be drawn from a long experience of more than 35 years.

  19. Chiropractic Adjustment

    MedlinePlus

    ... structural alignment and improve your body's physical function. Low back pain, neck pain and headache are the most common ... treated. Chiropractic adjustment can be effective in treating low back pain, although much of the research done shows only ...

  20. Adjustment disorder

    MedlinePlus

    ... from other people Skipped heartbeats and other physical complaints Trembling or twitching To have adjustment disorder, you ... ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get email updates Subscribe to RSS Follow ...

  1. '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)

  2. 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…

  3. High Residual Tumor Rate for Early Breast Cancer Patients Receiving Vacuum-assisted Breast Biopsy

    PubMed Central

    He, Xiao-Fang; Ye, Feng; Wen, Jia-Huai; Li, Shuai-Jie; Huang, Xiao-Jia; Xiao, Xiang-Sheng; Xie, Xiao-Ming

    2017-01-01

    Purpose: The objective of study is aiming to investigate the residual tumor rate after Vacuum-assisted Breast Biopsy (VABB) for early breast cancer excision and the efficacy of mammogram and ultrasound in detecting residual tumor. Methods: Patients who underwent VABB and were confirmed with breast cancer in Sun Yat-sen University Cancer Center from 2010 to 2015 were reviewed retrospectively. The residual tumor rate determined by histological examination was calculated, and then was compared with the results estimated by mammogram and ultrasound which were performed post VABB but before subsequent surgery. Univariate and multivariate analysis (logistic regression) were carried out to identify the independent risk factors associated with residual tumor. Results: In total, 126 eligible patients with early breast cancer were recruited for this study, of whom 79 (62.7%) had residual tumor and 47 (37.3 %) underwent complete excision. The residual tumor rates for lesions < 10mm, lesions 10 to 20 mm and lesions >20mm in size were 55.0%, 68.9% and 53.1%, respectively. The complete excision rates estimated by mammogram and ultrasound were 76.5% and 73.9%, with a negative predictive value of only 46.2% and 50.6%, respectively. In the multivariate logistic regression analysis, no specific factors were found associated with risk of residual tumor (all P > 0.05). Conclusions: There was a high residual tumor rate after VABB in early breast cancer. Both mammogram and ultrasound could not effectively detect the residual tumor after VABB. PMID:28261351

  4. 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.

  5. Beta2-microglobulin is a better predictor of treatment-free survival in patients with chronic lymphocytic leukaemia if adjusted according to glomerular filtration rate.

    PubMed

    Delgado, Julio; Pratt, Guy; Phillips, Neil; Briones, Javier; Fegan, Chris; Nomdedeu, Josep; Pepper, Chris; Aventin, Anna; Ayats, Ramon; Brunet, Salut; Martino, Rodrigo; Valcarcel, David; Milligan, Donald; Sierra, Jorge

    2009-06-01

    Even in the era of newer and sophisticated prognostic markers, beta(2)-microglobulin (B2M) remains a simple but very powerful predictor of treatment-free survival (TFS) and overall survival (OS) in patients with chronic lymphocytic leukaemia (CLL). However, B2M levels are heavily influenced by the patient's glomerular filtration rate (GFR) and this study aimed to evaluate whether GFR-adjusted B2M (GFR-B2M) had improved prognostic value compared to unadjusted B2M in a cohort of over 450 consecutive CLL patients from two separate institutions. Multivariate analysis identified a significantly shorter TFS in patients who were ZAP-70 + (P < 0.001), with increased GFR-B2M (P < 0.001), and del(11q) or del(17p) as detected by fluorescence in situ hybridization (FISH; P < 0.001). When OS was evaluated by multivariate analysis, age 65 years or older (P < 0.001) and poor risk FISH abnormalities (P < 0.001) had a confirmed adverse prognostic impact, but the predictive value of GFR-B2M was lost in the validation analysis. In all survival models, B2M did not attain independent significance unless GFR-B2M was eliminated from the analysis. In conclusion, GFR-B2M is a better predictor of TFS than unadjusted B2M in CLL patients.

  6. Probability versus representativeness in infancy: can infants use naïve physics to adjust population base rates in probabilistic inference?

    PubMed

    Denison, Stephanie; Trikutam, Pallavi; Xu, Fei

    2014-08-01

    A rich tradition in developmental psychology explores physical reasoning in infancy. However, no research to date has investigated whether infants can reason about physical objects that behave probabilistically, rather than deterministically. Physical events are often quite variable, in that similar-looking objects can be placed in similar contexts with different outcomes. Can infants rapidly acquire probabilistic physical knowledge, such as some leaves fall and some glasses break by simply observing the statistical regularity with which objects behave and apply that knowledge in subsequent reasoning? We taught 11-month-old infants physical constraints on objects and asked them to reason about the probability of different outcomes when objects were drawn from a large distribution. Infants could have reasoned either by using the perceptual similarity between the samples and larger distributions or by applying physical rules to adjust base rates and estimate the probabilities. Infants learned the physical constraints quickly and used them to estimate probabilities, rather than relying on similarity, a version of the representativeness heuristic. These results indicate that infants can rapidly and flexibly acquire physical knowledge about objects following very brief exposure and apply it in subsequent reasoning.

  7. Low-dose-rate or high-dose-rate brachytherapy in treatment of prostate cancer – between options

    PubMed Central

    2013-01-01

    Purpose Permanent low-dose-rate (LDR-BT) and temporary high-dose-rate (HDR-BT) brachytherapy are competitive techniques for clinically localized prostate radiotherapy. Although a randomized trial will likely never to be conducted comparing these two forms of brachytherapy, a comparative analysis proves useful in understanding some of their intrinsic differences, several of which could be exploited to improve outcomes. The aim of this paper is to look for possible similarities and differences between both brachytherapy modalities. Indications and contraindications for monotherapy and for brachytherapy as a boost to external beam radiation therapy (EBRT) are presented. It is suggested that each of these techniques has attributes that advocates for one or the other. First, they represent the extreme ends of the spectrum with respect to dose rate and fractionation, and therefore have inherently different radiobiological properties. Low-dose-rate brachytherapy has the great advantage of being practically a one-time procedure, and enjoys a long-term follow-up database supporting its excellent outcomes and low morbidity. Low-dose-rate brachytherapy has been a gold standard for prostate brachytherapy in low risk patients since many years. On the other hand, HDR is a fairly invasive procedure requiring several sessions associated with a brief hospital stay. Although lacking in significant long-term data, it possesses the technical advantage of control over its postimplant dosimetry (by modulating the source dwell time and position), which is absent in LDR brachytherapy. This important difference in dosimetric control allows HDR doses to be escalated safely, a flexibility that does not exist for LDR brachytherapy. Conclusions Radiobiological models support the current clinical evidence for equivalent outcomes in localized prostate cancer with either LDR or HDR brachytherapy, using current dose regimens. At present, all available clinical data regarding these two techniques

  8. Lower lung cancer rates in Jewish smokers in Israel and the USA.

    PubMed

    Rennert, Gad; Kremer, Ran; Rennert, Hedy S; Wollner, Mira; Agbarya, Abed; Pinchev, Mila; Lejbkowicz, Flavio; Spitz, Margaret R; Muscat, Joshua E

    2015-11-01

    Lung cancer rates in Israeli Jews have remained stable over the last five decades and are much lower than in most developed countries despite high historical smoking rates. We compared lung cancer risk in Jews and non-Jews in Israel and in the United States. Data were derived from a population-based, case-control study in Israel (638 cases, 496 controls) to estimate lung cancer risk associated with smoking. Data were also acquired from a case-control study in the United States with information on religious affiliation (5,093 cases, 4,735 controls). Smoking was associated with lung cancer risk in all religion/gender groups in both studies. However, major differences in risk magnitude were noted between Jews and non-Jews; ever smoking was associated with a moderately elevated risk of lung cancer in Jewish men and women in Israel (OR = 4.61, 2.90-7.31 and OR = 2.10, 1.36-3.24, respectively), and in Jewish men and women in the United States (OR = 7.63, 5.34-10.90 and OR = 8.50, 5.94-12.17) but were significantly higher in Israeli non-Jewish men (OR = 12.96, 4.83-34.76) and US non-Jewish men and women (OR = 11.33, 9.09-14.12 and OR = 12.78, 10.45-15.63). A significant interaction between smoking and religion was evident in light, moderate and heavy male and female smokers. The differences in risk level between Israeli Jews and non-Jews could not be explained by lung cancer genetic risk variants which were identified in GWAS (genes in the CHRNA5, TERT and CLPTM1L regions). Data from the two studies support the notion of a reduced risk of lung cancer in Jewish compared to non-Jewish smokers in different areas of the world.

  9. Risk algorithms that include pathology adjustment for HER2 amplification need to make further downward adjustments in likelihood scores.

    PubMed

    Evans, D G; Woodward, E R; Howell, S J; Verhoef, S; Howell, A; Lalloo, F

    2017-04-01

    To assess the need for adjustment in the likelihood of germline BRCA1/2 mutations in women with HER2+ breast cancers. We analysed primary mutation screens on women with breast cancer with unequivocal HER2 overexpression and assessed the likelihood of BRCA1/BRCA2 mutations by age, oestrogen receptor status and Manchester score. Of 1111 primary BRCA screens with confirmed HER2 status only 4/161 (2.5%) of women with HER2 amplification had a BRCA1 mutation identified and 5/161 (3.1%) a BRCA2 mutation. The pathology adjusted Manchester score between 10 and 19% and 20%+ thresholds resulted in a detection rate of only 6.5 and 15% respectively. BOADICEA examples appeared to make even less downward adjustment. There is a very low detection rate of BRCA1 and BRCA2 mutations in women with HER2 amplified breast cancers. The Manchester score and BOADICEA do not make sufficient downward adjustment for HER2 amplification. For unaffected women, assessment of breast cancer risk and BRCA1/2 probability should take into account the pathology of the most relevant close relative. Unaffected women undergoing mutation testing for BRCA1/2 should be advised that there is limited reassurance from a negative test result if their close relative had a HER2+ breast cancer.

  10. Acculturation, Inner Peace, Cancer Self-efficacy, and Self-rated Health among Latina Breast Cancer Survivors

    PubMed Central

    García-Jimenez, María; Santoyo-Olsson, Jasmine; Ortiz, Carmen; Lahiff, Maureen; Sokal-Gutierrez, Karen; Nápoles, Anna María

    2015-01-01

    Cancer self-efficacy (CSE) and spiritual well-being (SWB) have been associated with better self-rated health (SRH) among breast cancer survivors (BCS), but have not been well studied among Latina BCS (LBCS). Multivariate logistic regression analyses of secondary data from a cross-sectional population-based telephone survey of 330 LBCS explored relationships of language acculturation, CSE, and SWB subdomains of inner peace and faith with SRH. English proficiency was associated with SRH, independent of other covariates (OR=2.26, 95% CI 1.15, 4.45). Cancer self-efficacy attenuated this effect and was positively associated with SRH (OR=2.24, 95% CI 1.22, 4.10). Adding inner peace (a SWB subscale) attenuated the association of CSE and SRH (OR=1.67, 95% CI 0.88, 3.18). Inner peace remained associated with SRH (OR= 2.44, 95% CI 1.30, 4.56), controlling for covariates. Findings support the importance of a sense of inner peace and control over breast cancer to LBCS' perceived health. PMID:25418229

  11. 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

  12. 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.

  13. 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

  14. The impact factors on 5-year survival rate in patients operated with oral cancer

    PubMed Central

    Geum, Dong-Ho; Roh, Young-Chea; Yoon, Sang-Yong; Kim, Hyo-Geon; Lee, Jung-Han; Song, Jae-Min; Lee, Jae-Yeol; Hwang, Dae-Seok; Kim, Yong-Deok; Shin, Sang-Hun; Chung, In-Kyo

    2013-01-01

    Objectives The purpose of this study is to analyze clinical impact factors on the survival rate, and to acquire basic clinical data for the diagnosis of oral cancer, for a determination of the treatment plan with long-term survival in oral cancer patients. Materials and Methods Through a retrospective review of the medical records, the factors for long-term survival rate were analyzed. Thirty-seven patients, among patient database with oral cancer treated in the Department of Oral and Maxillofacial Surgery at Pusan National University Hospital within a period from March 1998 to March 2008, were selected within the study criteria and were followed-up for more than 5 years. The analyzed factors were gender, age, drinking, smoking, primary tumor site, type of cancer, TNM stage, recurrence of affected region, and metastasis of cervical lymph node. The 5-year survival rate on the impact factors was calculated statistically using the Kaplan-Meier method. Results By classification of clinical TNM at the 1st visit, there were 11 (29.7%) cases for stage I, 11 (29.7%) cases for stage II, 3 (8.1%) cases for stage III, and 12 (32.5%) cases for stage IV. The 5-year survival rate of total oral cancer patients after the operation were 75.7%, pathological TNM stage related 5-year survival rate were as follows: stage I 90.0%, stage II 81.8%, stage III 100% and stage IV 45.5%; in which the survival rate difference by each stage was significantly observed. The recurrence of cervical lymph node was the significant impact factor for the survival rate, because only 30.0% the survival rate in recurrent cases existed. During the follow-up, there were 15 (40.5%) patients with confirmed recurrence, and the 5-year survival rate of these patients was decreased as 46.7%. Conclusion The classification of clinical and pathological TNM stage, local recurrence after surgery, and metastasis of cervical lymph node after surgery were analyzed as the 3 most significant factors. PMID:24471047

  15. Comparing tumor rates in current and historical control groups in rodent cancer bioassays.

    PubMed

    Dinse, Gregg E; Peddada, Shyamal D

    2011-02-01

    When evaluating carcinogenicity, tumor rates from the current study are informally assessed within the context of relevant historical control tumor rates. Current rates outside the range of historical rates raise concerns. We propose a statistical procedure that formally compares tumor rates in current and historical control groups. We use a normal approximation for the null distribution of the proposed test when there are at least 5 historical control groups and the average tumor rate is above 0.5%; otherwise, we apply standard bootstrap techniques. For comparison purposes, we show that formally basing decisions on the range of historical control rates would yield unusually high false positive rates. That is, a range-based decision rule would not maintain the nominal 5% significance level and could produce Type I error rates as high as 67%. In other cases, the power could go to zero. The proposed test, however, controls Type I errors while adjusting for survival and extra variability among the historical studies. We illustrate the methods with data from a study of benzophenone. Compared to a range-based decision rule, the proposed test has several important advantages, including operating at the specified level and being applicable with as few as one historical study.

  16. The effect of administrative boundaries and geocoding error on cancer rates in California.

    PubMed

    Goldberg, Daniel W; Cockburn, Myles G

    2012-04-01

    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.

  17. Reducing the rate of cervical cancer: ethical challenges in public health.

    PubMed

    Beard, Kenya

    2010-12-01

    Human papilloma virus (HPV) is the most common sexually transmitted infection in the United States and HPV is the single most significant risk factor for acquiring cervical cancer. There are two vaccines that prevent some strains of HPV and are believed to help reduce the rate of cervical cancer: Whether or not the HPV vaccine should be mandated has resulted in monumental debates and given rise to several ethical concerns. For instance, how will mandating this vaccine affect the patient's right to self determination ? Will parents accept a vaccine that prevents a disease that is primarily sexually transmitted and targeted for adolescents girls? Have studies proven the vaccine to be effective against the types of HPV associated with cervical cancer? This paper critically analyzes several studies that address these questions and utilizes the nursing code of ethics as a framework to reveal inherent ethical issues confronting nurses.

  18. 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

  19. 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

  20. High Rate of Positive Circumferential Resection Margins Following Rectal Cancer Surgery: A Call to Action

    PubMed Central

    Rickles, Aaron S.; Dietz, David W.; Chang, George J.; Wexner, Steven D.; Berho, Mariana E.; Remzi, Feza H.; Greene, Frederick L.; Fleshman, James W.; Abbas, Maher A.; Peters, Walter; Noyes, Katia; Monson, John R.T.; Fleming, Fergal J.

    2017-01-01

    Objective To identify predictors of positive circumferential resection margin following rectal cancer resection in the United States. Background Positive circumferential resection margin is associated with a high rate of local recurrence and poor morbidity and mortality for rectal cancer patients. Prior study has shown poor compliance with national rectal cancer guidelines, but whether this finding is reflected in patient outcomes has yet to be shown. Methods Patients who underwent resection for stage I-III rectal cancer were identified from the 2010-2011 National Cancer Database. The primary outcome was a positive circumferential resection margin. The relationship between patient, hospital, tumor, and treatment-related characteristics was analyzed using bivariate and multivariate analysis. Findings A positive circumferential resection margin was noted in 2,859 (17.2%) of the 16,619 patients included. Facility location, clinical T and N stage, histologic type, tumor size, tumor grade, lymphovascular invasion, perineural invasion, type of operation, and operative approach were significant predictors of positive circumferential resection margin on multivariable analysis. Total proctectomy had nearly a 30% increased risk of positive margin compared to partial proctectomy (OR 1.293, 95%CI 1.185-1.411) and a laparoscopic approach had nearly 22% less risk of a positive circumferential resection margin compared to an open approach (OR 0.882, 95%CI 0.790-0.985). Interpretation Despite advances in surgical technique and multimodality therapy, rates of positive circumferential resection margin remain high in the United States. Several tumor and treatment characteristics were identified as independent risk factors, and advances in rectal cancer care are necessary to approach the outcomes seen in other countries. PMID:26473651

  1. 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.

  2. 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.

  3. 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

  4. 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.

  5. Strategies and resources to address colorectal cancer screening rates and disparities in the United States and globally.

    PubMed

    Potter, Michael B

    2013-01-01

    Colorectal cancer is a significant cause of mortality in the United States and globally. In the United States, increased access to screening and effective treatment has contributed to a reduction in colorectal cancer incidence and mortality for the general population, though significant disparities persist. Worldwide, the disparities are even more pronounced, with vastly different colorectal cancer mortality rates and trends among nations. Newly organized colorectal cancer screening programs in economically developed countries with a high burden of colorectal cancer may provide pathways to reduce these disparities over time. This article provides an overview of colorectal cancer incidence, mortality, screening, and disparities in the United States and other world populations. Promising strategies and resources are identified to address colorectal cancer screening rates and disparities in the United States and worldwide.

  6. The effects of air pollutants on the mortality rate of lung cancer and leukemia.

    PubMed

    Dehghani, Mansooreh; Keshtgar, Laila; Javaheri, Mohammad Reza; Derakhshan, Zahra; Oliveri Conti, Gea; Zuccarello, Pietro; Ferrante, Margherita

    2017-03-24

    World Health Organization classifies air pollution as the first cause of human cancer. The present study investigated impact of air pollutants on the mortality rates of lung cancer and leukemia in Shiraz, one of the largests cities of Iran. This cross‑sectional (longitudinal) study was carried out in Shiraz. Data on six main pollutants, CO, SO2, O3, NO2, PM10 and PM2.5, were collected from Fars Environmental Protection Agency for 3,001 days starting from 1 January, 2005. Also, measures of climatic factors (temperature, humidity, and air pressure) were obtained from Shiraz Meteorological Organization. Finally, data related to number of deaths due to lung and blood cancers (leukemia) were gathered from Shiraz University Hospital. Relationship between variations of pollutant concentrations and cancers in lung and blood was investigated using statistical software R and MiniTab to perform time series analysis. Results of the present study revealed that the mortality rate of leukemia had a direct significant correlation with concentrations of nitrogen dioxide and carbon monoxide in the air (P<0.05). Therefore, special attention should be paid to sources of these pollutants and we need better management to decrease air pollutant concentrations through, e.g., using clean energy respect to fossil fuels, better management of urban traffic planning, and the improvement of public transport service and car sharing.

  7. Prostate cancer detection rate in patients with obstructive voiding symptoms by sextant biopsy: preliminary results.

    PubMed

    Kiknavelidze, K; Tsintsadze, O; Goguadze, M; Pertia, A; Managadze, L

    2006-04-01

    To evaluate the effectiveness of a laterally directed sextant biopsy in the group of high volume prostate patients with obstructive voiding symptoms and suspected of prostate cancer. Biopsy was performed in 197 men (age: median 63 years, range 47 to 82 years) because of elevated PSA and/or abnormality in digital rectal examinations (DRE). In most cases, a markedly enlarged prostate was noted: the mean prostate volume was 79,9+/-38,5 cc, and in 73% of the cases, the volume of the prostate was >50 cc. Prostate cancer was diagnosed in 56 of 197 cases (28,4%). The prostate cancer detection rate among patients with a prostate volume of 80cc (high volume) were 39,6%, 32,8% and 18,6%, respectively. Our results showed that the laterally directed sextant biopsy with the overall detection rate as high as 28,4% and very low complications is an effective method for the detection of prostate cancer among the suspected patients with obstructive voiding symptoms and markedly enlarged prostates.

  8. Rates of BRCA1/2 mutation testing among young survivors of breast cancer.

    PubMed

    Kehl, Kenneth L; Shen, Chan; Litton, Jennifer K; Arun, Banu; Giordano, Sharon H

    2016-01-01

    Guidelines in the United States recommend consideration of testing for mutations in the BRCA1 and BRCA2 genes for women diagnosed with breast cancer under age 45. Identification of mutations among survivors has implications for secondary prevention and familial risk reduction. Although only 10 % of breast cancers are diagnosed under age 45, there are approximately 2.8 million breast cancer survivors in the United States, such that the young survivor population likely numbers in the hundreds of thousands. However, little is known about genetic testing rates in this population. We assessed trends in BRCA1/2 testing among breast cancer survivors who were under age 45 at diagnosis and were treated from 2005 to 2012. Using insurance claims from a national database (MarketScan), we identified incident breast cancer cases among (1) women aged ≤40 and (2) women aged 41-45. We measured BRCA1/2 testing using Kaplan-Meier analysis and Cox proportional hazards models. Among 26,985 patients analyzed, BRCA1/2 testing rates increased with each year of diagnosis from 2005 to 2012 (P < 0.001). However, among women treated in earlier years, testing rates did not approach those of patients treated later, even after extended follow-up (median time from surgery to testing among patients treated in 2005, not reached; median time to testing among patients treated in 2012, 0.2 months for women aged ≤40 and 1.0 month for women aged 41-45). Women aged 41-45 had lower rates than women aged ≤40 throughout the analysis period (P < 0.001 for each year). BRCA1/2 testing rates among young women with incident breast cancer increased substantially in the last decade. However, most survivors treated in earlier years have never been tested. Our results demonstrate a need to better incorporate genetic counseling into survivorship and primary care for this population.

  9. High-dose Rate Electronic Brachytherapy: A Nonsurgical Treatment Alternative for Nonmelanoma Skin Cancer

    PubMed Central

    Patel, Rakesh; Werschler, William Philip; Ceilley, Roger I.; Strimling, Robert

    2016-01-01

    The authors summarized data from a group of physicians with experience using high-dose rate electronic brachytherapy for the treatment of nonmelanoma skin cancer. The data have been published or presented in abstract format at national dermatology and radiation oncology meetings. The data included 1,822 treated lesions from 2009 to 2014 in patients ranging in age from 52 to 104 years. Most lesions were basal cell carcinoma (57%) or squamous cell carcinoma (38%) less than 2cm in size (97%). Median follow-up at the various centers ranged from 4 to 16 months, and results yielded an extremely low recurrence rate of less than one percent. Results show that within the confines of this follow up period, electronic brachytherapy is an effective, convenient, nonsurgical treatment option for patients with nonmelanoma skin cancer with few recurrences and excellent cosmetic results. PMID:28210385

  10. 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

  11. Current topics in the treatment of prostate cancer with low-dose-rate brachytherapy.

    PubMed

    Stock, Richard G; Stone, Nelson N

    2010-02-01

    The treatment of prostate cancer with low dose rate prostate brachytherapy has grown rapidly in the last 20 years. Outcome analyses performed in this period have enriched understanding of this modality. This article focuses on the development of a real-time ultrasound-guided implant technique, the importance of radiation dose, trimodality treatment of high-risk disease, long-term treatment outcomes, and treatment-associated morbidity.

  12. Decreases in Smoking-Related Cancer Mortality Rates Are Associated with Birth Cohort Effects in Korean Men.

    PubMed

    Jee, Yon Ho; Shin, Aesun; Lee, Jong-Keun; Oh, Chang-Mo

    2016-12-05

    Background: This study aimed to examine trends in smoking-related cancer mortality rates and to investigate the effect birth cohort on smoking-related cancer mortality in Korean men. Methods: The number of smoking-related cancer deaths and corresponding population numbers were obtained from Statistics Korea for the period 1984-2013. Joinpoint regression analysis was used to detect changes in trends in age-standardized mortality rates. Birth-cohort specific mortality rates were illustrated by 5 year age groups. Results: The age-standardized mortality rates for oropharyngeal decreased from 2003 to 2013 (annual percent change (APC): -3.1 (95% CI, -4.6 to -1.6)) and lung cancers decreased from 2002 to 2013 (APC -2.4 (95% CI -2.7 to -2.2)). The mortality rates for esophageal declined from 1994 to 2002 (APC -2.5 (95% CI -4.1 to -0.8)) and from 2002 to 2013 (APC -5.2 (95% CI -5.7 to -4.7)) and laryngeal cancer declined from 1995 to 2013 (average annual percent change (AAPC): -3.3 (95% CI -4.7 to -1.8)). By the age group, the trends for the smoking-related cancer mortality except for oropharyngeal cancer have changed earlier to decrease in the younger age group. The birth-cohort specific mortality rates and age-period-cohort analysis consistently showed that all birth cohorts born after 1930 showed reduced mortality of smoking-related cancers. Conclusions: In Korean men, smoking-related cancer mortality rates have decreased. Our findings also indicate that current decreases in smoking-related cancer mortality rates have mainly been due to a decrease in the birth cohort effect, which suggest that decrease in smoking rates.

  13. Decreases in Smoking-Related Cancer Mortality Rates Are Associated with Birth Cohort Effects in Korean Men

    PubMed Central

    Jee, Yon Ho; Shin, Aesun; Lee, Jong-Keun; Oh, Chang-Mo

    2016-01-01

    Background: This study aimed to examine trends in smoking-related cancer mortality rates and to investigate the effect birth cohort on smoking-related cancer mortality in Korean men. Methods: The number of smoking-related cancer deaths and corresponding population numbers were obtained from Statistics Korea for the period 1984–2013. Joinpoint regression analysis was used to detect changes in trends in age-standardized mortality rates. Birth-cohort specific mortality rates were illustrated by 5 year age groups. Results: The age-standardized mortality rates for oropharyngeal decreased from 2003 to 2013 (annual percent change (APC): −3.1 (95% CI, −4.6 to −1.6)) and lung cancers decreased from 2002 to 2013 (APC −2.4 (95% CI −2.7 to −2.2)). The mortality rates for esophageal declined from 1994 to 2002 (APC −2.5 (95% CI −4.1 to −0.8)) and from 2002 to 2013 (APC −5.2 (95% CI −5.7 to −4.7)) and laryngeal cancer declined from 1995 to 2013 (average annual percent change (AAPC): −3.3 (95% CI −4.7 to −1.8)). By the age group, the trends for the smoking-related cancer mortality except for oropharyngeal cancer have changed earlier to decrease in the younger age group. The birth-cohort specific mortality rates and age-period-cohort analysis consistently showed that all birth cohorts born after 1930 showed reduced mortality of smoking-related cancers. Conclusions: In Korean men, smoking-related cancer mortality rates have decreased. Our findings also indicate that current decreases in smoking-related cancer mortality rates have mainly been due to a decrease in the birth cohort effect, which suggest that decrease in smoking rates. PMID:27929405

  14. 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.

  15. A Web Tool for Age-Period-Cohort Analysis of Cancer Incidence and Mortality Rates

    PubMed Central

    Rosenberg, Philip S.; Check, David P.; Anderson, William F.

    2014-01-01

    BACKGROUND Age-period-cohort (APC) analysis can inform registry-based studies of cancer incidence and mortality, but concerns about statistical identifiability and interpretability, as well as the learning curves of statistical software packages, have limited its uptake. METHODS We implemented a panel of easy-to-interpret estimable APC functions and corresponding Wald tests in R code that can be accessed through a user-friendly web tool. RESULTS Input data for the web tool consist of age-specific numbers of events and person-years over time, in the form of a rate matrix of paired columns. Output functions include model-based estimators of cross-sectional and longitudinal age-specific rates; period and cohort rate ratios that incorporate the overall annual percentage change (net drift); and estimators of the age-specific annual percentage change (local drifts). The web tool includes built-in examples for teaching and demonstration. User data can be input from a Microsoft Excel worksheet or by uploading a comma-separated-value (csv) file. Model outputs can be saved in a variety of formats including R and Excel. CONCLUSIONS APC methodology can now be carried out through a freely-available user-friendly web tool. The tool can be accessed at http://analysistools.nci.nih.gov/apc/. IMPACT The web tool can help cancer surveillance researchers make important discoveries about emerging cancer trends and patterns. PMID:25146089

  16. Reduction of the Earth's magnetic field inhibits growth rates of model cancer cell lines.

    PubMed

    Martino, Carlos F; Portelli, Lucas; McCabe, Kevin; Hernandez, Mark; Barnes, Frank

    2010-12-01

    Small alterations in static magnetic fields have been shown to affect certain chemical reaction rates ex vivo. In this manuscript, we present data demonstrating that similar small changes in static magnetic fields between individual cell culture incubators results in significantly altered cell cycle rates for multiple cancer-derived cell lines. This change as assessed by cell number is not a result of apoptosis, necrosis, or cell cycle alterations. While the underlying mechanism is unclear, the implications for all cell culture experiments are clear; static magnetic field conditions within incubators must be considered and/or controlled just as one does for temperature, humidity, and carbon dioxide concentration.

  17. Shaft adjuster

    DOEpatents

    Harry, H.H.

    1988-03-11

    Abstract 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. 3 figs.

  18. 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.

  19. 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.

  20. Impacts of the Finnish service screening programme on breast cancer rates

    PubMed Central

    Anttila, Ahti; Sarkeala, Tytti; Hakulinen, Timo; Heinävaara, Sirpa

    2008-01-01

    Background The aim of the current study was to examine impacts of the Finnish breast cancer (BC) screening programme on the population-based incidence and mortality rates. The programme has been historically targeted to a rather narrow age band, mainly women of ages 50–59 years. Methods The study was based on the information on breast cancer during 1971–2003 from the files of the Finnish Cancer Registry. Incidence, cause-specific mortality as well as incidence-based (refined) mortality from BC were analysed with Poisson regression. Age-specific incidence and routine cause-specific mortality were estimated for the most recent five-year period available; incidence-based mortality, respectively, for the whole steady state of the programme, 1992–2003. Results There was excess BC incidence with actual screening ages; incidence in ages 50–69 was increased 8% (95 CI 2.9–13.4). There was an increasing temporal tendency in the incidence of localised BC; and, respectively, a decrease in that of non-localised BC. The latter was most consistent in age groups where screening had been on-going several years or eventually after the last screen. The refined mortality rate from BC diagnosed in ages 50–69 was decreased with -11.1% (95% CI -19.4, -2.1). Conclusions The current study demonstrates that BC screening in Finland is effective in reducing mortality rates from breast cancers, even though the impact on the population level is smaller than expected based on the results from randomised trials among women screened in age 50 to 69. This may be explained by the rather young age group targeted in our country. Consideration whether to targeted screening up to age 69 is warranted. PMID:18226204

  1. Cancer rates, medical comorbidities, and treatment modalities in the oldest patients.

    PubMed

    Zeber, John E; Copeland, Laurel A; Hosek, Brandon J; Karnad, Anand B; Lawrence, Valerie A; Sanchez-Reilly, Sandra E

    2008-09-01

    Cancer disproportionately afflicts older patients, with 56% of incident diagnoses and 71% of deaths occurring in this population. Yet little is known about the "oldest of the old", oncology patients underrepresented in clinical trials. We examined elderly veterans diagnosed with lung, colorectal, prostate or head-neck cancer in 2005 (n=194,797), analyses comparing treatment receipt by age group, 70-84 versus 85-115. Treatment was more common among younger elders, including surgery (1.3% versus 0.6%), chemotherapy (2.1% versus 0.8%) and radiation (1.7% versus 0.7%). Differences were sharper for certain cancers, e.g., chemotherapy for lung (9.0% versus 2.9%), or colorectal surgery (5.8% versus 3.4%). Cancer prevalence is high among elders yet treatment rates appear extremely low, despite evidence of well-tolerated treatment. Toxicity concerns and comorbidities may inhibit pursuit of definitive treatment. As we reconcile definitions of 'elderly' with appropriate treatment options, compassionate care requires identifying geriatric oncology guidelines that improve survival and quality of life.

  2. Do amount of variant differentiation and mitotic rate in bladder cancer change with neoadjuvant chemotherapy?

    PubMed

    Shen, Helen M; D'Souza, Amber M; Green, Ian F; Pohar, Kamal S; Mortazavi, Amir; Zynger, Debra L

    2015-09-01

    Neoadjuvant chemotherapy (NAC) is currently recommended to all candidate patients with muscularis propria-invasive bladder cancer. However, NAC is effective in only a subset of patients, and predictors of response are lacking. Our study aimed to characterize tumoral changes with NAC usage and to identify features at bladder biopsy/transurethral resection (Bx/TUR) that may predict response. A retrospective search was performed to identify patients with bladder cancer that were pT2 at Bx/TUR upon whom a radical cystectomy (RC) was performed from 2007 to 2010. A blinded slide review of the Bx/TUR and RC was conducted. Presence, type, percent of tumor variant morphology, and tumoral mitotic rate were assessed. Ninety RC patients with slides available were identified (46 NAC, 44 non-NAC). In NAC-treated patients, there was a significantly higher percentage of nonurothelial variant differentiation in the RC compared with Bx/TUR, whereas there was no difference in the non-NAC subgroup. Percent variant differentiation at Bx/TUR was not a predictor of response. There was a significant decrease in mitotic rate between Bx/TUR and RC in NAC patients, whereas there was no difference in the non-NAC subgroup, although mitotic rate was not a predictor of response. In conclusion, percent variant differentiation and mitotic rate changed significantly from Bx/TUR to RC with NAC usage, although neither predicted response. Pathologists should be aware that variant differentiation is common in bladder cancer, with increased presence after NAC, in order to improve recognition and documentation of these findings.

  3. Improved Estimates of Cancer-Specific Survival Rates From Population-Based Data

    PubMed Central

    Ries, Lynn A. G.; Mariotto, Angela B.; Reichman, Marsha E.; Ruhl, Jennifer; Cronin, Kathleen A.

    2010-01-01

    Background Accurate estimates of cancer survival are important for assessing optimal patient care and prognosis. Evaluation of these estimates via relative survival (a ratio of observed and expected survival rates) requires a population life table that is matched to the cancer population by age, sex, race and/or ethnicity, socioeconomic status, and ideally risk factors for the cancer under examination. Because life tables for all subgroups in a study may be unavailable, we investigated whether cause-specific survival could be used as an alternative for relative survival. Methods We used data from the Surveillance, Epidemiology, and End Results Program for 2 330 905 cancer patients from January 1, 1992, through December 31, 2004. We defined cancer-specific deaths according to the following variables: cause of death, only one tumor or the first of multiple tumors, site of the original cancer diagnosis, and comorbidities. Estimates of relative survival and cause-specific survival that were derived by use of an actuarial method were compared. Results Among breast cancer patients who were white, black, or of Asian or Pacific Islander descent and who were older than 65 years, estimates of 5-year relative survival (107.5%, 106.6%, and 103.0%, respectively) were higher than estimates of 5-year cause-specific survival (98.6%, 95% confidence interval [CI] = 98.4% to 98.8%; 97.4%, 95% CI = 96.2% to 98.2%; and 99.2%, 95% CI = 98.4%, 99.6%, respectively). Relative survival methods likely underestimated rates for cancers of the oral cavity and pharynx (eg, for white cancer patients aged ≥65 years, relative survival = 54.2%, 95% CI = 53.1% to 55.3%, and cause-specific survival = 60.1%, 95% CI = 59.1% to 60.9%) and the lung and bronchus (eg, for black cancer patients aged ≥65 years, relative survival = 10.5%, 95% CI = 9.9% to 11.2%, and cause-specific survival = 11.9%, 95% CI = 11.2 % to 12.6%), largely because of mismatches between the population with these diseases and

  4. 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…

  5. 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…

  6. 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

  7. 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

  8. Survival rates of breast cancer: a hospital-based study from northeast of Thailand.

    PubMed

    Poum, Amornsak; Kamsa-ard, Supot; Promthet, Supannee

    2012-01-01

    A retrospective cohort study was carried out with 340 female breast cancer at a teaching university in northeast of Thailand recruited and followed-up until the end of 2006. Survival probabilities were estimated using the Kaplan-Meier method. 161 cases were alive after five years and 58 patients were lost to follow-up. The overall observed survival rates at 1, 3 and 5 years were 83.3%, 59.9% and 42.9%, respectively. When analysis was conducted for stage combined into 2 groups, early (stage I, II and unknown) and late (stage III and IV), the 5-year survival rate for early stage (60%; 95%CI: 0.51-0.67), was higher than for late stage (27%; 95%CI: 0.19-0.34) with high statistical significance (p<0.001). The hazard ratio of patients with stage IV was 11.6 times greater than for stage I (p=0.03). The findings indicate that the different stages of breast cancer markedly effect the overall survival rate.

  9. Cancer incidence and incidence rates in Japan in 2009: a study of 32 population-based cancer registries for the Monitoring of Cancer Incidence in Japan (MCIJ) project.

    PubMed

    Hori, Megumi; Matsuda, Tomohiro; Shibata, Akiko; Katanoda, Kota; Sobue, Tomotaka; Nishimoto, Hiroshi

    2015-09-01

    The Japan Cancer Surveillance Research Group aimed to estimate the cancer incidence in Japan in 2009 based on data collected from 32 of 37 population-based cancer registries, as part of the Monitoring of Cancer Incidence in Japan (MCIJ) project. The incidence of only primary invasive cancer in Japan for 2009 was estimated to be 775 601. Stomach cancer and breast cancer were the leading types of cancer in males and females, respectively.

  10. 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.

  11. Capping risk adjustment?

    PubMed

    Eugster, Patrick; Sennhauser, Michèle; Zweifel, Peter

    2010-07-01

    When premiums are community-rated, risk adjustment (RA) serves to mitigate competitive insurers' incentive to select favorable risks. However, unless fully prospective, it also undermines their incentives for efficiency. By capping its volume, one may try to counteract this tendency, exposing insurers to some financial risk. This in term runs counter the quest to refine the RA formula, which would increase RA volume. Specifically, the adjuster, "Hospitalization or living in a nursing home during the previous year" will be added in Switzerland starting 2012. This paper investigates how to minimize the opportunity cost of capping RA in terms of increased incentives for risk selection.

  12. [Evaluation of chemotherapy for stage IV non-small cell lung cancer employing a regression tree type method for quality-adjusted survival analysis to determine prognostic factors].

    PubMed

    Fujita, A; Takabatake, H; Tagaki, S; Sohda, T; Sekine, K

    1996-03-01

    To evaluate the effect of chemotherapy on QOL, the survival period was categorized by 3 intervals: one in the hospital for chemotherapy (TOX), on an outpatient basis (TWiST Time without Symptom and Toxicity), and in the hospital for conservative therapy (REL). Coefficients showing the QOL level were expressed as ut, uw and ur. If uw was 1 and ut and ur were plotted at less than 1, ut TOX+uwTWiST+urREL could be a quality-adjusted value relative to TWiST (Q-TWiST). One hundred five patients with stage IV non-small cell lung cancer were included. Sixty-five were given chemotherapy, and the other 40 were not. The observation period was 2 years. Q-TWiST values for age, sex, PS, histology and chemotherapy were calculated. Their quantification was performed employing a regression tree type method. Chemotherapy contributed to Q-TWiST when ut approached 1 i.e., no side effect was supposed). When ut was less than 0.5, PS and sex had an appreciable role.

  13. 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

  14. Premenopausal Obesity and Breast Cancer Growth Rates in a Rodent Model.

    PubMed

    Matthews, Shawna B; McGinley, John N; Neil, Elizabeth S; Thompson, Henry J

    2016-04-11

    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.

  15. 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.

  16. 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.

  17. Fertility Rates in Young Korean Breast Cancer Patients Treated with Gonadotropin-Releasing Hormone and Chemotherapy

    PubMed Central

    Kim, Isaac; Ryu, Jai Min; Paik, Hyun-June; Park, Sungmin; Bae, Soo Youn; Lee, Se Kyung; Yu, Jonghan; Kim, Seok Won; Nam, Seok Jin

    2017-01-01

    Purpose Gonadotropin-releasing hormone (GnRH) agonists have been used with adjuvant chemotherapy to protect ovarian function. However, there are no data on the actual pregnancy rates among young breast cancer patients receiving GnRH agonists and concurrent chemotherapy in Korea. Methods Among patients who underwent surgery from January 2002 to April 2012, premenopausal patients aged between 20 and 40 years were included in the analysis. We retrospectively reviewed clinicopathologic features (e.g., age, obstetric and menstruation history), recurrence, and survival status. The rate of resumption of menstruation was calculated in all patients. In the married group, pregnancy and delivery rates were also recorded. Results Among 101 patients, 19 were lost to follow-up and 82 were eligible for the analysis. Among them, 31 were married, 10 of 51 got married, and 41 remained unmarried through the follow-up period. Among the married patients, 15 became pregnant and gave birth to 19 babies, whereas 26 did not become pregnant. The pregnancy rate in the married group was 50.0% (15/30). Three of 15 pregnancies (20.0%) were multiparous. Most of the delivered babies were healthy and 80.0% of patients had no problems breastfeeding (12/15). More than half the patients in all groups recovered menstrual status within 12 months. Conclusion Fifty percent of young breast cancer patients who attempted pregnancy succeeded in pregnancy after adjuvant chemotherapy and GnRH agonists. Further studies that include control groups are required to confirm whether the use of GnRH agonists improves pregnancy. PMID:28382099

  18. High-dose-rate intraluminal brachytherapy during preoperative chemoradiation for locally advanced rectal cancers

    PubMed Central

    Tunio, Mutahir Ali; Rafi, Mansoor; Hashmi, Altaf; Mohsin, Rehan; Qayyum, Abdul; Hasan, Mujahid; Sattar, Amjad; Mubarak, Muhammad

    2010-01-01

    AIM: To determine the feasibility and safety of high dose rate intraluminal brachytherapy (HDR-ILBT) boost during preoperative chemoradiation for rectal cancer. METHODS: Between 2008 and 2009, thirty-six patients with locally advanced rectal cancer (≥ T3 or N+), were treated initially with concurrent capecitabine (825 mg/m2 oral twice daily) and pelvic external beam radiotherapy (EBRT) (45 Gy in 25 fractions), then were randomized to group A; HDR-ILBT group (n = 17) to receive 5.5-7 Gy × 2 to gross tumor volume (GTV) and group B; EBRT group (n = 19) to receive 5.4 Gy × 3 fractions to GTV with EBRT. All patients underwent total mesorectal excision. RESULTS: Grade 3 acute toxicities were registered in 12 patients (70.6%) in group A and in 8 (42.1%) in group B. Complete pathologic response of T stage (ypT0) in group A was registered in 10 patients (58.8%) and in group B, 3 patients (15.8%) had ypT0 (P < 0.0001). Sphincter preservation was reported in 6/9 patients (66.7%) in group A and in 5/10 patients (50%) in group B (P < 0.01). Overall radiological response was 68.15% and 66.04% in Group A and B, respectively. During a median follow up of 18 mo, late grade 1 and 2 sequelae were registered in 3 patients (17.6%) and 4 patients (21.1%) in the groups A and B, respectively. CONCLUSION: HDR-ILBT was found to be effective dose escalation technique in preoperative chemoradiation for rectal cancers, with higher response rates, downstaging and with manageable acute toxicities. PMID:20845511

  19. 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.

  20. 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.

  1. Cancer incidence and incidence rates in Japan in 2008: a study of 25 population-based cancer registries for the Monitoring of Cancer Incidence in Japan (MCIJ) project.

    PubMed

    Matsuda, Ayako; Matsuda, Tomohiro; Shibata, Akiko; Katanoda, Kota; Sobue, Tomotaka; Nishimoto, Hiroshi

    2014-04-01

    The Japan Cancer Surveillance Research Group aimed to estimate the cancer incidence in Japan in 2008 based on data collected from 25 of 34 population-based cancer registries, as part of the Monitoring of Cancer Incidence in Japan project. The incidence in Japan for 2008 was estimated to be 749 767 (C00-C96). Stomach cancer and breast cancer were the leading types of cancer in males and females, respectively.

  2. 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

  3. Rates and predictors of consideration for adjuvant radiotherapy among high-risk breast cancer patients: a cohort study.

    PubMed

    Krotneva, Stanimira; Reidel, Kristen; Nassif, Mohammed; Trabulsi, Nora; Mayo, Nancy; Tamblyn, Robyn; Meguerditchian, Ari N

    2013-07-01

    Radiotherapy (RT) after breast conserving surgery (BCS) represents the standard for local control of breast cancer (BC). However, variations in practice persist. We aimed to characterize the rate of RT consideration (or referral) after BCS and identify predictors in Quebec, Canada, where universal health insurance is in place. A historical prospective cohort study using the provincial hospital discharge and medical services databases was conducted. All women with incident, non-metastatic BC (stages I-III) undergoing BCS (1998-2005) were identified. Odds ratios (ORs) and 95 % confidence intervals (CIs) for RT consideration were estimated with a generalized estimating equations regression model, adjusting for clustering of patients within physicians. Of the 27,483 women selected, 90 % were considered for RT and 84 % subsequently received it. Relative to women 50-69 years old, younger and older women were less likely to be considered: ORs of 0.82 (95 % CI 0.73-0.93) and 0.10 (0.09-0.12), respectively. Emergency room visits and hospitalizations unrelated to BC were associated with decreased odds of RT consideration: 0.85 (0.76-0.94) and 0.83 (0.71-0.97). Women with regional BC considered for chemotherapy were more likely to be considered for RT: 3.41 (2.83-4.11). RT consideration odds increased by 7 % (OR of 1.07, 95 % CI 1.03-1.10) for every ten additional BCSs performed by the surgeon in the prior year. Social isolation, comorbidities, and greater distance to a referral center lowered the odds. Demographic and clinical patient-related risk factors, health service use, gaps in other aspects of BC management, and surgeon's experience predicted RT consideration.

  4. Survival rate of gastric cancer in Iran; a systematic review and meta-analysis

    PubMed Central

    Veisani, Yousef; Delpisheh, Ali

    2016-01-01

    Aim: In this study, we aimed to estimate one- to five-year survival rates in Iranian patients with gastric cancer (GC). In addition, we preformed subgroup analyses and meta-regression to explore possible sources of heterogeneity between studies. Background: According to literatures, there has been increasing attention to the long-term survival rate in patients with GC in Iran. However, results have been inconsistent and remain controversial in overall survival rates. Patients and methods: Literature searches were conducted using PubMed, Scopus, and ISI, as well as Magiran, Medlib, SID, and Iran Medex databases. Studies were pooled and summary one to five survival rates were calculated. Univariate and multivariate regression analyses were used to explore possible sources of heterogeneity among studies. Subgroup analyses were also conducted. Analyses were conducted using the STATA statistical software package. Results: Final analysis of 29361 patients from 26 eligible studies was performed. The overall survival rate (one to five years) in all studies, by meta-analysis of 24, 14, 23, 12 and 22 studies were 52%, 31%, 24%, 22%, and 15%, respectively. Meta-regression analysis showed an increase in one- and five-year survival rate over the time (Reg Coef = 0.016, p= 0.04) and (Reg Coef= 0.021, p= 0.049), respectively. Positive heterogeneity was observed between quality of papers and data sources (P<0.001). Conclusion: More than half of GC deaths happened in the first year at diagnosis, and another 30% plus they occurred during the second year after confirmed diagnosis. Our results admit lower survival rates in Iran, similar to other developing countries. PMID:27099666

  5. High-dose-rate brachytherapy boost for prostate cancer: rationale and technique.

    PubMed

    Morton, Gerard C

    2014-10-01

    High-dose-rate brachytherapy (HDR) is a method of conformal dose escalation to the prostate. It can be used as a local boost in combination with external beam radiotherapy, with a high degree of efficacy and low rate of long term toxicity. Data consistently reports relapse free survival rates of greater than 90% for intermediate risk patients and greater than 80% for high risk. Results are superior to those achieved with external beam radiotherapy alone. A wide range of dose and fractionation is reported, however, we have found that a single 15 Gy HDR combined with hypofractionated radiotherapy to a dose of 37.5 Gy in 15 fractions is well tolerated and is associated with a long term relapse-free survival of over 90%. Either CT-based or trans-rectal ultrasound-based planning may be used. The latter enables treatment delivery without having to move the patient with risk of catheter displacement. We have found it to be an efficient and quick method of treatment, allowing catheter insertion, planning, and treatment delivery to be completed in less than 90 minutes. High-dose-rate boost should be considered the treatment of choice for many men with high and intermediate risk prostate cancer.

  6. Tumor Volume Reduction Rate After Preoperative Chemoradiotherapy as a Prognostic Factor in Locally Advanced Rectal Cancer

    SciTech Connect

    Yeo, Seung-Gu; Kim, Dae Yong; Park, Ji Won; Oh, Jae Hwan; Kim, Sun Young; Chang, Hee Jin; Kim, Tae Hyun; Kim, Byung Chang; Sohn, Dae Kyung; Kim, Min Ju

    2012-02-01

    Purpose: To investigate the prognostic significance of tumor volume reduction rate (TVRR) after preoperative chemoradiotherapy (CRT) in locally advanced rectal cancer (LARC). Methods and Materials: In total, 430 primary LARC (cT3-4) patients who were treated with preoperative CRT and curative radical surgery between May 2002 and March 2008 were analyzed retrospectively. Pre- and post-CRT tumor volumes were measured using three-dimensional region-of-interest MR volumetry. Tumor volume reduction rate was determined using the equation TVRR (%) = (pre-CRT tumor volume - post-CRT tumor volume) Multiplication-Sign 100/pre-CRT tumor volume. The median follow-up period was 64 months (range, 27-99 months) for survivors. Endpoints were disease-free survival (DFS) and overall survival (OS). Results: The median TVRR was 70.2% (mean, 64.7% {+-} 22.6%; range, 0-100%). Downstaging (ypT0-2N0M0) occurred in 183 patients (42.6%). The 5-year DFS and OS rates were 77.7% and 86.3%, respectively. In the analysis that included pre-CRT and post-CRT tumor volumes and TVRR as continuous variables, only TVRR was an independent prognostic factor. Tumor volume reduction rate was categorized according to a cutoff value of 45% and included with clinicopathologic factors in the multivariate analysis; ypN status, circumferential resection margin, and TVRR were significant prognostic factors for both DFS and OS. Conclusions: Tumor volume reduction rate was a significant prognostic factor in LARC patients receiving preoperative CRT. Tumor volume reduction rate data may be useful for tailoring surgery and postoperative adjuvant therapy after preoperative CRT.

  7. 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....

  8. 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

  9. 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

  10. Dose equivalence for high-dose-rate to low-dose-rate intracavitary irradiation in the treatment of cancer of the uterine cervix

    SciTech Connect

    Akine, Y.; Tokita, N.; Ogino, T.; Kajiura, Y.; Tsukiyama, I.; Egawa, S. )

    1990-12-01

    By comparing the incidence of major radiation injury, we estimated doses clinically equivalent for high-dose-rate (HDR) to conventional low-dose-rate (LDR) intracavitary irradiation in patients with Stages IIb and IIIb cancer of the uterine cervix. We reviewed a total of 300 patients who were treated with external beam therapy to the pelvis (50 Gy in 5 weeks) followed either by low-dose-rate (253 patients) or high-dose-rate (47 patients) intracavitary treatment. The high-dose-rate intracavitary treatment was given 5 Gy per session to point A, 4 fractions in 2 weeks, with a total dose of 20 Gy. The low-dose-rate treatment was given with one or two application(s) delivering 11-52 Gy to the point A. The local control rates were similar in both groups. The incidence of major radiation injury requiring surgical intervention were 5.1% (13/253) and 4.3% (2/47) for low-dose-rate and high-dose-rate groups, respectively. The 4.3% incidence corresponded to 29.8 Gy with low-dose-rate irradiation, thus, it was concluded that the clinically equivalent dose for high-dose-rate irradiation was approximately 2/3 (20/29.8) of the dose used in low-dose-rate therapy.

  11. Differences in the survival rates of older patients with colorectal cancers in 2003 and 2009

    PubMed Central

    Shin, Je-Wook; Park, Byung Kwan; Kim, Min Jung; Kim, Bun; Kim, Byung Chang; Park, Sung Chan; Han, Kyung Su; Oh, Jae Hwan

    2017-01-01

    Purpose The aim of this study was to investigate survival in patients aged ≥70 years who underwent colorectal cancer surgery in 2003 and 2009. In addition, we aimed to identify the factors that could affect survival in these patients. Methods In a cross-sectional study, a retrospective review of the data for 878 patients who underwent colorectal cancer surgery with curative intent in the years 2003 and 2009 was performed. The primary outcome was the 5-year overall survival rate (5-OSR), and the clinicopathologic factors that could affect overall survival were analyzed. Results The 5-OSR was 77.8% and 84.9% in 2003 and 2009, respectively (P = 0.013). Age, American Society of Anesthesiologists physical status classification, stage, type of surgery, and length of hospital stay possibly affected survival per the univariate and multivariate analyses. In patients aged ≥70 years, the 5-OSR in 2009 was 75.9%, which showed improvement compared to 53.7% in 2003 (P = 0.027). The stage, type of surgery, and hospital stay were the variables that possibly affected survival in patients aged ≥70 years per the univariate analysis, whereas the stage (III; hazard ratio [HR], 2.188; P = 0.005) and length of hospital stay (>12 days; HR, 2.307; P = 0.004), were the variables that showed statistical significance on the multivariate analysis. Conclusion We found that early stage and shortening the length of hospital stay could affect survival in older patients with colorectal cancers. Because of limited evidence on the influence of shortening the length of hospital stay on survival in older patients, further investigations are warranted. PMID:28382291

  12. 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

  13. Metabolic and protein interaction sub-networks controlling the proliferation rate of cancer cells and their impact on patient survival.

    PubMed

    Feizi, Amir; Bordel, Sergio

    2013-10-24

    Cancer cells can have a broad scope of proliferation rates. Here we aim to identify the molecular mechanisms that allow some cancer cell lines to grow up to 4 times faster than other cell lines. The correlation of gene expression profiles with the growth rate in 60 different cell lines has been analyzed using several genome-scale biological networks and new algorithms. New possible regulatory feedback loops have been suggested and the known roles of several cell cycle related transcription factors have been confirmed. Over 100 growth-correlated metabolic sub-networks have been identified, suggesting a key role of simultaneous lipid synthesis and degradation in the energy supply of the cancer cells growth. Many metabolic sub-networks involved in cell line proliferation appeared also to correlate negatively with the survival expectancy of colon cancer patients.

  14. Targeted cancer therapy with a novel low-dose rate alpha-emitting radioimmunoconjugate.

    PubMed

    Dahle, Jostein; Borrebaek, Jørgen; Jonasdottir, Thora J; Hjelmerud, Anne Kristine; Melhus, Katrine B; Bruland, Øyvind S; Press, Oliver W; Larsen, Roy H

    2007-09-15

    Alpha-emitting radionuclides are highly cytotoxic and are of considerable interest in the treatment of cancer. A particularly interesting approach is in radioimmunotherapy. However, alpha-emitting antibody conjugates have been difficult to exploit clinically due to the short half-life of the radionuclides, low production capability, or limited source materials. We have developed a novel technology based on the low-dose rate alpha-particle-emitting nuclide (227)Th, exemplified here using the monoclonal antibody rituximab. In vitro, this radioimmunoconjugate killed lymphoma cells at Becquerel per milliliter (Bq/mL) levels. A single injection of (227)Th-rituximab induced complete tumor regression in up to 60% of nude mice bearing macroscopic (32-256 mm(3)) human B-lymphoma xenografts at Becquerel per gram (Bq/g) levels without apparent toxicity. Therapy with (227)Th-rituximab was significantly more effective than the control radioimmunoconjugate (227)Th-trastuzumab and the standard beta-emitting radioimmunoconjugate for CD20(+) lymphoma(90)Y-tiuxetan-ibritumomab. Thorium-227 based constructs may provide a novel approach for targeted therapy against a wide variety of cancers.

  15. A trend analysis of breast cancer incidence rates in the United States from 2000 to 2009 shows a recent increase.

    PubMed

    Hou, Ningqi; Huo, Dezheng

    2013-04-01

    Recent reports have shown that the breast cancer incidence rate in the US stabilized after a sharp reduction in 2002 and 2003. It is important to continue monitoring breast cancer incidence rates according to age group, race/ethnicity, estrogen receptor (ER) status, and tumor stage. Age-standardized breast cancer incidence rates were calculated using data from the surveillance, epidemiology, and end results 18 registries from 2000 to 2009, for 677,774 female breast cancer patients aged 20 and above. Jointpoint regression models were used to fit a series of joined straight lines on a log scale to annual age-standardized rates. The incidence rates of all breast cancer significantly increased for non-Hispanic blacks from 2005 to 2009 (annual percentage change, APC = 2.0 %, p = 0.01) and Asian/Pacific Islanders from 2000 to 2009 (APC = 1.2 %, p = 0.02). Since 2004, incidence rates in women aged 40-49 years significantly increased for most racial/ethnic groups (overall APC = 1.1 %, p = 0.001). The incidence rate of carcinoma in situ significantly increased in all racial/ethnic groups, with an APC range from 2.3 to 3.0 % (p < 0.005). The localized breast cancer incidence significantly increased in non-Hispanic blacks (APC = 1.3 %, p = 0.004) and Asians (APC = 1.2 %, p = 0.03). ER-positive breast cancer significantly increased in almost all age/race sub-groups after 2005 (APC by race: non-Hispanic whites 1.5 %, non-Hispanic blacks 4.3 %, Asian/Pacific Islanders 1.7 %, and Hispanics 1.8 %; all p values <0.05), while ER-negative breast cancer decreased in most sub-groups (APC by race: non-Hispanic whites-3.9 %, non-Hispanic blacks-3.7 %, Asian/Pacific Islanders-1.5 %, and Hispanics-4.3 %; all p values <0.05). Recently the incidence of breast cancer appears to be increasing in certain subgroups, including ER-positive, early-stage breast cancers, in particular among non-Hispanic blacks and Asian/Pacific Islanders. Further studies are

  16. 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.

  17. 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.

  18. 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.

  19. Continuous Low-dose-rate Irradiation of Iodine-125 Seeds Inhibiting Perineural Invasion in Pancreatic Cancer

    PubMed Central

    Lu, Zheng; Dong, Teng-Hui; Si, Pei-Ren; Shen, Wei; Bi, Yi-Liang; Min, Min; Chen, Xin; Liu, Yan

    2016-01-01

    Background: Perineural invasion (PNI) is a histopathological characteristic of pancreatic cancer (PanCa). The aim of this study was to observe the treatment effect of continuous low-dose-rate (CLDR) irradiation to PNI and assess the PNI-related pain relief caused by iodine-125 (125I) seed implantation. Methods: The in vitro PNI model established by co-culture with dorsal root ganglion (DRG) and cancer cells was interfered under 2 and 4 Gy of 125I seeds CLDR irradiation. The orthotopic models of PNI were established, and 125I seeds were implanted in tumor. The PNI-related molecules were analyzed. In 30 patients with panCa, the pain relief was assessed using a visual analog scale (VAS). Pain intensity was measured before and 1 week, 2 weeks, and 1, 3, and 6 months after 125I seed implantation. Results: The co-culture of DRG and PanCa cells could promote the growth of PanCa cells and DRG neurites. In co-culture groups, the increased number of DRG neurites and pancreatic cells in radiation group was significantly less. In orthotopic models, the PNI-positive rate in radiation and control group was 3/11 and 7/11; meanwhile, the degrees of PNI between radiation and control groups was significant difference (P < 0.05). At week 2, the mean VAS pain score in patients decreased by 50% and significantly improved than the score at baseline (P < 0.05). The pain scores were lower in all patients, and the pain-relieving effect was retained about 3 months. Conclusions: The CLDR irradiation could inhibit PNI of PanCa with the value of further study. The CLDR irradiation could do great favor in preventing local recurrence and alleviating pain. PMID:27748339

  20. Incidence rates of specific histological types of lung cancer in Singapore Chinese dialect groups, and their aetiological significance.

    PubMed

    Law, C H; Day, N E; Shanmugaratnam, K

    1976-03-15

    Significant differences in the incidence levels of lung cancer have been observed among major Chinese dialect groups or communities (Kokkien, Teochew and Cantonese) in Singapore. Among males, the incidence rate is highest in the Hokkiens (age-standardized incidence rate per 100,000 persons per year in Hokkien 67.8, Teochew 55.3, Cantonese 54.0) and among females, it is highest in the Cantonese (Hokkien 12.4, Teochew 12.8, Cantonese 27.2). The present investigation was undertaken to determine the incidence rates of each of the main histological types of lung cancer in the Chinese population and to determine whether there are any correlations between histological patterns and the dialect group differentials that may be of aetiological significance. During the period 1968-1972, a total of 1,747 cases of lung cancer (1,285 males and 462 females) were reported to the Singapore Cancer Registry. It proved possible to type the neoplasms histologically in 476 males (37.0%) and 154 females (33.3%). Age-standardized rates by histological type were computed on the assumption that those histologically typed were a representative sample of all lung cancers. This study shows that Hokkien males have a significantly higher incidence rate of epidermoid carcinoma than the other dialect groups (Hokkien 36.1, Teochew 21.1, Cantonese 17.3). The Cantonese females have significantly higher incidence rates of both epidermoid carcinoma (Hokkien 3.7, Teochew 2.3, Cantonese 5.9) and adenocarcinoma (Hokkien 4.6, Teochew 3.6, Cantonese 11.9). Various sources of bias in studied of this type were examined; it is concluded that the differences in the histologic-specific incidence rates of lung cancer among the various Chinese dialect groups in Singapore are real and not artefactual. The significance of these findings in relation to possible aetiological factors is discussed.

  1. How the probability of presentation to a primary care clinician correlates with cancer survival rates: a European survey using vignettes

    PubMed Central

    Harris, Michael; Frey, Peter; Esteva, Magdalena; Gašparović Babić, Svjetlana; Marzo-Castillejo, Mercè; Petek, Davorina; Petek Ster, Marija; Thulesius, Hans

    2017-01-01

    Objective European cancer survival rates vary widely. System factors, including whether or not primary care physicians (PCPs) are gatekeepers, may account for some of these differences. This study explores where patients who may have cancer are likely to present for medical care in different European countries, and how probability of presentation to a primary care clinician correlates with cancer survival rates. Design Seventy-eight PCPs in a range of European countries assessed four vignettes representing patients who might have cancer, and consensus groups agreed how likely those patients were to present to different clinicians in their own countries. These data were compared with national cancer survival rates. Setting A total of 14 countries. Subjects Consensus groups of PCPs. Main outcome measures Probability of initial presentation to a PCP for four clinical vignettes. Results There was no significant correlation between overall national 1-year relative cancer survival rates and the probability of initial presentation to a PCP (r  = −0.16, 95% CI −0.39 to 0.08). Within that there was large variation depending on the type of cancer, with a significantly poorer lung cancer survival in countries where patients were more likely to initially consult a PCP (lung r = −0.57, 95% CI −0.83 to −0.12; ovary: r = −0.13, 95% CI −0.57 to 0.38; breast r = 0.14, 95% CI −0.36 to 0.58; bowel: r = 0.20, 95% CI −0.31 to 0.62). Conclusions There were wide variations in the degree of gatekeeping between countries, with no simple binary model as to whether or not a country has a “PCP-as-gatekeeper” system. While there was case-by-case variation, there was no overall evidence of a link between a higher probability of initial consultation with a PCP and poorer cancer survival. Key points European cancer survival rates vary widely, and health system factors may account for some of these differences. The data from 14 European

  2. Accumulation of cytoplasmic Cdk1 is associated with cancer growth and survival rate in epithelial ovarian cancer

    PubMed Central

    Shin, Ha-Yeon; Chung, Joon-Yong; Kang, Eun Suk; Lee, Eun-ju; Kim, Jae-Hoon

    2016-01-01

    Cyclin dependent kinase 1 (Cdk1) have previously reported correlation with cancer growth and a key regulator for cell cycle. Mostly, Cdk1′s function of nucleus for cell cycle is well known to be associated with cancer, but cytoplasmic Cdk1′s traits are not clearly identified, yet. We revealed that tissue microarray blocks of epithelial ovarian cancer (n = 249) showed increased level of cytoplasmic Cdk1 (p < 0.001), but not in nucleus (p = 0.192) of histologic cell type independently. On survival analysis, Cdk1 overexpression conferred a significantly worse prognosis in 5-year overall survival (Log-rank p = 0.028, Hazard ratio = 2.016, 95% CI = 1.097 to 4.635). Also, the expression of Cdk1 was increased in ovarian cancer cell lines and Gene Expression Omnibus datasets. When the expression and activity of Cdk1 were inhibited by si-Cdk1 or RO-3306 which is a potent Cdk1 inhibitor, the growth of ovarian cancer was diminished. Moreover, combined treatment with RO-3306 and cisplatin in ovarian cancer significantly elevated anti-cancer effects than single-agent treatment. In conclusion, cytoplasmic Cdk1 expression which was elevated in ovarian cancer predicts a poor overall survival. The inhibition of Cdk1 expression and activity reduced ovarian cancer growth. PMID:27385216

  3. 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

  4. 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

  5. Comparison of Age- Standard Incidence Rate Trends of Gynecologic and Breast Cancer in Iran and Other Countries

    PubMed Central

    ARAB, Maliheh; NOGHABAEI, Giti

    2014-01-01

    Abstract Background Female cancer, especially breast and gynecologic cancers are considered multistage disease, highly influenced by risk and protective factors and/or screening preventive modalities. Consequences of all these factors result in the trend of change over time. Methods In this comparative study, based on data of national cancer registry of Iran 2004 published by Iranian Ministry of Health, age — standard incidence rate (ASR) according to the world population was calculated in all reported gynecologic and breast cancers. Source of all subjects are pathologic based. In the next step, the calculated ASR of Iran and those of the other countries in 2004 were compared to GLOBOCAN ASR reports of 2008. Results In Iran ASR of breast cancer 2004 (24.93) changed to 18.4 in 2008. Ovarian cancer ASR of 2004, 3.07 was 3.1 in 2008. Endometrial cancer ASR in 2004 (2.29) was 1.7 in 2008. Cervical cancer ASR of 1.71 in 2004 was 2.2 in 2008. Conclusions In Iran incidence trend of breast and endometrium are decreasing in the same direction of USA and Australia. Increasing trend of ovary and cervix ASR in Iran is in the inverse direction of USA and Australia which are decreasing. Future studies to find out the same trend or any changes, might develop these findings and improve consequent practical decisions based on results of this study and complementary future studies. PMID:26060699

  6. 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.

  7. Non-melanoma skin cancer treated with high-dose-rate brachytherapy: a review of literature

    PubMed Central

    Rembielak, Agata; Manfredi, Bruno; Ursino, Stefano; Pasqualetti, Francesco; Laliscia, Concetta; Orlandi, Francesca; Morganti, Riccardo; Fabrini, Maria Grazia; Paiar, Fabiola

    2016-01-01

    Purpose The incidence of non-melanoma skin cancer (NMSC) has been increasing over the past 30 years. There are different treatment options and surgical excision is the most frequent treatment due to its low rates of recurrence. Radiotherapy is an effective alternative of surgery, and brachytherapy (BT) might be a better therapeutic option due to high radiation dose concentration to the tumor with rapid dose fall-off resulting in normal tissues sparing. The aim of this review was to evaluate the local control, toxicity, and cosmetic outcomes in NMSC treated with high-dose-rate BT (HDR-BT). Material and methods In May 2016, a systematic search of bibliographic database of PubMed, Web of Science, Scopus, and Cochrane Library with a combination of key words of “skin cancer”, “high dose rate brachytherapy”, “squamous cell carcinoma”, “basal cell carcinoma”, and “non melanoma skin cancer“ was performed. In this systematic review, we included randomized trials, non-randomized trials, prospective and retrospective studies in patients affected by NMSC treated with HDR-BT. Results Our searches generated a total of 85 results, and through a process of screening, 10 publications were selected for the review. Brachytherapy was well tolerated with acceptable toxicity and high local control rates (median: 97%). Cosmetic outcome was reported in seven study and consisted in an excellent and good cosmetic results in 94.8% of cases. Conclusions Based on the review data, we can conclude that the treatment of NMSC with HDR-BT is effective with excellent and good cosmetics results, even in elderly patients. The hypofractionated course appears effective with very good local disease control. More data with large-scale randomized controlled trials are needed to assess the efficacy and safety of brachytherapy. PMID:28115960

  8. PET-Adjusted Intensity Modulated Radiation Therapy and Combination Chemotherapy in Treating Patients With Stage II-IV Non-small Cell Lung Cancer

    ClinicalTrials.gov

    2017-01-23

    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

  9. Anastomotic leak rate after low anterior resection for rectal cancer after chemoradiation therapy.

    PubMed

    Phillips, Benjamin R; Harris, Lisa J; Maxwell, Pinckney J; Isenberg, Gerald A; Goldstein, Scott D

    2010-08-01

    Anastomotic leak may be the most concerning complication after colorectal anastomosis. To compare open with laparoscopic rectal resection, we must have accurate leak rates in patients who have received neoadjuvant chemoradiation therapy to serve as a benchmark for comparison. All patients who had preoperative chemoradiation therapy with rectal resection and low pelvic anastomosis for cancer in a single colorectal practice over a 7-year period were retrospectively reviewed. All patients had proximal diversion and a contrast enema study before stoma reversal. Eighty-seven consecutive patients were included in the study. Average age was 58 years. Fifty-nine per cent of patients were male. Sixty-six per cent were smokers. Pathologic T stage was 5 per cent T0, 16 per cent T1, 28 per cent T2, 47 per cent T3, and 5 per cent T4. Seventy-five per cent of patients were pathologically lymph node-negative. Average time to stoma reversal was 122 days. Total anastomotic leak rate was 10.3 per cent (8% clinical leaks). Five (56%) patients with leak successfully underwent reversal of their diverting stoma (average time to reversal, 290 days). Patients who had the complication of anastomotic leakage had less likelihood of stoma reversal and a significantly prolonged time to stoma reversal.

  10. 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

  11. 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

  12. Canadian National Breast Screening Study: 1. Breast cancer detection and death rates among women aged 40 to 49 years.

    PubMed Central

    Miller, A B; Baines, C J; To, T; Wall, C

    1992-01-01

    OBJECTIVES: To evaluate the efficacy of the combination of annual screening with mammography, physical examination of the breasts and the teaching of breast self-examination in reducing the rate of death from breast cancer among women aged 40 to 49 years on entry. DESIGN: Individually randomized controlled trial. SETTING: Fifteen urban centres in Canada with expertise in the diagnosis and treatment of breast cancer. PARTICIPANTS: Women with no history of breast cancer and no mammography in the previous 12 months were randomly assigned to undergo either annual mammography and physical examination (MP group) or usual care after an initial physical examination (UC group). The 50,430 women enrolled from January 1980 through March 1985 were followed for a mean of 8.5 years. DATA COLLECTION: Derived from the participants by initial and annual self-administered questionnaires, from the screening examinations, from the patients' physicians, from the provincial cancer registries and by record linkage to the Canadian National Mortality Data Base. Expert panels evaluated histologic and death data. MAIN OUTCOME MEASURES: Rates of referral from screening, rates of detection of breast cancer from screening and from community care, nodal status, tumour size, and rates of death from all causes and from breast cancer. RESULTS: Over 90% of the women in each group attended the screening sessions or returned the annual questionnaires, or both, over years 2 to 5. The characteristics of the women in the two groups were similar. Compared with the Canadian population, the participants were more likely to be married, have fewer children, have more education, be in a professional occupation, smoke less and have been born in North America. The rate of screen-detected breast cancer on first examination was 3.89 per 1000 in the MP group and 2.46 per 1000 in the UC group; more node-positive tumours were found in the MP group than in the UC group. During years 2 through 5 the ratios of observed

  13. Clinical implementation of a novel applicator in high-dose-rate brachytherapy treatment of esophageal cancer

    PubMed Central

    Hansen, Jorgen L.; Bhagwat, Mandar S.; O'Farrell, Desmond A.; Friesen, Scott; Harris, Thomas C.; Damato, Antonio L.; Cormack, Robert A.; Martin, Neil E.; Devlin, Phillip M.

    2016-01-01

    Purpose In this study, we present the clinical implementation of a novel transoral balloon centering esophageal applicator (BCEA) and the initial clinical experience in high-dose-rate (HDR) brachytherapy treatment of esophageal cancer, using this applicator. Material and methods Acceptance testing and commissioning of the BCEA were performed prior to clinical use. Full performance testing was conducted including measurements of the dimensions and the catheter diameter, evaluation of the inflatable balloon consistency, visibility of the radio-opaque markers, congruence of the markers, absolute and relative accuracy of the HDR source in the applicator using the radiochromic film and source position simulator, visibility and digitization of the applicator on the computed tomography (CT) images under the clinical conditions, and reproducibility of the offset. Clinical placement of the applicator, treatment planning, treatment delivery, and patient's response to the treatment were elaborated as well. Results The experiments showed sub-millimeter accuracy in the source positioning with distal position at 1270 mm. The digitization (catheter reconstruction) was uncomplicated due to the good visibility of markers. The treatment planning resulted in a favorable dose distribution. This finding was pronounced for the treatment of the curvy anatomy of the lesion due to the improved repeatability and consistency of the delivered fractional dose to the patient, since the radioactive source was placed centrally within the lumen with respect to the clinical target due to the five inflatable balloons. Conclusions The consistency of the BCEA positioning resulted in the possibility to deliver optimized non-uniform dose along the catheter, which resulted in an increase of the dose to the cancerous tissue and lower doses to healthy tissue. A larger number of patients and long-term follow-up will be required to investigate if the delivered optimized treatment can lead to improved

  14. Association of the recurrence and canceration rate of vocal leukoplakia with interleukin-10 promoter variants over a 2-year period.

    PubMed

    Zhou, Jian; Zhang, Duo; Zhou, Liang; Yang, Yue; Liu, Fei; Tao, Lei; Lu, Li-Ming

    2016-11-01

    Conclusion This study indicates that IL-10 promoter polymorphism variants, smoking, and alcohol consumption increase the risk of recurrence and canceration in vocal leukoplakia. Objective This prospective, clinical trial was performed to evaluate the association of interleukin (IL)-10 promoter polymorphism variants and canceration and recurrence rates in vocal leukoplakia (a pre-cancerous laryngeal carcinoma lesion) over a 2-year period. Participants and method Sixty-one post-operative patients with vocal leukoplakia were enrolled in this prospective, observational study and genotyped for the IL-10 promoter gene (IL-10-1082 A/G, -819 T/C and -592 A/C) using pyrosequencing, and responded to a 2-year follow-up survey. Recurrence and canceration rates were used to evaluate the association between the genotype variants and the clinical outcome. Results There was an increased canceration rate in the variant genotype group compared to that in the normal genotype group in the 2-year follow-up period (18.4% vs 0%, p-value = 0.038). Compared with the non-smoker group, the smoker group had a higher recurrence rate of vocal leukoplakia (29.3% vs 5%, p-value =0.044). Likewise, the recurrence rate in the alcohol consumption group was also higher (30.6% vs 8%, p-value =0.034). The percentage of cancerization in the alcohol consumption group was significantly higher than that in the non-alcohol consumption group (19.4% vs 0%, p-value =0.035).

  15. Tumor Volume Reduction Rate during Adaptive Radiation Therapy as a Prognosticator for Nasopharyngeal Cancer

    PubMed Central

    Lee, Hyebin; Ahn, Yong Chan; Oh, Dongryul; Nam, Heerim; Noh, Jae Myoung; Park, Su Yeon

    2016-01-01

    Purpose The purpose of this study is to evaluate the prognostic significance of the tumor volume reduction rate (TVRR) measured during adaptive definitive radiation therapy (RT) for nasopharyngeal cancer (NPC). Materials and Methods We reviewed the RT records of 159 NPC patients treated with definitive RT with or without concurrent chemotherapy between January 2006 and February 2013. Adaptive re-planning was performed in all patients at the third week of RT. The pre- and mid-RT gross tumor volumes (GTVs) of the primary tumor and the metastatic lymph nodes were measured and analyzed for prognostic implications. Results After a median follow-up period of 41.5 months (range, 11.2 to 91.8 months) for survivors, there were 43 treatment failures. The overall survival and progression-free survival (PFS) rates at 5 years were 89.6% and 69.7%, respectively. The mean pre-RT GTV, mid-RT GTV, and TVRR were 45.9 cm3 (range, 1.5 to 185.3 cm3), 26.7 cm3 (1.0 to 113.8 cm3), and –41.9% (range, –87% to 78%), respectively. Patients without recurrence had higher TVRR than those with recurrence (44.3% in the no recurrence group vs. 34.0% in the recurrence group, p=0.004), and those with TVRR > 35% achieved a significantly higher rate of PFS at 5 years (79.2% in TVRR > 35% vs. 53.2% in TVRR ≤ 35%; p < 0.001). In multivariate analysis, TVRR was a significant factor affecting PFS (hazard ratio, 2.877; 95% confidence interval, 1.555 to 5.326; p=0.001). Conclusion TVRR proved to be a significant prognostic factor in NPC patients treated with definitive RT, and could be used as a potential indicator for early therapeutic modification during the RT course. PMID:26194371

  16. An index of unhealthy lifestyle is associated with coronary heart disease mortality rates for small areas in England after adjustment for deprivation.

    PubMed

    Scarborough, P; Allender, S; Rayner, M; Goldacre, M

    2011-03-01

    Indices of socio-economic deprivation are often used as a proxy for differences in the health behaviours of populations within small areas, but these indices are a measure of the economic environment rather than the health environment. Sets of synthetic estimates of the ward-level prevalence of low fruit and vegetable consumption, obesity, raised blood pressure, raised cholesterol and smoking were combined to develop an index of unhealthy lifestyle. Multi-level regression models showed that this index described about 50% of the large-scale geographic variation in CHD mortality rates in England, and substantially adds to the ability of an index of deprivation to explain geographic variations in CHD mortality rates.

  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. Canadian National Breast Screening Study: 2. Breast cancer detection and death rates among women aged 50 to 59 years.

    PubMed Central

    Miller, A B; Baines, C J; To, T; Wall, C

    1992-01-01

    OBJECTIVE: To evaluate the efficacy of annual mammography over and above annual physical examination of the breasts and the teaching of breast self-examination among women aged 50 to 59 on entry. DESIGN: Individually randomized controlled trial. SETTING: Fifteen urban centres in Canada with expertise in the diagnosis and treatment of breast cancer. PARTICIPANTS: Women with no history of breast cancer and no mammography in the previous 12 months were randomly assigned to undergo either annual mammography and physical examination (MP group) or annual physical examination only (PO group). The 39,405 women enrolled from January 1980 through March 1985 were followed for a mean of 8.3 years. DATA COLLECTION: Derived from the participants by initial and annual self-administered questionnaires, from the screening examinations, from the patients' physicians, from the provincial cancer registries and by record linkage to the Canadian National Mortality Data Base. Expert panels evaluated histologic and death data. MAIN OUTCOME MEASURES: Rates of referral from screening, rates of detection of breast cancer from screening and from community care, nodal status, tumour size and rates of death from all causes and from breast cancer. RESULTS: Over 85% of the women in each group attended the screening sessions after screen 1. The characteristics of the women in the two groups were similar. Compared with the Canadian population the participants were more likely to be married, have fewer children, have more education, be in a professional occupation, smoke less and have been born in North America. The rate of screen-detected breast cancer on first examination was 7.20 per 1000 in the MP group and 3.45 per 1000 in the PO group, more node-positive tumours were found in the MP group than in the PO group. At subsequent screens the detection rates were a little less than half the rates at screen 1. During years 2 through 5 the ratios of observed to expected cases of invasive breast cancer

  19. 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

  20. 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

  1. 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

  2. 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.

  3. Degradation Rate of 5-Fluorouracil in Metastatic Colorectal Cancer: A New Predictive Outcome Biomarker?

    PubMed Central

    Botticelli, Andrea; Borro, Marina; Onesti, Concetta Elisa; Strigari, Lidia; Gentile, Giovanna; Cerbelli, Bruna; Romiti, Adriana; Occhipinti, Mario; Sebastiani, Claudia; Lionetto, Luana; Marchetti, Luca; Simmaco, Maurizio; Marchetti, Paolo; Mazzuca, Federica

    2016-01-01

    Background 5-FU based chemotherapy is the most common first line regimen used for metastatic colorectal cancer (mCRC). Identification of predictive markers of response to chemotherapy is a challenging approach for drug selection. The present study analyzes the predictive role of 5-FU degradation rate (5-FUDR) and genetic polymorphisms (MTHFR, TSER, DPYD) on survival. Materials and Methods Genetic polymorphisms of MTHFR, TSER and DPYD, and the 5-FUDR of homogenous patients with mCRC were retrospectively studied. Genetic markers and the 5-FUDR were correlated with clinical outcome. Results 133 patients affected by mCRC, treated with fluoropyrimidine-based chemotherapy from 2009 to 2014, were evaluated. Patients were classified into three metabolic classes, according to normal distribution of 5-FUDR in more than 1000 patients, as previously published: poor-metabolizer (PM) with 5-FU-DR ≤ 0,85 ng/ml/106 cells/min (8 pts); normal metabolizer with 0,85 < 5-FU-DR < 2,2 ng/ml/106 cells/min (119 pts); ultra-rapid metabolizer (UM) with 5-FU-DR ≥ 2,2 ng/ml/106 cells/min (6 pts). PM and UM groups showed a longer PFS respect to normal metabolizer group (14.5 and 11 months respectively vs 8 months; p = 0.029). A higher G3-4 toxicity rate was observed in PM and UM, respect to normal metabolizer (50% in both PM and UM vs 18%; p = 0.019). No significant associations between genes polymorphisms and outcomes or toxicities were observed. Conclusion 5-FUDR seems to be significantly involved in predicting survival of patients who underwent 5-FU based CHT for mCRC. Although our findings require confirmation in large prospective studies, they reinforce the concept that individual genetic variation may allow personalized selection of chemotherapy to optimize clinical outcomes. PMID:27656891

  4. High-dose rate brachytherapy in localized penile cancer: short-term clinical outcome analysis

    PubMed Central

    2014-01-01

    Purpose To assess clinical outcomes of high-dose rate interstitial brachytherapy (HIB) in localized penile carcinoma. Material and methods From 03/2006 to 08/2013, patients with biopsy-proven T1-T2 (<4 cm) non-metastatic localized penile squamous cell carcinoma underwent HIB. Under general anaesthesia, after Foley catheter placement, needles were placed in the target volume using a dedicated template. Planification was carried out with a post-implant CT-scan to deliver a total dose of 36 Gy in 9 fractions over 5 days (in adjuvant setting) or 39 Gy in 9 fractions over 5 days (as monotherapy). Dose-volume adaptation was manually achieved using graphical optimization. Dosimetric data and clinical outcomes were retrospectively analyzed. Toxicities were graded using the CTC v4.0. Results With a median follow-up of 27 months [5.1-83], 12 patients including 8 T1a, 3 T1b and 1 T2 N0 underwent HIB (sole therapy: 11 pts; adjuvant: 1 pt). The actuarial 5-year relapse-free, cause-specific and overall survival rates were 83%, 100% and 78% respectively. Comparing pre and post treatment evaluation, no IPSS or IIEF-5 changes were reported. Dermatitis was reported systematically 1 month after HIB including 6 G1, 5 G2 and 1 G3. Only 1 experienced long-term G3 successfully treated with hyperbaric oxygen therapy. One urethral meatus stenosis G3 required meatotomy. Conclusion In selected patients with T1-T2 localized penile cancer, HIB may be considered as an optional conservative therapy. Longer follow-up is needed to confirm these encouraging preliminary results. PMID:24941956

  5. Fixed-dose-rate administration of gemcitabine in cancer-bearing cats: A pilot study.

    PubMed

    Garnett, Crystal L; Guerrero, Teri A; Rodriguez, Carlos O

    2016-11-01

    Gemcitabine is an antimetabolite chemotherapy agent with schedule-dependent metabolism and efficacy. The purpose of this study was to identify the fixed-dose-rate (FDR) of gemcitabine administration in cancer-bearing cats that achieved a target plasma concentration (TPC) of 10 to 20 μM. Fifteen client-owned cats received gemcitabine infusions administered at various FDR for 1 to 6 hours. Plasma gemcitabine and dFdU (2',2'-difluorodeoxyuridine), the major gemcitabine metabolite, were quantitated by high performance liquid chromatography. Cats treated with an FDR less than 2.5 mg/m(2) per minute failed to achieve TPC, whereas cats treated with an FDR of 10 mg/m(2) per minute quickly exceeded the target range. An FDR of 5 mg/m(2) per minute provided the longest duration of exposure without exceeding the upper limit of the TPC. Plasma dFdU concentration mirrored plasma gemcitabine concentrations. These data suggest that in order to maintain TPC of gemcitabine in cats the FDR lies between 2.5 and 5 mg/m(2) per minute. A Phase II study to evaluate efficacy and toxicity of this approach is underway.

  6. Therapeutic analysis of high-dose-rate {sup 192}Ir vaginal cuff brachytherapy for endometrial cancer using a cylindrical target volume model and varied cancer cell distributions

    SciTech Connect

    Zhang, Hualin Donnelly, Eric D.; Strauss, Jonathan B.; Qi, Yujin

    2016-01-15

    Purpose: To evaluate high-dose-rate (HDR) vaginal cuff brachytherapy (VCBT) in the treatment of endometrial cancer in a cylindrical target volume with either a varied or a constant cancer cell distributions using the linear quadratic (LQ) model. Methods: A Monte Carlo (MC) technique was used to calculate the 3D dose distribution of HDR VCBT over a variety of cylinder diameters and treatment lengths. A treatment planning system (TPS) was used to make plans for the various cylinder diameters, treatment lengths, and prescriptions using the clinical protocol. The dwell times obtained from the TPS were fed into MC. The LQ model was used to evaluate the therapeutic outcome of two brachytherapy regimens prescribed either at 0.5 cm depth (5.5 Gy × 4 fractions) or at the vaginal mucosal surface (8.8 Gy × 4 fractions) for the treatment of endometrial cancer. An experimentally determined endometrial cancer cell distribution, which showed a varied and resembled a half-Gaussian distribution, was used in radiobiology modeling. The equivalent uniform dose (EUD) to cancer cells was calculated for each treatment scenario. The therapeutic ratio (TR) was defined by comparing VCBT with a uniform dose radiotherapy plan in term of normal cell survival at the same level of cancer cell killing. Calculations of clinical impact were run twice assuming two different types of cancer cell density distributions in the cylindrical target volume: (1) a half-Gaussian or (2) a uniform distribution. Results: EUDs were weakly dependent on cylinder size, treatment length, and the prescription depth, but strongly dependent on the cancer cell distribution. TRs were strongly dependent on the cylinder size, treatment length, types of the cancer cell distributions, and the sensitivity of normal tissue. With a half-Gaussian distribution of cancer cells which populated at the vaginal mucosa the most, the EUDs were between 6.9 Gy × 4 and 7.8 Gy × 4, the TRs were in the range from (5.0){sup 4} to (13

  7. Bevacizumab Addition in Neoadjuvant Treatment Increases the Pathological Complete Response Rates in Patients with HER-2 Negative Breast Cancer Especially Triple Negative Breast Cancer: A Meta-Analysis

    PubMed Central

    Zhang, Jing; Zhang, Binglan; Shi, Changle; Liu, Lei

    2016-01-01

    Background Neoadjuvant therapy is administered to breast cancer patients as an induction process before surgery or radiotherapy to reduce tumor size. Human epidermal growth factor receptor-2 (HER-2) negative breast cancer lacks effective standard target therapy. Bevacizumab has a controversial role in the treatment of breast cancer and we conduct a meta-analysis to evaluate the value of adding bevacizumab in neoadjuvant regimen. Methods Potentially eligible studies were retrieved using PubMed, EMBASE and Medline. Clinical characteristics of patients and statistical data with pathological complete response (pCR) data were collected. Then a meta-analysis model was established to investigate the correlation between administration of bevacizumab in neoadjuvant therapy and pCR rates in HER-2 negative breast cancer. Results Seven eligible studies and 5408 patients were yielded. The pCR rates for “breast” or “breast plus lymph node” were similar. In subgroup analysis, we emphasized on patients with triple-negative breast cancer (TNBC). In the criterion of “lesions in breast” the pooled ORs was 1.55 [1.29, 1.86], P<0.00001 and regarding to the evaluation criterion of “lesions in breast and lymph nodes”, the pooled ORs was 1.48 [1.23, 1.78], P<0.0001, in favor of bevacizumab administration. Conclusion According to our pooled results, we finally find that bevacizumab addition as a neoadjuvant chemotherapy component, for induction use with limited cycle to improve the pCR rates and patients may avoid long-term adverse event and long-term invalid survival improvement. Especially in subgroup analysis, pCR rates could be improved significantly and physicians could consider bevacizumab with caution. As patients could avoid the adverse event caused by long-term using of bevacizumab, long-term quality of life improvement may be achieved, especially in TNBC. PMID:27579484

  8. 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

  9. 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

  10. [Side effects of postoperative irradiation of uterine cancer with high dose rate iridium and low dose rate radium].

    PubMed

    Kucera, H; Unel, N; Weghaupt, K

    1986-02-01

    A report is given about reversible and irreversible complications following postoperative irradiation in cases of endometrial carcinoma. Intravaginal brachytherapy was performed. In advanced cases or in cases with poor prognosis (tumor grading) percutaneous irradiation was added (Co60). In 156 cases low-dose-rate irradiation (Ra226) and in 143 cases high-dose-rate irradiation (Ir192) was applied intravaginally. Reversible complications (cystitis, proctitis) could be observed following Radium in 7%, following Iridium in 14%. Irreversible complications (fistulas, stenoses): 1.9% following Radium and 3.5% following Iridium. When high-dose-rate irradiation was combined with percutaneous Co60 therapy, reversible complications occurred in 22.8%. After changing the Iridium-therapy scheme (reduction of dose from 10 to 7 Gy and irradiation only of the upper two thirds of the vagina) complications only could be observed in the same level as in Radium-therapy. High-dose-rate irradiation does not need hospitalization of the patients.

  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. Lateral biopsies added to the traditional sextant prostate biopsy pattern increases the detection rate of prostate cancer.

    PubMed

    Bauer, J J; Zeng, J; Zhang, W; McLeod, D G; Sesterhenn, I A; Connelly, R R; Mun, S K; Moul, J W

    2000-07-01

    Urologists routinely use the systematic sextant needle biopsy technique to detect prostate cancer. However, recent evidence suggests that this technique has a significant sampling error and data based upon whole-mounted step-sectioned radical prostatectomy specimens using a three-dimensional computer-assisted prostate biopsy simulator suggests that an increased detection rate is possible using laterally placed biopsies. The simulated 10-core biopsy pattern (traditional sextant biopsy cores and four laterally placed biopsies in the right and left apex and mid portion of the prostate gland) was shown to be superior to the traditional sextant biopsy. The objective of this pilot study was to confirm the higher prostate cancer detection rate obtained using the 10-core biopsy pattern in patients. We reviewed data on 35 consecutive patients with a pathologic diagnosis of prostate cancer biopsied by a single urologist using the 10-core biopsy pattern. The frequency of positive biopsy was determined for each core. Additionally, the sextant and 10-core prostate biopsy patterns were compared with respect to prostate cancer detection rate. Of the 35 patients diagnosed with prostate cancer, 54.3%(19/35) were diagnosed by the sextant biopsy only. The 10-core pattern resulted in an additional 45.7%(16/35) of patients being diagnosed solely with the laterally placed biopsies. The laterally placed biopsies had the highest frequency of positive biopsies when compared to the sextant cores. In conclusion, biopsy protocols that use laterally placed biopsies based upon a five region anatomical model are superior to the routinely used sextant prostate biopsy pattern. Prostate Cancer and Prostatic Diseases (2000) 3, 43-46

  13. 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

  14. Nuclear anomalies, chromosomal aberrations and proliferation rates in cultured lymphocytes of head and neck cancer patients.

    PubMed

    George, Alex; Dey, Rupraj; Bhuria, Vikas; Banerjee, Shouvik; Ethirajan, Sivakumar; Siluvaimuthu, Ashok; Saraswathy, Radha

    2014-01-01

    Head and neck cancers (HNC) are extremely complex disease types and it is likely that chromosomal instability is involved in the genetic mechanisms of its genesis. However, there is little information regarding the background levels of chromosome instability in these patients. In this pilot study, we examined spontaneous chromosome instability in short-term lymphocyte cultures (72 hours) from 72 study subjects - 36 newly diagnosed HNC squamous cell carcinoma patients and 36 healthy ethnic controls. We estimated chromosome instability (CIN) using chromosomal aberration (CA) analysis and nuclear level anomalies using the Cytokinesis Block Micronucleus Cytome Assay (CBMN Cyt Assay). The proliferation rates in cultures of peripheral blood lymphocytes (PBL) were assessed by calculating the Cytokinesis Block Proliferation Index (CBPI). Our results showed a significantly higher mean level of spontaneous chromosome type aberrations (CSAs), chromatid type aberration (CTAs) dicentric chromosomes (DIC) and chromosome aneuploidy (CANEUP) in patients (CSAs, 0.0294±0.0038; CTAs, 0.0925±0.0060; DICs, 0.0213±0.0028; and CANEUPs, 0.0308±0.0035) compared to controls (CSAs, 0.0005±0.0003; CTAs, 0.0058±0.0015; DICs, 0.0005±0.0003; and CANEUPs, 0.0052±0.0013) where p<0.001. Similarly, spontaneous nuclear anomalies showed significantly higher mean level of micronuclei (MNi), nucleoplasmic bridges (NPBs) and nuclear buds (NBUDs) among cases (MNi, 0.01867±0.00108; NPBs, 0.01561±0.00234; NBUDs, 0.00658±0.00068) compared with controls (MNi, 0.00027±0.00009; NPBs, 0.00002±0.00002; NBUDs, 0.00011±0.00007).The evaluation of CBPI supported genomic instability in the peripheral blood lymphocytes showing a significantly lower proliferation rate in HNC patients (1.525±0.005552) compared to healthy subjects (1.686±0.009520 ) (p<0.0001). In conclusion, our preliminary results showed that visible spontaneous genomic instability and low rate proliferation in the cultured peripheral

  15. 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

  16. Sex steroid binding protein receptor (SBP-R) is related to a reduced proliferation rate in human breast cancer.

    PubMed

    Catalano, M G; Comba, A; Fazzari, A; Benedusi-Pagliano, E; Sberveglieri, M; Revelli, A; Massobrio, M; Frairia, R; Fortunati, N

    1997-02-01

    In the last years, an increasing amount of studies described a membrane receptor for the Sex Steroid Binding Protein (SBP) on several androgen-estrogen dependent tissues. One of the suggested biological roles of the interaction between SBP and its receptor seems to be a negative control of the E2 induced proliferation of human breast cancer cells through the cAMP pathway. In the present work, SBP membrane receptor was evaluated on human breast cancer specimens with a radio-binding assay. Each tissue sample was also evaluated for ER and PGR status. Cytosol Thymidine Kinase levels were measured in tissue samples in order to evaluate cell proliferation rate. SBP binding to membranes of ER +/PGR + samples was time and temperature dependent, specific and at high affinity. In addition, SBP recognized on breast cancer membranes two sites at different affinity, as previously described for other human tissues and cultured cells. Membrane SBP-R was detected in a significantly higher number of samples positive for both ER and PGR than in negative samples. SBP-R positive samples showed a significantly lower proliferation rate than SBP-R negative samples as demonstrated by TK activity. The present study contains evidences for the existence of a specific membrane receptor for SBP in breast cancer sample membranes and the presence of SBP-R seems to be strictly related to a lower proliferation rate of the sample.

  17. The incidence rate of thyroid cancer among women in Saudi Arabia: an observational descriptive epidemiological analysis of data from Saudi Cancer Registry 2001-2008.

    PubMed

    Alghamdi, Ibrahim G; Hussain, Issam I; Alghamdi, Mohamed S; Dohal, Ahlam A; Almalki, Shaia S; El-Sheemy, Mohammed A

    2015-06-01

    This study provides a descriptive epidemiological data of thyroid cancer cases diagnosed from 2001 to 2008 among Saudi women, including the frequency and percentage of cases, the crude incidence rate (CIR) and the age-standardised incidence rate (ASIR) stratified by the region and year of diagnosis. This is a retrospective descriptive epidemiological analysis of all Saudi thyroid cancer cases recorded in the Saudi Cancer Registry (SCR) between January 2001 and December 2008. The statistical analyses were applied using descriptive statistics with the Statistical Package for the Social Sciences version 20.0. A total of 2,930 cases were recorded in the SCR between January 2001 and December 2008. The region of Riyadh in Saudi Arabia had the highest overall ASIR at 9.43 per 100,000 women, followed by Tabuk at 7.11 and eastern region at 6.5, while Jazan and Jouf had the lowest average ASIRs at 1.97 and at 2.72, respectively. The region of Qassim recorded the greatest changes of ASIR at 5.5 per 100,000 women from 2001 to 2008. There was a slight increase in the CIRs and ASIRs for thyroid cancer in Saudi Arabia between 2001 and 2008. Riyadh, Tabuk and eastern region were the highest overall ASIR in Saudi Arabia. While, Jazan and Hail had the lowest rates. Finally, the region of Qassim had the highest changes in CIR and ASIR from 2001 to 2008. Further analytical studies are needed to determine the potential risk factors of thyroid cancer disease among Saudi women.

  18. Associations of Census-Tract Poverty with Subsite-Specific Colorectal Cancer Incidence Rates and Stage of Disease at Diagnosis in the United States

    PubMed Central

    Henry, Kevin A.; Sherman, Recinda L.; 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

  19. 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.

  20. 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.