Science.gov

Sample records for adjusted cancer rates

  1. Risk-adjusted melanoma skin cancer incidence rates in Whites (United States).

    PubMed

    Merrill, Ray Martell

    2011-12-01

    The objective of this study was to obtain a better population-based measure of risk for melanoma skin cancer. A method has been previously proposed for estimating cancer incidence rates for data collected from the Surveillance, Epidemiology, and End Results (SEER) program. Unlike conventionally reported incidence rates in the USA, this method uses the first primary cancer and adjusts for population-based cancer prevalence to obtain a better measure of cancer risk. The study involves SEER data for white men and women. Conventional melanoma incidence rates overestimate risk for men, increasingly so from 3.3% in the age group of 30-39 years to 11.3% in the age group of 80 years and older. Overestimation in risk for women ranged from 3.3% in the age group of 30-39 years to 8.9% in the age group of 80 years and older. Overestimation of risk was more pronounced when both in-situ and malignant melanomas were considered. Increasing trends in conventional rates were slightly greater than trends in risk-adjusted incidence rates (RAIRs). In 2007, the estimated number of cases with malignant melanoma among the white population based on conventional cancer incidence rates is 37 636 (64 125 including in-situ cases) for men and 28 935 (49 361 including in-situ cases) for women. The estimated number of cases in the USA based on RAIRS is 34 652 [(7.9%); 55 413 (13.6%) including in-situ cases] for male and 27 178 [(6.1%); 44 467 (9.9%) including in-situ cases] for women. We concluded that RAIRs are a better measure of melanoma skin cancer risk and should be used for estimating the number of cancer patients in the USA.

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

    PubMed

    2016-01-01

    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. PMID:27632152

  3. Vibrato rate adjustment.

    PubMed

    Dromey, Christopher; Carter, Neisha; Hopkin, Arden

    2003-06-01

    The goal of the present study was to document the acoustic changes that occur as singers attempt to increase or decrease their vibrato rate to match target stimuli. Eight advanced singing students produced vowels with vibrato in three registers, both naturally and while attempting to match faster or slower rate stimuli. Slower rates were associated with lower intensity and less steady vibrato. Faster rates involved increased vibrato extent in the chest register and increased intensity in the head register. Singers whose spontaneous vibrato rates were naturally either slower or faster tended to also be relatively slower or faster when matching target rates. This ability to modify rate may have beneficial effects on the artistic quality of the voice for performance. PMID:12825649

  4. 78 FR 62712 - Rate Adjustment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-22

    ... noticing a recent Postal Service filing seeking postal rate adjustments based on exigent circumstances...,'' is ``premised on the recent recession as an exigent event.'' Id. at 1, 2. In Order No. 1059,...

  5. 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.

  6. Psychosocial adjustment to recurrent cancer.

    PubMed

    Mahon, S M; Cella, D F; Donovan, M I

    1990-01-01

    This descriptive study of the perceptions and needs of people with recurrent malignancies asks three questions: How do patients describe the meaning of a recurrence of cancer? Do individuals perceive the diagnosis of recurrence and the initial diagnosis of cancer differently? What are the key psychosocial problems associated with recurrent cancer? The theoretical framework was based on Lazarus and Folkman's theory of stress, appraisal, and coping. Subjects completed the Impact of Event Scale (IES), the Psychosocial Adjustment to Illness Scale--Self-Report (PAIS), and a semistructured qualitative interview. The interview elicited perceptions of the event of recurrence and differences between the diagnosis of recurrence and the initial diagnosis. The convenience sample included 40 patients diagnosed with recurrent cancer within the last 30 days. Many subjects (78%) reported that the recurrence was more upsetting than the initial diagnosis. Scores on both the IES and the PAIS were high when compared to normative samples of patients with cancer suggesting that this sample of patients experienced a lot of psychological distress as well as problems at home, work, and in their social lives. These concerns often were unknown to caregivers. Although more research is needed, the authors propose that, with more accurate assessment, more effective intervention could be implemented and the quality of life improved for patients with recurrent cancer.

  7. 76 FR 42140 - Rate Adjustment Remand

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-18

    ... the amount of the revenue lost as a result of the exigent circumstances.'' Id. \\6\\ Id. The court... amount of the proposed adjustments precisely to the amount of revenue lost as a result of the exigent... amount of an exigent rate adjustment must match the amount of revenue lost as a result of an...

  8. 76 FR 7883 - Postal Service Rate Adjustment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-11

    ... rate adjustment.\\1\\ The Notice concerns the inbound portion of a bilateral agreement with HongKong Post... upon the Postal Service obtaining all regulatory approvals and notifying HongKong Post that all such... Agreement (CPG) Agreement. The Postal Service and HongKong Post, the postal operator for Hong Kong,...

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

    PubMed

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

    1993-01-01

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

  10. Risk Adjustment for a Children's Capitation Rate

    PubMed Central

    Newhouse, Joseph P.; Sloss, Elizabeth M.; Manning, Willard G.; Keeler, Emmett 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 outpatient expenditure we find to be potentially predictable. Demographic factors such as age and gender only explain 5 percent of such variance; health status measures explain 25 percent, prior use and health status measures together explain 65 to 70 percent. The profit from risk selection falls less than proportionately with improved ability to adjust for risk. Partial capitation rates may be necessary to mitigate skimming and dumping. PMID:10133708

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

    PubMed

    Kodama, M; Kodama, T; Murakami, M

    2000-01-01

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

  12. 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.

  13. 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 ...

  14. Adjustment process in Iranian women with breast cancer.

    PubMed

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

    2008-01-01

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

  15. 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...

  16. 18 CFR 154.403 - Periodic rate adjustments.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Periodic rate 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 Changes § 154.403 Periodic rate adjustments....

  17. 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 ...

  18. 7 CFR 4287.112 - Interest rate adjustments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  19. 7 CFR 4287.112 - Interest rate adjustments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

  20. 7 CFR 4287.112 - Interest rate adjustments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 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...

  1. 7 CFR 4287.112 - Interest rate adjustments.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 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...

  2. 7 CFR 4287.112 - Interest rate adjustments.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 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...

  3. 5 CFR 536.305 - Adjusting an employee's retained rate when a pay schedule is adjusted.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... employee's existing position of record. (2) As provided in 5 CFR 531.206, a retained rate adjustment under... MANAGEMENT CIVIL SERVICE REGULATIONS GRADE AND PAY RETENTION Pay Retention § 536.305 Adjusting an employee's... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Adjusting an employee's retained...

  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. 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...

  6. 10 CFR 436.22 - Adjusted internal rate of return.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 3 2012-01-01 2012-01-01 false Adjusted internal rate of return. 436.22 Section 436.22 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS... adjusted internal rate of return is the overall rate of return on an energy or water conservation...

  7. 10 CFR 436.22 - Adjusted internal rate of return.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 3 2014-01-01 2014-01-01 false Adjusted internal rate of return. 436.22 Section 436.22 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS... adjusted internal rate of return is the overall rate of return on an energy or water conservation...

  8. 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... Western Area Power Administrations § 903.11 Advance announcement of rate adjustment. The Administrator may... advertisement, and/or by Federal Register publication. Written comments relevant to rate policy and design...

  9. 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... Western Area Power Administrations § 903.11 Advance announcement of rate adjustment. The Administrator may... advertisement, and/or by Federal Register publication. Written comments relevant to rate policy and design...

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

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Advance announcement of rate adjustment. 903.11 Section... Western Area Power Administrations § 903.11 Advance announcement of rate adjustment. The Administrator may... advertisement, and/or by Federal Register publication. Written comments relevant to rate policy and design...

  11. 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, and Western Area Power Administrations §...

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

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Advance announcement of rate adjustment. 903.11 Section... Western Area Power Administrations § 903.11 Advance announcement of rate adjustment. The Administrator may... advertisement, and/or by Federal Register publication. Written comments relevant to rate policy and design...

  13. 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...

  14. 5 CFR 9701.322 - Setting and adjusting rate ranges.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

  15. 10 CFR 436.22 - Adjusted internal rate of return.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Adjusted internal rate of return. 436.22 Section 436.22 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methodology and Procedures for Life Cycle Cost Analyses § 436.22 Adjusted internal rate of return....

  16. 75 FR 455 - Adjustment of Cable Statutory License Royalty Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-05

    ... Participate. SUMMARY: The Copyright Royalty Judges are announcing the commencement of the proceeding to adjust the rates for the cable statutory license. The Copyright Royalty Judges also are announcing the date... Copyright Royalty Board Adjustment of Cable Statutory License Royalty Rates AGENCY: Copyright Royalty...

  17. 76 FR 53160 - Postal Service Rate Adjustment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-25

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

  18. 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…

  19. 18 CFR 154.403 - Periodic rate adjustments.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Periodic rate... COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER NATURAL GAS ACT RATE SCHEDULES AND TARIFFS Limited Rate Changes § 154.403 Periodic rate adjustments. (a) This section applies to the passthrough, on a...

  20. 18 CFR 154.403 - Periodic rate adjustments.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Periodic rate... COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER NATURAL GAS ACT RATE SCHEDULES AND TARIFFS Limited Rate Changes § 154.403 Periodic rate adjustments. (a) This section applies to the passthrough, on a...

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

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... National Housing Act. (a) Types of mortgages insurable. The types of adjustable rate mortgages that are... payment, except that, for these types of mortgages, the first adjustment shall be no sooner or later than... secured by a principal dwelling under the Truth in Lending Act, 15 U.S.C. 1601 et seq. (h)...

  2. Social Support and Parental Adjustment to Pediatric Cancer.

    ERIC Educational Resources Information Center

    Morrow, Gary R.; And Others

    1981-01-01

    Assessed the psychosocial adjustment of (N=107) parents whose children had cancer. Different patterns of association between 11 sources of social support and adjustment were found among groups of parents. Psychosocial adjustment of parents with a child in treatment was correlated more frequently with perceived social support. (Author)

  3. 5 CFR 9701.322 - Setting and adjusting rate ranges.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

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

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

    Code of Federal Regulations, 2014 CFR

    2014-01-01

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

  5. 75 FR 29577 - Rate Adjustments for Indian Irrigation Projects

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-26

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

  6. 38 CFR 3.27 - Automatic adjustment of benefit rates.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... adjustment of benefit rates. (a) Improved pension. Whenever there is a cost-of-living increase in benefit... income limitation and maximum monthly rates. Whenever there is a cost-of-living increase in benefit...(b)(1)) (c) Monetary allowance under 38 U.S.C. chapter 18 for certain individuals who are children...

  7. 38 CFR 3.27 - Automatic adjustment of benefit rates.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... adjustment of benefit rates. (a) Improved pension. Whenever there is a cost-of-living increase in benefit... income limitation and maximum monthly rates. Whenever there is a cost-of-living increase in benefit...(b)(1)) (c) Monetary allowance under 38 U.S.C. chapter 18 for certain individuals who are children...

  8. 38 CFR 3.27 - Automatic adjustment of benefit rates.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... adjustment of benefit rates. (a) Improved pension. Whenever there is a cost-of-living increase in benefit... income limitation and maximum monthly rates. Whenever there is a cost-of-living increase in benefit...(b)(1)) (c) Monetary allowance under 38 U.S.C. chapter 18 for certain individuals who are children...

  9. 38 CFR 3.27 - Automatic adjustment of benefit rates.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... adjustment of benefit rates. (a) Improved pension. Whenever there is a cost-of-living increase in benefit... income limitation and maximum monthly rates. Whenever there is a cost-of-living increase in benefit...(b)(1)) (c) Monetary allowance under 38 U.S.C. chapter 18 for certain individuals who are children...

  10. 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 ...

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

    PubMed

    Peterson, Leif E; Kovyrshina, Tatiana

    2015-12-01

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

  12. 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)

  13. 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…

  14. 76 FR 53982 - New Postal Product and Rate Adjustment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-30

    ...). In Order No. 700, the Commission approved the functionally equivalent HongKong Post Agreement.\\2\\ The..., TNT Agreement, and the HongKong Post Agreement. The Postal Service requests that the China Post 2011... Operators 1 product. Notice at 2. \\2\\ See Docket No. R2011-4, Order Approving Rate Adjustment for...

  15. 24 CFR 203.49 - Eligibility of adjustable rate mortgages.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... section shall apply only to mortgage loans described under sections 203(b), 203(h) and 203(k) of the...; (ii) Three-year adjustable rate mortgages—no sooner than 36 months or later than 42 months; (iii) Five... secured by a principal dwelling under the Truth in Lending Act, 15 U.S.C. 1601 et seq. (h)...

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

    PubMed Central

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

    1996-01-01

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

  17. Psychosocial adjustment in children of mothers with breast cancer.

    PubMed

    Hoke, L A

    2001-01-01

    Thirty-five children of 28 mothers diagnosed with breast cancer during the previous year were compared to 34 children of 24 mothers with recent benign breast biopsies. Mothers and children, ages 8-16, completed questionnaires about mood, behavior problems and social functioning to assess whether children of mothers with breast cancer were at increased risk for adjustment problems. Significant differences were not found between children in the breast cancer group and the comparison group on any of the measures, even though mothers with breast cancer reported more psychological distress than mothers with benign biopsies. In addition, children in both groups were functioning better than normative samples on some adjustment measures. Variables measuring the mother's illness and treatment were not significantly related to children's adjustment in the breast cancer group. Findings suggested that some adolescents whose mothers had breast cancer did better in social and academic activities when their mothers were more distressed, while adolescents whose mothers had benign biopsies did less well when their mothers were distressed. The study's small sample size limits conclusions that can be drawn; however, clinical and research implications are discussed, given other reports that some children of parents with cancer may experience adjustment problems.

  18. Predictors of Sexual Adjustment in Cancer Patients Receiving Chemotherapy.

    PubMed

    Park, Eun-Young; Kim, Jung-Hee

    2015-01-01

    The goal of this study was to determine the relationship between sexual adjustment, mastery, age, subjective health, and changes in sexual satisfaction in cancer patients receiving chemotherapy. A cross-sectional descriptive correlation study was conducted with a convenience sample comprising cancer patients who were visiting two cancer centers in Korea. Data were collected using self-report questionnaires, including the Global Sexual Satisfaction Index and sexual adjustment subscale of the Psychosocial Adjustment to Illness Scale. The Mastery Scale was used to assess self-control. The hypothesized model was tested using a path analysis with AMOS 17.0. The path model was used to investigate causal relationships between variables, to obtain maximum-likelihood estimates of model parameters, and to provide goodness-of-fit indices. The proposed path model showed a good fit to the data. Subjective health and age may have an effect, mediated by mastery, on sexual adaption. Participants who reported more decreased sexual satisfaction showed lower levels of sexual adjustment. Mastery was not a mediating factor between changes in sexual satisfaction and sexual adjustment. Our model provides a framework for improving sexual adaption in cancer patients with chemotherapy. Health professionals should recognize and assess prior sexual satisfaction and sexual problems when providing sexual health care during treatment. PMID:26178455

  19. 39 CFR 3010.44 - Proceedings for Type 2 rate adjustments.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 39 Postal Service 1 2013-07-01 2013-07-01 false Proceedings for Type 2 rate adjustments. 3010.44... DOMINANT PRODUCTS Rules for Rate Adjustments for Negotiated Service Agreements (Type 2 Rate Adjustments) § 3010.44 Proceedings for Type 2 rate adjustments. (a) The Commission will establish a docket for...

  20. 39 CFR 3010.44 - Proceedings for Type 2 rate adjustments.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 39 Postal Service 1 2012-07-01 2012-07-01 false Proceedings for Type 2 rate adjustments. 3010.44... DOMINANT PRODUCTS Rules for Rate Adjustments for Negotiated Service Agreements (Type 2 Rate Adjustments) § 3010.44 Proceedings for Type 2 rate adjustments. (a) The Commission will establish a docket for...

  1. 39 CFR 3010.44 - Proceedings for Type 2 rate adjustments

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 39 Postal Service 1 2011-07-01 2011-07-01 false Proceedings for Type 2 rate adjustments 3010.44... DOMINANT PRODUCTS Rules for Rate Adjustments for Negotiated Service Agreements (Type 2 Rate Adjustments) § 3010.44 Proceedings for Type 2 rate adjustments (a) The Commission will establish a docket for...

  2. 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:…

  3. 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.…

  4. 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...

  5. 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...

  6. 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...

  7. 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...

  8. 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...

  9. 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.

  10. 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.

  11. 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.

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

    PubMed

    Donoghoe, Mark W; Marschner, Ian C

    2016-08-15

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

  13. 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

  14. 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…

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

    PubMed

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

    2015-09-01

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

  16. 39 CFR 3010.26 - Calculation of unused rate adjustment authority.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... unused rate adjustment authority. Link to an amendment published at 79 FR 33834, June 12, 2014. (a... the second notice is filed and interim unused rate adjustment authority will be calculated for the... months before the second notice is filed. (2) Interim unused rate adjustment authority is equal to...

  17. 76 FR 26324 - Order Making Fiscal Year 2012 Annual Adjustments to Section 31 Fee Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-06

    ... FR 24757 (May 5, 2010). \\7\\ The annual adjustments, as well as the mid-year adjustments required in... COMMISSION Order Making Fiscal Year 2012 Annual Adjustments to Section 31 Fee Rates I. Background Section 31... Commission to make one final adjustment for fiscal year 2012.\\8\\ \\6\\ Order Making Fiscal Year 2011...

  18. Ecological integrity of streams related to human cancer mortality rates.

    PubMed

    Hitt, Nathaniel P; Hendryx, Michael

    2010-08-01

    Assessments of ecological integrity have become commonplace for biological conservation, but their role for public health analysis remains largely unexplored. We tested the prediction that the ecological integrity of streams would provide an indicator of human cancer mortality rates in West Virginia, USA. We characterized ecological integrity using an index of benthic macroinvertebrate community structure (West Virginia Stream Condition Index, SCI) and quantified human cancer mortality rates using county-level data from the Centers for Disease Control and Prevention. Regression and spatial analyses revealed significant associations between ecological integrity and public health. SCI was negatively related to age-adjusted total cancer mortality per 100,000 people. Respiratory, digestive, urinary, and breast cancer rates increased with ecological disintegrity, but genital and oral cancer rates did not. Smoking, poverty, and urbanization were significantly related to total cancer mortality, but did not explain the observed relationships between ecological integrity and cancer. Coal mining was significantly associated with ecological disintegrity and higher cancer mortality. Spatial analyses also revealed cancer clusters that corresponded to areas of high coal mining intensity. Our results demonstrated significant relationships between ecological integrity and human cancer mortality in West Virginia, and suggested important effects of coal mining on ecological communities and public health. Assessments of ecological integrity therefore may contribute not only to monitoring goals for aquatic life, but also may provide valuable insights for human health and safety.

  19. 43 CFR 38.3 - Administration of adjusted rates of pay.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

  20. 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...

  1. 43 CFR 38.3 - Administration of adjusted rates of pay.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  2. 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...

  3. 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...

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

    PubMed Central

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

    2011-01-01

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

  5. A comparative study of psychosexual adjustment in men with testicular cancer and acute leukemia.

    PubMed

    Gorzynski, G; Lebovits, A; Holland, J; Vugrin, D

    1981-01-01

    Twenty-five men with testicular germ cell tumors were compared by developmental history and past and present psychologic adjustment to 25 men with acute leukemia. The mean age was 30 years for the cancer group and 25 years for the leukemia group. Current and Past Psychopathology Scales (18 scales of prior and 8 of present adjustment) were rated during a semistructured interview. The following differences were found in developmental history: Onset of puberty was 12.4 years for leukemics and 15.1 years for the cancer group (P less than 0.001); cryptorchidism was found in 20% of cancer patients and 4% of leukemia; incidence of opiate drug abuse was 36% in cancer patients and 24% in leukemia patients; psychiatric disturbance prior to illness characterized 32% of the cancer group and 12% of the leukemia group. Major psychiatric illness was diagnosed in 20% of the testicular cancer group and 4% of the leukemia group. Findings of delayed puberty and psychiatric disturbance in men with germ cell testicular tumors as compared to leukemics suggest a possible impairment of the hypothalamic-pituitary-gonadal axis. The etiology of this impairment is discussed (genetic factors, prenatal endocrine milieu, abnormal luteinizing hormone (LH) receptors, and abnormal interaction between dopaminergic system, LH, and endorphins).

  6. 5 CFR 535.105 - Setting and adjusting rates of basic pay.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  7. 77 FR 10767 - Rate Adjustments for Indian Irrigation Projects

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-23

    ..., Telephone: (435) 722-4341. Walker River Irrigation Project Athena Brown, Superintendent, 311 E. Washington... Federal Register on September 20, 2011 (76 FR 58293) to propose adjustments to the irrigation assessment... 203(d) of the Arizona Water Settlements Act (Pub. L. 108-451). Issue: The BIA should not use...

  8. 76 FR 26759 - Rate Adjustments for Indian Irrigation Projects

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-09

    ... Federal Register on November 1, 2010 (75 FR 67095) to propose adjustments to the irrigation assessment..., Oregon 97232-4169, Telephone: (503) 231- 6702 Project Name Project/Agency Contacts Fort Hall Dean Fox..., PH: (406) 653-1752 602 6th Avenue North Wolf Point, MT 59201 Wind River Ed Lone Fight,...

  9. 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…

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

    PubMed

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

    2015-04-01

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

  11. 39 CFR 3010.27 - Application of unused rate adjustment authority.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... unused rate adjustment authority. Link to an amendment published at 79 FR 33834, June 12, 2014. Link to an amendment published at 79 FR 33834, June 12, 2014. When the percentage change in rates for a class.... Second, the unused rate adjustment authority generated in the most recent Type 1-A or Type 1-B...

  12. 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

    ... Adjustable Rate Mortgages (ARMs) Rates AGENCY: Office of the Assistant Secretary for Housing, HUD. ACTION... of 1995 (44 U.S.C. Chapter 35, as amended). This Notice is soliciting comments from members of the... also lists the following information: Title of Proposal: Disclosure of Adjustable Rate Mortgages...

  13. 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...

  14. 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

    ... COMMISSION Order Making Fiscal Year 2012 Mid-Year Adjustments to Transaction Fee Rates I. Background Section... Commission by Congress for such fiscal year.''). \\5\\ Id. \\6\\ Order Making Fiscal Year 2012 Annual Adjustments... fiscal year 2012 calculated by the Commission in its Order Making Fiscal Year 2012 Annual Adjustments...

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

    PubMed

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

    2000-01-01

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

  16. 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

  17. 18 CFR 154.403 - Periodic rate adjustments.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER NATURAL GAS ACT RATE SCHEDULES AND TARIFFS Limited Rate... section of this subpart, and to revisions on a periodic basis of a gas reimbursement percentage. (b) Where a pipeline recovers fuel use and unaccounted-for natural gas in kind, the fuel...

  18. 75 FR 81817 - Adjustments of Certain Rates of Pay

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-29

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

  19. 78 FR 71501 - Cost of Living Adjustment to Satellite Carrier Compulsory License Royalty Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-29

    ... the section 119 compulsory license for the 2010-2014 term. See 75 FR 53198. The rates adopted by the... 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...

  20. 77 FR 3818 - Order Making Fiscal Year 2012 Annual Adjustments to Transaction Fee Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-25

    ... COMMISSION Order Making Fiscal Year 2012 Annual Adjustments to Transaction Fee Rates I. Background Section 31... Rel. No. 34-64373, Order Making Fiscal Year 2012 Annual Adjustments to the Fee Rates Applicable under... Exchange Act effective on the later of October 1, 2011 or the date of enactment of an Act making a...

  1. 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... notice of the new fee rates under Section 31 not later than 30 days after the date on which an Act making... appendix also includes the data used by the Commission in making this adjustment. III. Effective Date...

  2. A Short Form of the Teacher Rating Scale of School Adjustment

    ERIC Educational Resources Information Center

    Betts, Lucy R.; Rotenberg, Ken J.

    2007-01-01

    A total of 278 children at Time 1 (144 male and 134 female) from School Years 1 and 2 in the United Kingdom serve as participants. The children complete self-rated scales of school adjustment, and their teachers complete the Teacher Rating Scale of School Adjustment (TRSSA) twice across a 1-year period. At Time 1, children's performance on…

  3. 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.

  4. 42 CFR 417.594 - Computation of adjusted community rate (ACR).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

  5. 42 CFR 417.594 - Computation of adjusted community rate (ACR).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  6. Sense of humor, childhood cancer stressors, and outcomes of psychosocial adjustment, immune function, and infection.

    PubMed

    Dowling, Jacqueline S; Hockenberry, Marilyn; Gregory, Richard L

    2003-01-01

    The diagnosis, treatment, and side effects of childhood cancer have been described as extremely stressful experiences in the life of a child. Anecdotally, children report that a sense of humor helps them cope with the daily experiences of living with cancer; however, no research has examined sense of humor and childhood cancer stressors. This study investigated the effect of sense of humor on the relationship between cancer stressors and children's psychosocial adjustment to cancer, immune function, and infection using Lazarus and Folkman's theory of stress, appraisal, and coping. A direct relationship was observed between sense of humor and psychosocial adjustment to cancer, such that children with a high sense of humor had greater psychological adjustment, regardless of the amount of cancer stressors. A moderating effect was observed for incidence of infection. As childhood cancer stressors increase, children with high coping humor scores reported fewer incidences of infection than low scorers.

  7. 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

  8. 78 FR 80451 - Adjustments of Certain Rates of Pay

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-31

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

  9. A 5-trial adjusting delay discounting task: Accurate discount rates in less than 60 seconds

    PubMed Central

    Koffarnus, Mikhail N.; Bickel, Warren K.

    2014-01-01

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

  10. 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

  11. Trends in cancer incidence rates in Georgia, 1982–2011

    PubMed Central

    Yoo, Wonsuk; Coughlin, Steven S.; Lillard, James W.

    2015-01-01

    Background Although data from the Surveillance, Epidemiology, and End results (SEER)-affiliated cancer registry are accessible to the public, there is a shortage of published research describing cancer incidences for White, Black, and other residents in Georgia. The objective of this research is to provide an overview of the trends in incidence of cancer in Georgia. Methods Incidence data were obtained from the Surveillance, Epidemiology, and End Results (SEER) 9 program, supported by the National Cancer Institute, spanning the years 1982 to 2011. To assess trends over time, age-adjusted cancer incidence rates relative to the 2000 Standard US population and annual percent changes (APCs) were calculated using SEER*Stat software. Results In Georgia, cancer incidence rates for women increased from 365.1 per 100,000 in 1982 to 404.2 per 100,000 in 2011, with an overall APC of 0.3% (95% confidence interval: 0.2 to 0.4), but, for men, cancer incidence rates showed a slight decline from 528.0 per 100,000 in 1982 to 513.7 per 100,000 in 2011 (APC of 0.2%, 95% CI: −0.6 to 0.1). For Black, White, and Other (Asian/Pacific Islanders/American Indians) females, there were increases in incidence in this period, with APC values of 0.6, 0.4, and 0.3, respectively. For all males and for Black and White males, there were overall decreases in incidence, with APC values of −0.2. For Other males, however, the APC value was −0.9. Conclusions In Georgia, increases in cancer incidence rates occurred during 1982–2011 among the female population and within various racial groups in this population, but there was relative stability in incidence rates among the male population, except for Other males. PMID:26336654

  12. 75 FR 75624 - Cost of Living Adjustment to Satellite Carrier Compulsory License Royalty Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-06

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

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

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  14. 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,...

  15. 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,...

  16. 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,...

  17. 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,...

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  19. 12 CFR 747.1001 - Adjustment of civil money penalties by the rate of inflation.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

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

  20. 12 CFR 747.1001 - Adjustment of civil money penalties by the rate of inflation.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

  1. 12 CFR 747.1001 - Adjustment of civil money penalties by the rate of inflation.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

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

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

    Code of Federal Regulations, 2013 CFR

    2013-01-01

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

  3. How to improve colon cancer screening rates.

    PubMed

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

    2015-12-15

    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

  4. 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

  5. 75 FR 53198 - Rate Adjustment for the Satellite Carrier Compulsory License

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-31

    ... rates in the Federal Register. 75 FR 39891 (July 13, 2010). Section 119(c)(1)(D)(ii)(III) provides that... proposed rates as published on July 13, 2010. See 75 FR 39891. List of Subjects in 37 CFR Part 386... Copyright Royalty Board 37 CFR Part 386 Rate Adjustment for the Satellite Carrier Compulsory License...

  6. 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

    ... 39 Postal Service 1 2012-07-01 2012-07-01 false Proceedings for Type 1-A and Type 1-B rate... (Type 1-A and 1-B Rate Adjustments) § 3010.13 Proceedings for Type 1-A and Type 1-B rate adjustment... pursuant to appropriate action by the Governors. (e) If planned rate adjustments are found...

  7. 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.

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

    PubMed Central

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

    2012-01-01

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

  9. High dose rate brachytherapy for oral cancer

    PubMed Central

    YamazakI, Hideya; Yoshida, Ken; Yoshioka, Yasuo; Shimizutani, Kimishige; Furukawa, Souhei; Koizumi, Masahiko; Ogawa, Kazuhiko

    2013-01-01

    Brachytherapy results in better dose distribution compared with other treatments because of steep dose reduction in the surrounding normal tissues. Excellent local control rates and acceptable side effects have been demonstrated with brachytherapy as a sole treatment modality, a postoperative method, and a method of reirradiation. Low-dose-rate (LDR) brachytherapy has been employed worldwide for its superior outcome. With the advent of technology, high-dose-rate (HDR) brachytherapy has enabled health care providers to avoid radiation exposure. This therapy has been used for treating many types of cancer such as gynecological cancer, breast cancer, and prostate cancer. However, LDR and pulsed-dose-rate interstitial brachytherapies have been mainstays for head and neck cancer. HDR brachytherapy has not become widely used in the radiotherapy community for treating head and neck cancer because of lack of experience and biological concerns. On the other hand, because HDR brachytherapy is less time-consuming, treatment can occasionally be administered on an outpatient basis. For the convenience and safety of patients and medical staff, HDR brachytherapy should be explored. To enhance the role of this therapy in treatment of head and neck lesions, we have reviewed its outcomes with oral cancer, including Phase I/II to Phase III studies, evaluating this technique in terms of safety and efficacy. In particular, our studies have shown that superficial tumors can be treated using a non-invasive mold technique on an outpatient basis without adverse reactions. The next generation of image-guided brachytherapy using HDR has been discussed. In conclusion, although concrete evidence is yet to be produced with a sophisticated study in a reproducible manner, HDR brachytherapy remains an important option for treatment of oral cancer. PMID:23179377

  10. 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,…

  11. 75 FR 32228 - Rate Adjustment for the Satellite Carrier Compulsory License

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-07

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

  12. 75 FR 39891 - Rate Adjustment for the Satellite Carrier Compulsory License

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-13

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

  13. 77 FR 47582 - Great Lakes Pilotage Rates-2013 Annual Review and Adjust; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-09

    ..., 2012 (77 FR 45539) proposing rate adjustments for pilotage services on the Great Lakes. The charge rate... of proposed rulemaking published in the Federal Register on August 1, 2012 (77 FR 45539) is corrected...-9826. SUPPLEMENTARY INFORMATION: The NPRM published August 1, 2012 (77 FR 45539) contains an...

  14. 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 adjusted periodically? 166.408 Section 166.408 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER GRAZING PERMITS Grazing Rental Rates, Payments, and Late Payment Collections Rental...

  15. 25 CFR 166.408 - Is the grazing rental rate established by the BIA adjusted periodically?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 1 2012-04-01 2011-04-01 true Is the grazing rental rate established by the BIA adjusted periodically? 166.408 Section 166.408 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER GRAZING PERMITS Grazing Rental Rates, Payments, and Late Payment Collections Rental...

  16. 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 adjusted periodically? 166.408 Section 166.408 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER GRAZING PERMITS Grazing Rental Rates, Payments, and Late Payment Collections Rental...

  17. 25 CFR 166.408 - Is the grazing rental rate established by the BIA adjusted periodically?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false Is the grazing rental rate established by the BIA adjusted periodically? 166.408 Section 166.408 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER GRAZING PERMITS Grazing Rental Rates, Payments, and Late Payment Collections Rental...

  18. 25 CFR 166.408 - Is the grazing rental rate established by the BIA adjusted periodically?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false Is the grazing rental rate established by the BIA adjusted periodically? 166.408 Section 166.408 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER GRAZING PERMITS Grazing Rental Rates, Payments, and Late Payment Collections Rental...

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

    PubMed

    Smith, Timothy W; Williams, Paula G

    2015-04-01

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

  1. 75 FR 24757 - Order Making Fiscal Year 2011 Annual Adjustments to the Fee Rates Applicable Under Section 6(b...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-05

    ...), 75 FR 9964 (March 4, 2010). \\10\\ The annual adjustments, as well as the mid-year adjustments required... COMMISSION Order Making Fiscal Year 2011 Annual Adjustments to the Fee Rates Applicable Under Section 6(b) of... adjustment based on that estimate. The appendix includes the data used by the Commission in making...

  2. 12 CFR 622.61 - Adjustment of civil money penalties by the rate of inflation under the Federal Civil Penalties...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

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

  3. 12 CFR 622.61 - Adjustment of civil money penalties by the rate of inflation under the Federal Civil Penalties...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

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

  4. 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,...

  5. 12 CFR 622.61 - Adjustment of civil money penalties by the rate of inflation under the Federal Civil Penalties...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

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

  6. 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,...

  7. 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

  8. Computations of adjusted rates and lifetime risks from occupational cohort data: a program package using FORTRAN and GLIM.

    PubMed

    Zhou, S Y; Mazumdar, S; Redmond, C K; Dong, M H; Costantino, J P

    1991-02-01

    A program package using FORTRAN and GLIM is presented to compute lifetime risks of dying from a particular cause of death for a worker subjected to specific risk exposures using death rates adjusted for selected covariates (risk factors). Calculations of the exposure index and adjusted rates depend on several commonly used procedures. Tests of homogeneity and trend for adjusted rates are provided. Lifetime risks are calculated in two different ways: adjusting or ignoring competing causes of death.

  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. The single match approach to strike rate adjustments in batting performance measures in cricket.

    PubMed

    Lemmer, Hermanus H

    2011-01-01

    Batting performance measures containing strike rate adjustments take into account the important fact that if two batsmen had scored the same number of runs in a match, the one with the better strike rate had performed best. But match conditions can influence the batting and bowling performances of cricket players. On a good pitch a batsman can get a good score at a high strike rate, but if the pitch was bad, a similar good score is normally accompanied by a much lower strike rate. The main objective of this study is to propose a method that can be used to make batsmen's scores comparable despite the fact that playing conditions might have been very different. The number of runs scored by a batsman is adjusted by comparing his strike rate with the overall strike rate of all the players in the specific match. These adjusted runs are then used in the most appropriate formula to calculate the average of the batsman. The method is illustrated by using the results of the Indian Premier League 2009 Twenty20 Series played during May and June 2009. The main conclusion is that the traditional average is not the most appropriate measure to compare batsmen's performances after conclusion of a short series. Key pointsIt is unfair to compare the score of a batsman obtained on a good pitch under ideal batting conditions with that of a batsman who had to battle under severe conditions.By comparing a batsman's strike rate with the overall strike rate of the players in the specific match, his score can be adjusted to get a better figure for his true performance.The results demonstrate clearly that the use of adjusted scores lead to rankings that differ from those based on the traditional measures.

  11. Coping responses following breast cancer diagnosis predict psychological adjustment three years later.

    PubMed

    Hack, Thomas F; Degner, Lesley F

    2004-04-01

    The relationship between coping responses and psychological adjustment to a breast cancer diagnosis is well documented for time periods close to diagnosis. The purpose of the present study was to assess the long term association between these two variables. Fifty-five women completed measures of coping response, decisional control, frustration expression, and psychological adjustment within six months of receiving their breast cancer diagnosis. These women were contacted three years later and their psychological adjustment-as measured by the profile of mood states (POMS)-was reassessed. Univariate and multivariate analyses were performed. The results showed that women who were depressed at time of treatment planning, and who responded to their cancer diagnosis with cognitive avoidance, i.e. acceptance/resignation, had significantly worse psychological adjustment three years later. Poor adjustment was significantly associated with cognitive avoidance and minimal use of approach-based coping responses. The findings suggest that women who respond to their breast cancer diagnosis with passive acceptance and resignation are at significant risk for poor long term psychological adjustment. Psychological interventions for these women should address cognitive avoidance, with the aim of fostering approach-based coping and positive well-being.

  12. Estimating cancer mortality rates from SEER incidence and survival data.

    PubMed Central

    Chu, K C; Horm, J W; Smart, C R

    1990-01-01

    A method to estimate site-specific cancer mortality rates using Surveillance, Epidemiology, and End Results (SEER) Program incidence and survival data is proposed, calculated, and validated. This measure, the life table-derived mortality rate (LTM), is the sum of the product of the probability of being alive at the beginning of an interval times the probability of dying of the cancer of interest during the interval times the annual age-adjusted incidence rate for each year that data have been collected. When the LTM is compared to death certificate mortality rates (DCM) for organ sites with no known misclassification problems, the LTM was within 10 percent of the death certificate rates for 13 of 14 organ sites. In the sites that have problems with the death certificate rates, there were major disagreements between the LTM and DCM. The LTM was systematically lower than the DCM for sites if there was overreporting on the death certificates, and the LTM was higher than the DCM for sites if there was underreporting. The limitations and applications of the LTM are detailed. PMID:2106703

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

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... be developed from the most recent applicable Commission approved analytical principles. Effective... text, (b)(4), and (e), redesignating paragraphs (b)(9) and (10) as (b)(11) and (12) respectively, and... added and revised text is set forth as follows: § 3010.12 Contents of notice of rate adjustment. (a)...

  14. 76 FR 55139 - Order Making Fiscal Year 2012 Annual Adjustments to Registration Fee Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-06

    ... From the Federal Register Online via the Government Publishing Office SECURITIES AND EXCHANGE COMMISSION Order Making Fiscal Year 2012 Annual Adjustments to Registration Fee Rates I. Background The... includes the data used by the Commission in making its ``baseline estimate of the aggregate...

  15. 78 FR 54934 - Order Making Fiscal Year 2014 Annual Adjustments to Registration Fee Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-06

    ... From the Federal Register Online via the Government Publishing Office SECURITIES AND EXCHANGE COMMISSION Order Making Fiscal Year 2014 Annual Adjustments to Registration Fee Rates I. Background The... includes the data used by the Commission in making its ``baseline estimate of the aggregate...

  16. 77 FR 55240 - Order Making Fiscal Year 2013 Annual Adjustments to Registration Fee Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-07

    ... From the Federal Register Online via the Government Publishing Office SECURITIES AND EXCHANGE COMMISSION Order Making Fiscal Year 2013 Annual Adjustments to Registration Fee Rates I. Background The... Commission in making its ``baseline estimate of the aggregate maximum offering price'' for fiscal year...

  17. 48 CFR 52.222-32 - Construction Wage Rate Requirements-Price Adjustment (Actual Method).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... include any allowance for any increased cost for which adjustment is being requested. (c) The Contracting... be limited to increases or decreases in wages and fringe benefits as described in paragraph (c) of... DBA craft New WD Hourly rate paid Diff. Actual hrs. Actual units (sq. yard) Increase/sq. yard...

  18. 76 FR 590 - Adjustment or Determination of Compulsory License Rates for Making and Distributing Phonorecords

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-05

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

  19. 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 SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM (DEPARTMENT OF HOMELAND SECURITY-OFFICE OF PERSONNEL MANAGEMENT) DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Setting...

  20. 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 SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM (DEPARTMENT OF HOMELAND SECURITY-OFFICE OF PERSONNEL MANAGEMENT) DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Setting...

  1. 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…

  2. 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,…

  3. Parenting stress and external stressors as predictors of maternal ratings of child adjustment.

    PubMed

    Ostberg, Monica; Hagekull, Berit

    2013-06-01

    This study sought to disentangle the effects of different kinds of stress on maternal ratings of child externalizing and internalizing problems, social inhibition, and social competence, with a primary focus on parenting stress. The relations were explored in a sample consisting of mothers of 436 children (Mage  = 7 years) in Sweden. Half the sample had had early clinical contacts during infancy due to child regulation problems, and the rest were mothers without known such early contacts. Demographic factors, family stressors, and parenting stress were examined in stress - adjustment models. Family stressors were clinical contact during infancy, current child and parent health problems, recent negative life events, and insufficient social support. Parenting stress as a mediator of the effect of other stressors on rated child adjustment was tested as was social support as a moderator of the effect of parenting stress on adjustment. The results showed that a higher parenting stress level was associated with maternal ratings of more externalizing and internalizing behaviors, more social inhibition, and lower social competence. Other family stressors and background variables were also found to be of importance, mainly for externalizing and internalizing problems and to some extent for social competence. Social inhibition had a unique relation to parenting stress only. Parenting stress mediated effects of other stressors in twelve models, whereas social support had no moderating effect on the link between parenting stress and child adjustment. Thus, parenting stress seems to be an important overarching construct. Clinical implications are proposed.

  4. Female breast cancer mortality rates in Turkey.

    PubMed

    Dogan, Nurhan; Toprak, Dilek

    2014-01-01

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

  5. 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…

  6. Iranian Version of the Mini-Mental Adjustment to Cancer Scale: Factor Structure and Psychometric Properties.

    PubMed

    Patoo, Mozhgan; Allahyari, Abbas Ali; Moradi, Ali Reza; Payandeh, Mehrdad

    2015-01-01

    Mental adjustment to cancer is known as a psychological, physical, and psychological health variable among cancer patients. The present study examines the factor structure and psychometric properties of the Mini-Mental Adjustment to Cancer scale (Mini-MAC) in a sample of Iranian adults who suffer from cancer. The sample consists of 320 cancer patients selected through non-random convenient sampling procedure from the hospitals and clinics in the cities of Kermanshah and Shiraz in Iran, using the Mini-MAC scale. One hundred of these patients also completed the Hospital Anxiety and Depression scale. Statistical methods used to analyze the data included confirmatory and exploratory factor analysis, discriminate validity, and Cronbach alpha coefficients for internal consistency. Factor analysis confirms five factors in the Mini-MAC. The values of fit indices are within the acceptable range. Significant correlations between the Mini-MAC and other measures also show that this scale has discriminate validity. Alpha coefficients for the subscales are Helplessness/Hopelessness,.94; Cognitive Avoidance.76; Anxious Preoccupation,.90; Fatalism,.77; Fighting Spirit.80; and total scale.84, respectively. The results confirm the five-factor structure of the Persian Mini-MAC scale and also prove that it is a reliable and valid scale. They show that this scale has sufficient power to measure different aspects of mental adjustment in patients with cancer. PMID:26600241

  7. 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...

  8. 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...

  9. 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...

  10. 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...

  11. 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...

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

    PubMed Central

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

  14. 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…

  15. 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,…

  16. 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…

  17. Rising lung cancer death rates among black men: the importance of occupation and social class.

    PubMed

    Miller, W J; Cooper, R

    1982-03-01

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

  18. 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

  19. Indirect Medical Education and Disproportionate Share Adjustments to Medicare Inpatient Payment Rates

    PubMed Central

    Nguyen, Nguyen Xuan; Sheingold, Steven H.

    2011-01-01

    The indirect medical education (IME) and disproportionate share hospital (DSH) adjustments to Medicare's prospective payment rates for inpatient services are generally intended to compensate hospitals for patient care costs related to teaching activities and care of low income populations. These adjustments were originally established based on the statistical relationships between IME and DSH and hospital costs. Due to a variety of policy considerations, the legislated levels of these adjustments may have deviated over time from these “empirically justified levels,” or simply, “empirical levels.” In this paper, we estimate the empirical levels of IME and DSH using 2006 hospital data and 2009 Medicare final payment rules. Our analyses suggest that the empirical level for IME would be much smaller than under current law— about one-third to one-half. Our analyses also support the DSH adjustment prescribed by the Affordable Care Act of 2010 (ACA)—about one-quarter of the pre-ACA level. For IME, the estimates imply an increase in costs of 1.88% for each 10% increase in teaching intensity. For DSH, the estimates imply that costs would rise by 0.52% for each 10% increase in the low-income patient share for large urban hospitals. PMID:22340777

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

    PubMed Central

    Marek, Ewelina; Deptała, Andrzej

    2015-01-01

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

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

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... requirements of 39 U.S.C. chapter 36, subchapter 1: (1) Whether the planned rate adjustments measured using the... an order announcing its findings. (h) If the planned rate adjustments as amended are found to be... 39 U.S.C. chapter 36, subchapter 1 is provisional and subject to subsequent review....

  2. 39 CFR 3010.13 - Proceedings for Type 1-A and Type 1-B rate adjustment filings.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... requirements of 39 U.S.C. chapter 36, subchapter 1: (1) Whether the planned rate adjustments measured using the... an order announcing its findings. (h) If the planned rate adjustments as amended are found to be... 39 U.S.C. chapter 36, subchapter 1 is provisional and subject to subsequent review....

  3. Prescriptions of traditional Chinese medicine are specific to cancer types and adjustable to temperature changes.

    PubMed

    Chiu, Pei-Hsun; Hsieh, Hsin-Ying; Wang, Sun-Chong

    2012-01-01

    Targeted cancer therapies, with specific molecular targets, ameliorate the side effect issue of radiation and chemotherapy and also point to the development of personalized medicine. Combination of drugs targeting multiple pathways of carcinogenesis is potentially more fruitful. Traditional Chinese medicine (TCM) has been tailoring herbal mixtures for individualized healthcare for two thousand years. A systematic study of the patterns of TCM formulas and herbs prescribed to cancers is valuable. We analysed a total of 187,230 TCM prescriptions to 30 types of cancer in Taiwan in 2007, a year's worth of collection from the National Health Insurance reimbursement database (Taiwan). We found that a TCM cancer prescription consists on average of two formulas and four herbs. We show that the percentage weights of TCM formulas and herbs in a TCM prescription follow Zipf's law with an exponent around 0.6. TCM prescriptions to benign neoplasms have a larger Zipf's exponent than those to malignant cancers. Furthermore, we show that TCM prescriptions, via weighted combination of formulas and herbs, are specific to not only the malignancy of neoplasms but also the sites of origins of malignant cancers. From the effects of formulas and natures of herbs that were heavily prescribed to cancers, that cancers are a 'warm and stagnant' syndrome in TCM can be proposed, suggesting anti-inflammatory regimens for better prevention and treatment of cancers. We show that TCM incorporated relevant formulas to the prescriptions to cancer patients with a secondary morbidity. We compared TCM prescriptions made in different seasons and identified temperatures as the environmental factor that correlates with changes in TCM prescriptions in Taiwan. Lung cancer patients were among the patients whose prescriptions were adjusted when temperatures drop. The findings of our study provide insight to TCM cancer treatment, helping dialogue between modern western medicine and TCM for better cancer care.

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

    PubMed

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

    2016-06-15

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

  5. 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.

  6. 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

  7. 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

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

    PubMed

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

    2016-09-01

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

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

    PubMed

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

    2016-09-01

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

  10. Effects of emotional support-focused nursing interventions on the psychosocial adjustment of breast cancer patients.

    PubMed

    Gümüs, Aysun Babacan; Cam, Olcay

    2008-01-01

    The purpose was to examine the effect of emotional support-focused nursing interventions on the psychosocial adjustment of breast cancer patients. The research was conducted in the Radiation Oncology Department of Ege University Medical Faculty Hospital and at Talay Aktas Oncology Hospital in Turkey. There were 30 newly diagnosed breast cancer patients included in the sample. Emotional support-focused nursing interventions were administered in seven sessions individually with each patient. A total of 210 hours of meetings with the patients were conducted. Data were collected by administering a pre-test and post-test in two phases with the patients using a Descriptive Information Form and the Psychosocial Adjustment to Illness Scale - Self Report (PAIS-SR). The patients mean age was 44.5 (SD=6.38) years and the mean duration of illness was 6.46 (SD=1.99) months. In the comparison of the PAIS-SR pretest and post-test mean scores it was determined that there was a significant increase in patients adaptation to health care orientation (p=0.001), domestic environment (p<0.01), sexual relationships (p<0.05), extended family relationships (p<0.001) and social environment (p<0.001), and a significant decrease in psychological distress (p<0.001). However, there was no change in patients vocational adjustment (p<0.05). According to these findings emotional support-focused nursing interventions had a part in increasing patients psychosocial adjustment. PMID:19256761

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

    PubMed Central

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

    2013-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2015-11-01

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

  13. 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

  14. 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

  15. 5 CFR 591.228 - How does OPM convert the price index plus adjustment factor to a COLA rate?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

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

    PubMed Central

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

    1991-01-01

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

  17. 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

  18. Posttraumatic growth moderates the effects of posttraumatic stress symptoms on adjustment and positive affective reactions in digestive system cancer patients.

    PubMed

    Ben-Zur, Hasida; Cohen, Miri; Gouzman, Julia

    2015-01-01

    The study aims were twofold: (1) To investigate the associations of posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG) with adjustment and affective reactions of digestive system cancer patients and (2) To assess the moderating effects of PTG on the associations of PTSS with adjustment and affective reactions. The sample consisted of 200 respondents 1-4 years following diagnosis and treatment for digestive system cancer. Participants completed questionnaires assessing PTSS, PTG, adjustment, positive affect (PA), and negative affect (NA). The results showed that PTG was positively associated with adjustment and PA, while PTSS was negatively associated with these outcomes and positively associated with NA. Moderation effects of PTG were also observed: The negative associations between PTSS and adjustment or PA were weaker under high levels than under low levels of PTG. It was concluded that PTG is important both as a contributor to better adjustment and PA, as well as a moderator of the detrimental effects of PTSS on adjustment and PA following recovery from cancer. Thus, when developing post-cancer intervention programs, PTG should be viewed as a factor to be encouraged and nurtured for the benefit of cancer patients' adjustment and their long-term well-being.

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

    PubMed

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

    2014-06-01

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

  20. Compact range reflector analysis using the plane wave spectrum approach with an adjustable sampling rate

    NASA Astrophysics Data System (ADS)

    McKay, James P.; Rahmat-Samii, Yahya

    1991-06-01

    An improved method for determining the test zone field of compact range reflectors is presented. The plane wave spectrum (PWS) approach is used to obtain the test zone field from knowledge of the reflector aperture field distribution. The method is particularly well suited to the analysis of reflectors with a linearly serrated rim for reduced edge diffraction. Computation of the PWS of the reflector aperture field is facilitated by a closed-form expression for the Fourier transform of a polygonal window function. Inverse transformation in the test zone region is accomplished using a fast Fourier transform (FFT) algorithm with a properly adjusted sampling rate (which is a function of both the reflector size and the distance from the reflector). The method is validated by comparison with results obtained using surface current and aperture field integration techniques. The performance of several serrated reflectors is evaluated in order to observe the effects of edge diffraction on the test zone fields.

  1. 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

  2. 34 CFR 668.208 - General requirements for adjusting official cohort default rates and for appealing their...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... default rates and for appealing their consequences. 668.208 Section 668.208 Education Regulations of the... EDUCATION STUDENT ASSISTANCE GENERAL PROVISIONS Cohort Default Rates § 668.208 General requirements for adjusting official cohort default rates and for appealing their consequences. (a) Remaining eligible. You...

  3. 34 CFR 668.189 - General requirements for adjusting official cohort default rates and for appealing their...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... default rates and for appealing their consequences. 668.189 Section 668.189 Education Regulations of the... EDUCATION STUDENT ASSISTANCE GENERAL PROVISIONS Two Year Cohort Default Rates § 668.189 General requirements for adjusting official cohort default rates and for appealing their consequences. (a)...

  4. 34 CFR 668.208 - General requirements for adjusting official cohort default rates and for appealing their...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... default rates and for appealing their consequences. 668.208 Section 668.208 Education Regulations of the... EDUCATION STUDENT ASSISTANCE GENERAL PROVISIONS Cohort Default Rates § 668.208 General requirements for adjusting official cohort default rates and for appealing their consequences. (a) Remaining eligible. You...

  5. 34 CFR 668.208 - General requirements for adjusting official cohort default rates and for appealing their...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... default rates and for appealing their consequences. 668.208 Section 668.208 Education Regulations of the... EDUCATION STUDENT ASSISTANCE GENERAL PROVISIONS Cohort Default Rates § 668.208 General requirements for adjusting official cohort default rates and for appealing their consequences. (a) Remaining eligible. You...

  6. 34 CFR 668.208 - General requirements for adjusting official cohort default rates and for appealing their...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... default rates and for appealing their consequences. 668.208 Section 668.208 Education Regulations of the... EDUCATION STUDENT ASSISTANCE GENERAL PROVISIONS Cohort Default Rates § 668.208 General requirements for adjusting official cohort default rates and for appealing their consequences. (a) Remaining eligible. You...

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

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... default rates and for appealing their consequences. 668.208 Section 668.208 Education Regulations of the... EDUCATION STUDENT ASSISTANCE GENERAL PROVISIONS Cohort Default Rates § 668.208 General requirements for adjusting official cohort default rates and for appealing their consequences. (a) Remaining eligible. You...

  8. 34 CFR 668.189 - General requirements for adjusting official cohort default rates and for appealing their...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... default rates and for appealing their consequences. 668.189 Section 668.189 Education Regulations of the... EDUCATION STUDENT ASSISTANCE GENERAL PROVISIONS Two Year Cohort Default Rates § 668.189 General requirements for adjusting official cohort default rates and for appealing their consequences. (a)...

  9. 34 CFR 668.189 - General requirements for adjusting official cohort default rates and for appealing their...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... default rates and for appealing their consequences. 668.189 Section 668.189 Education Regulations of the... EDUCATION STUDENT ASSISTANCE GENERAL PROVISIONS Two Year Cohort Default Rates § 668.189 General requirements for adjusting official cohort default rates and for appealing their consequences. (a)...

  10. 34 CFR 668.189 - General requirements for adjusting official cohort default rates and for appealing their...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... default rates and for appealing their consequences. 668.189 Section 668.189 Education Regulations of the... EDUCATION STUDENT ASSISTANCE GENERAL PROVISIONS Two Year Cohort Default Rates § 668.189 General requirements for adjusting official cohort default rates and for appealing their consequences. (a)...

  11. 34 CFR 668.189 - General requirements for adjusting official cohort default rates and for appealing their...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... default rates and for appealing their consequences. 668.189 Section 668.189 Education Regulations of the... EDUCATION STUDENT ASSISTANCE GENERAL PROVISIONS Two Year Cohort Default Rates § 668.189 General requirements for adjusting official cohort default rates and for appealing their consequences. (a)...

  12. 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.

  13. 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

  14. 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…

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

    SciTech Connect

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

    1989-12-06

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

  16. Breast cancer incidence rates among Orthodox Jewish women

    PubMed Central

    Tkatch, Rifky; Schwartz, Kendra; Shore, Ronald D.; Penner, Louis A.; Simon, Michael S.; Albrecht, Terrance L.

    2013-01-01

    BRCA 1/BRCA2 founder mutations have been documented among Ashkenazi Jews. Little is known about cancer rates and cancer-related health behaviors among an insular subset of this population, Orthodox Jews. The goal of this study was estimate the risk of breast and ovarian among the Orthodox Jewish population. We used geo-coding with SEER data to identify this subgroup and estimate breast and ovarian cancer rates. Relative to neighborhoods with lower estimated Jewish populations, higher breast cancer rates were found in neighborhoods with higher estimated Orthodox Jewish population, there were no comparable differences in ovarian cancer rates. Implications include more research on health behaviors that may contribute to breast cancer in this insular community. PMID:23584710

  17. Colorectal Cancer Rates by Race and Ethnicity

    MedlinePlus

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

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

    PubMed Central

    Hu, Zishuo Ian; Smith, Dylan M.

    2016-01-01

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

  19. [Parental cancer--parents ways of coping, family functioning, and psychosocial adjustment of dependent children].

    PubMed

    Krattenmacher, Thomas; Kühne, Franziska; Führer, Daniel; Ernst, Johanna; Brähler, Elmar; Herzog, Wolfgang; von Klitzing, Kai; Flechtner, Hans-Henning; Bergelt, Corinna; Romer, Georg; Möller, Birgit

    2012-01-01

    Children exposed to parental cancer have an increased risk of mental health problems. However, the parental illness itself and its features do not predict children's psychological adjustment. Parent- and family-related factors are more predictive for children's well-being and the incidence of psychopathological symptoms, respectively. This study focuses on parental ways of coping with illness from both, the ill and healthy parent's perspective, and the relationship with family functioning and children's adjustment. Results show a significant impact of parental coping styles on children's health-related quality of life and psychopathological symptoms and, furthermore, that this relationship is mediated by aspects of family functioning. This study support the importance of family systems approaches. Implications for further studies and practical issues are discussed. PMID:22950338

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

    Cancer.gov

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

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

    PubMed

    2016-01-01

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

  2. 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...

  3. Survival rates of cervical cancer patients in Malaysia.

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2014-01-01

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

  5. 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

  6. Association Between Air Temperature and Cancer Death Rates in Florida

    PubMed Central

    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. PMID:26674418

  7. Prostate Cancer Rates by Race and Ethnicity

    MedlinePlus

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

  8. Cervical Cancer Rates by Race and Ethnicity

    MedlinePlus

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

  9. Breast Cancer Rates by Race and Ethnicity

    MedlinePlus

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

  10. Toward a better understanding of the comparatively high prostate cancer incidence rates in Utah

    PubMed Central

    Merrill, Ray M; Hilton, Sterling C; Wiggins, Charles L; Sturgeon, Jared D

    2003-01-01

    Background This study assesses whether comparatively high prostate cancer incidence rates among white men in Utah represent higher rates among members of the Church of Jesus Christ of Latter-day Saints (LDS or Mormons), who comprise about 70% of the state's male population, and considers the potential influence screening has on these rates. Methods Analyses are based on 14,693 histologically confirmed invasive prostate cancer cases among men aged 50 years and older identified through the Utah Cancer Registry between 1985 and 1999. Cancer records were linked to LDS Church membership records to determine LDS status. Poisson regression was used to derive rate ratios of LDS to nonLDS prostate cancer incidence, adjusted for age, disease stage, calendar time, and incidental detection. Results LDS men had a 31% (95% confidence interval, 26% – 36%) higher incidence rate of prostate cancer than nonLDS men during the study period. Rates were consistently higher among LDS men over time (118% in 1985–88, 20% in 1989–92, 15% in 1993–1996, and 13% in 1997–99); age (13% in ages 50–59, 48% in ages 60–69, 28% in ages 70–79, and 16% in ages 80 and older); and stage (36% in local/regional and 17% in unstaged). An age- and stage-shift was observed for both LDS and nonLDS men, although more pronounced among LDS men. Conclusions Comparatively high prostate cancer incidence rates among LDS men in Utah are explained, at least in part, by more aggressive screening among these men. PMID:12720571

  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. 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

  13. 42 CFR 422.308 - Adjustments to capitation rates, benchmarks, bids, and payments.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... aged enrollees, disabled enrollees, and enrollees who have ESRD. (2) The amount calculated in paragraph... risk adjustment data. This factor is phased as follows: (A) 100 percent of payments for ESRD...

  14. 39 CFR 3010.22 - Calculation of annual limitation when notices of rate adjustment are less than 12 months apart.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... dividing the sum by 12 (Recent Average). The partial year limitation is then calculated by dividing the Recent Average by the Recent Average from the most recent previous notice of rate adjustment (Previous Recent Average) applicable to each affected class of mail and subtracting 1 from the quotient. The...

  15. Differences in Interaction Patterns of Families with First or Second Grade Sons Rated High or Low in Classroom Adjustment.

    ERIC Educational Resources Information Center

    St. Pierre, Susan; And Others

    This study attempts to determine whether families with a son rated by his teacher as either "high" or "low" on classroom adjustment (behavior indicative of social maturity and achievement motivation) could be differentiated on the basis of their communicative patterns. It was questioned if significant differences existed in the amount of positive…

  16. 2 CFR 200.411 - Adjustment of previously negotiated indirect (F&A) cost rates containing unallowable costs.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 2 Grants and Agreements 1 2014-01-01 2014-01-01 false Adjustment of previously negotiated indirect (F&A) cost rates containing unallowable costs. 200.411 Section 200.411 Grants and Agreements Office of Management and Budget Guidance for Grants and Agreements OFFICE OF MANAGEMENT AND BUDGET GUIDANCE Reserved UNIFORM ADMINISTRATIVE...

  17. 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.

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

    PubMed

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

    2016-01-01

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

  19. 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

  20. 42 CFR 422.308 - Adjustments to capitation rates, benchmarks, bids, and payments.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... chronic health conditions—(i) General rule. For 2011 and subsequent years, for purposes of the adjustment... chronic health status of similar individuals. Such risk score is used instead of the default risk score... associated with frailty, individuals with multiple, comorbid chronic conditions, and individuals with...

  1. 42 CFR 422.308 - Adjustments to capitation rates, benchmarks, bids, and payments.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... chronic health conditions—(i) General rule. For 2011 and subsequent years, for purposes of the adjustment... chronic health status of similar individuals. Such risk score is used instead of the default risk score... associated with frailty, individuals with multiple, comorbid chronic conditions, and individuals with...

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

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... chronic health conditions—(i) General rule. For 2011 and subsequent years, for purposes of the adjustment... chronic health status of similar individuals. Such risk score is used instead of the default risk score... associated with frailty, individuals with multiple, comorbid chronic conditions, and individuals with...

  3. 42 CFR 422.308 - Adjustments to capitation rates, benchmarks, bids, and payments.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... multiple, comorbid chronic conditions, and individuals with a diagnosis of mental illness; and (B) Costs.... (6) Improvements to risk adjustment for special needs individuals with chronic health conditions—(i... risk score that reflects the known underlying risk profile and chronic health status of...

  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

    ...\\ yielded no objections. See 75 FR 53198 (August 31, 2010). Section 119(c)(2) requires the Judges annually... 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...

  5. 76 FR 74703 - Cost of Living Adjustment to Satellite Carrier Compulsory License Royalty Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-01

    ...\\ yielded no objections. See 75 FR 53198 (August 31, 2010). Section 119(c)(2) requires the Judges annually... 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...

  6. 78 FR 13521 - Great Lakes Pilotage Rates-2013 Annual Review and Adjustment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-28

    ... Accountant CPI Consumer Price Index E.O. Executive Order FR Federal Register GLPA Canadian Great Lakes...--2013 Annual Review and Adjustment'' in the Federal Register (77 FR 45539). We received six comments on..., 5, and 7 have been designated by Presidential Proclamation, pursuant to the Act, to be waters...

  7. 76 FR 57992 - Assessment Rate Adjustment Guidelines for Large and Highly Complex Institutions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-19

    ... by the FDIC Board on February 7, 2011 (76 FR 10672 (Feb. 25, 2011)). FOR FURTHER INFORMATION CONTACT... Adjustment Guidelines for Large Institutions and Insured Foreign Branches in Risk Category I, 72 FR 27122... into a total score.\\4\\ \\2\\ Assessments, Large Bank Pricing, 76 FR 10672 (Feb. 25, 2011) (codified at...

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

    PubMed

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

    2016-09-01

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

  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

    2016-01-01

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

  10. [Clinical usefulness of the new Japanese glomerular filtration rate equation for initial and individualized dosage adjustment concentrations of vancomycin].

    PubMed

    Kuroda, Naoki; Ueshima, Satoshi; Sato, Tomoaki; Kobiki, Eriko; Kawasaki, Yoichi; Matsunaga, Hisashi; Nakura, Hironori; Sendo, Toshiaki

    2012-01-01

    To clarify whether the new Japanese glomerular filtration rate (eGFR) equation was able to accurately determine the initial and individualized dosage adjustment concentrations of vancomycin (VCM), the predictive performance for VCM concentrations using the eGFR and Cockcroft-Gault (CG) equations was compared. Data were retrospectively collected from clinical records of 90 patients with MRSA infection whose trough and peak VCM concentrations had been determined. The predicted VCM initial and individualized dosage adjustment concentrations were performed with the 2-compartment linear model using pharmacokinetic parameter means and their individual values via Bayesian estimation, respectively. The prediction error (PE) and its absolute value (APE) between the observed and predicted VCM concentrations were calculated as indices of bias and accuracy in predictive performance, respectively. In the initial dosage adjustment of VCM, the PE value, calculated with the eGFR equation in trough and peak VCM concentrations of patients whose BMI were 18.5 kg/m(2) and higher, was significantly smaller than that calculated with the CG equation. In particular, both PE and APE values obtained from the eGFR calculated concentrations from nonelderly patients (younger than 65 years old) were significantly improved compared with those from the CG equation. In the individualized dosage adjustment of VCM, the eGFR equation gave a significantly smaller PE value in nonelderly patients' trough concentrations than the CG equation. These findings provide useful information for adjusting the VCM dosage to achieve optimal therapeutic efficacy in patients with MRSA infection.

  11. 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

  12. 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…

  13. The growth rate of "clinically significant" renal cancer.

    PubMed

    Gofrit, Ofer N; Yutkin, Vladimir; Zorn, Kevin C; Duvdevani, Mordechai; Landau, Ezekiel H; Hidas, Guy; Pode, Dov

    2015-01-01

    Surveillance studies of enhancing renal masses report on a mean tumor growth rate of about 0.3 cm/year. In most of these studies however, only small tumors in elderly patients were followed. In the current report, we attempt to evaluate the growth rate of "clinically significant" renal carcinomas defined as tumors that were treated immediately upon diagnosis. 46 patients (mean age 64 years SD 11 years) were treated for renal carcinoma. All had a cross-sectional imaging studies performed 6-60 months prior to diagnosis of kidney cancer demonstrating no tumor. Tumor growth rate was calculated by dividing tumor's largest diameter by the time interval between the normal kidney imaging and diagnosis of renal cancer. Mean tumor diameter was 4.5 cm (SD 2.4 cm). Mean time period from the normal imaging to diagnosis of renal cancer was 33.6 months (SD 18 months). According to the proposed model, the average growth rate of "clinically significant" renal carcinomas was 2.13 cm/year (SD 1.45, range 0.2-6.5 cm/year). Tumor growth rate correlated inversely with patient's age (p = 0.007). Patient gender or Fuhrman's grade did not correlate however. The growth rate of "clinically significant" renal cancer appears to be higher than the rate reported in surveillance trials. Renal tumors tend to grow faster in young patients. As such, variable growth rate should be taken into account when considering active surveillance in young patients and when designing trials for evaluation of anti-cancer agents. PMID:26543715

  14. High Rate of Sexual Dysfunction Following Surgery for Rectal Cancer

    PubMed Central

    Ertekin, Caglar; Tinay, Ilker; Yegen, Cumhur

    2014-01-01

    Purpose Although rectal cancer is a very common malignancy and has an improved cure rate in response to oncological treatment, research on rectal-cancer survivors' sexual function remains limited. Sexual dysfunction (SD) after rectal cancer treatment was measured, and possible predisposing factors that may have an impact on the development of this disorder were identified. Methods Patients undergoing curative rectal cancer surgery from January 2012 to September 2013 were surveyed using questionnaires. The female sexual function index or the International Index of Erectile Function was recorded. A multiple logistic regression was used to test associations of clinical factors with outcomes. Results Fifty-six men (56%) and 28 women (44%) who completed the questionnaire were included in the study. A total of 76 patients of the 86 patients (90.5%) with the diagnosis of rectal cancer who were included in this study reported different levels of SD after radical surgery. A total of 64 patients (76%) from the whole cohort reported moderate to severe SD after treatment of rectal cancer. Gender (P = 0.011) was independently associated with SD. Female patients reported significantly higher rates of moderate to severe SD than male patients. Patients were rarely treated for dysfunction. Conclusion Sexual problems after surgery for rectal cancer are common, but patients are rarely treated for SD. Female patients reported higher rates of SD than males. These results point out the importance of sexual (dys)function in survivors of rectal cancer. More attention should be drawn to this topic for clinical and research purposes. PMID:25360427

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

    PubMed Central

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

    2003-01-01

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

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

    PubMed

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

    2016-12-01

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

  17. 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.

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

    PubMed

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

    2014-01-01

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

  19. 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...

  20. 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

  1. 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

    .... During the workshops, BPA staff presented and discussed information about costs, load and resource forecasting, generation inputs pricing, segmentation, revenue forecasts, load forecasts, risk analysis and... to flexibly serve their retail load. Point-to-Point (PTP-12) rate--The PTP rate is a contract...

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  3. Childhood Cancer Death Rates Continue to Fall: CDC

    MedlinePlus

    ... 19, for black and white children, and for boys and girls. A noteworthy point, Curtin said, is that black ... see disparities," she said. On the other hand, boys consistently had higher cancer death rates than girls -- 30 percent higher in 2014. The full explanation ...

  4. 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

  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. 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

  7. 77 FR 29259 - Adjustment of Determination of Compulsory License Rates for Mechanical and Digital Phonorecords

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-17

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

  8. 75 FR 51191 - Great Lakes Pilotage Rates-2011 Annual Review and Adjustment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-19

    ...'' then click on the balloon shape in the ``Actions'' column. If you submit your comments by mail or hand... in the January 17, 2008 issue of the Federal Register (73 FR 3316). D. Public Meeting We do not plan... was published on April 3, 2006 (71 FR 16501). Since then, rates have been reviewed under Appendix...

  9. 5 CFR 9701.334 - Setting and adjusting locality and special rate supplements.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

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

  10. 5 CFR 9701.334 - Setting and adjusting locality and special rate supplements.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

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

  11. 75 FR 14150 - Proposed Rate Adjustment, Public Forum, and Opportunities for Public Review and Comment for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-24

    ... rate for the sale of power from the Georgia-Alabama-South Carolina System of Projects (75 FR 12740... April 29, 2010. The address of the forum was established as the Sheraton Gateway Atlanta Airport.... Southeastern is changing the address of the forum to Atlanta Airport Hilton, 1031 Virginia Avenue, Atlanta,...

  12. 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.

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

    ERIC Educational Resources Information Center

    Hesketh, Beryl; And Others

    1992-01-01

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

  14. 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

  15. A comparison of pressure ulcer prevalence rates in nursing homes in the Netherlands and Germany, adjusted for population characteristics.

    PubMed

    Tannen, Antje; Bours, Gerrie; Halfens, Ruud; Dassen, Theo

    2006-12-01

    Annual pressure ulcer surveys in the Netherlands and Germany have shown remarkable differences in prevalence rates. We explored the differences between the two populations, and the degree to which these differences were associated with differences in prevalence. To this end, data from 48 Dutch and 45 German facilities (n = 9772) from 2003 were analyzed. The prevalence of pressure ulcers (excluding grade 1) was 12.5% in the Netherlands and 4.3% in Germany. After adjusting for age, sex, and other risk factors, the probability of developing a pressure ulcer of stage 2 or higher in Dutch nursing homes was three times greater than in German homes.

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

    NASA Astrophysics Data System (ADS)

    Tillmann, Wolfgang; Momeni, Soroush

    2016-03-01

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

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

    PubMed

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

    2006-05-01

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

  18. Measuring awareness in people with mild to moderate Alzheimer's disease: development of the Memory Awareness Rating Scale--adjusted.

    PubMed

    Hardy, Rachel M; Oyebode, Jan R; Clare, Linda

    2006-04-01

    Variations in level of awareness among people with Alzheimer's disease (AD) may impact on well-being for the person with dementia and their carer, and may influence outcomes of cognitive rehabilitation interventions. Awareness has often been assessed using discrepancies between self and proxy rating or between self-rating and objective task performance, with the latter considered to be preferable. Measures are available that are suitable for people with mild AD, for example the Memory Awareness Rating Scale (MARS). However, these may be less appropriate for people whose impairments are more advanced and who consequently have more difficulty with the objective task component. In order to provide a measure suitable for people with moderate AD, an adjusted Memory Awareness Rating Scale (MARSA) was developed by altering the objective task component of the MARS. The MARSA was piloted with 41 participants with mild to moderate AD. It was found to be suitable for use with a broader group of participants than the MARS. The component ratings were found to have good internal consistency. The component ratings and the two indices of awareness had high test-retest reliability. The extension of the original measure offers the opportunity to consider awareness throughout the course of the disease and provides a basis for longitudinal investigations of awareness.

  19. 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

  20. Individual and Marital Adjustment among Bereaved and Nonbereaved Parents of Children Treated for Cancer.

    ERIC Educational Resources Information Center

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

    Studies of parents of children treated for cancer have rarely included adequate samples of fathers or couples. Further, bereaved parents have been over-represented as compared to parents of cancer survivors. This study investigated the personal and interpersonal effects of having a child treated for cancer on 124 parents. Twenty-seven married…

  1. 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

  2. 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.

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

    PubMed Central

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

    2016-01-01

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

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

    SciTech Connect

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

    2012-01-01

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

  5. 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…

  6. 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

  7. Bayesian adjustment for the misclassification in both dependent and independent variables with application to a breast cancer study.

    PubMed

    Liu, Juxin; Gustafson, Paul; Huo, Dezheng

    2016-10-15

    In this paper, we propose a Bayesian method to address misclassification errors in both independent and dependent variables. Our work is motivated by a study of women who have experienced new breast cancers on two separate occasions. We call both cancers primary, because the second is usually not considered as the result of a metastasis spreading from the first. Hormone receptors (HRs) are important in breast cancer biology, and it is well recognized that the measurement of HR status is subject to errors. This discordance in HR status for two primary breast cancers is of concern and might be an important reason for treatment failure. To sort out the information on true concordance rate from the observed concordance rate, we consider a logistic regression model for the association between the HR status of the two cancers and introduce the misclassification parameters (i.e., sensitivity and specificity) accounting for the misclassification in HR status. The prior distribution for sensitivity and specificity is based on how HR status is actually assessed in laboratory procedures. To account for the nonlinear effect of one error-free covariate, we introduce the B-spline terms in the logistic regression model. Our findings indicate that the true concordance rate of HR status between two primary cancers is greater than the observed value. Copyright © 2016 John Wiley & Sons, Ltd.

  8. 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.

  9. 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.

  10. 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

  11. A structural model of the relationships among self-efficacy, psychological adjustment, and physical condition in Japanese advanced cancer patients.

    PubMed

    Hirai, Kei; Suzuki, Yoko; Tsuneto, Satoru; Ikenaga, Masayuki; Hosaka, Takashi; Kashiwagi, Tetsuo

    2002-01-01

    We made detailed research for relationships among physical condition, self-efficacy and psychological adjustment of patients with advanced cancer in Japan. The sample consisted of 85 (42 males and 43 females) advanced cancer patients. Interviews were conducted with some measurement scales including the Self-efficacy scale for Advanced Cancer (SEAC), and the Hospital Anxiety and Depression Scale (HADS). Karnofsky Performance Status (KPS) and medication status were also recorded from the evaluation by physicians. We used structural equation modeling (SEM) for statistical analysis. The analysis revealed that the model, including three self-efficacy subscales, depression, anxiety, KPS, meal-, liquid-intake, prognosis and three latent variables: 'Self-efficacy', 'Emotional Distress', and 'Physical Condition,' fit the data (chi-square(24)=28.67, p=0.23; GFI=0.93; CFI=0.98; RMSEA=0.05). In this model, self-efficacy accounted for 71% of the variance in emotional distress and physical condition accounted for 8% of the variance in self-efficacy. Overall, our findings suggest clearly that close relationships existed among physical condition, self-efficacy and emotional distress. That is, patients in good physical condition had a high self-efficacy, and patients with high self-efficacy were less emotionally distressed. These results imply that psychological intervention which emphasizes self-efficacy would be effective for advanced cancer patients.

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

    PubMed Central

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

    2015-01-01

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

  13. 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

  14. Late Quaternary incision rates in the southern French Alps from river longitudinal profiles inversion: climatic forcing and internal adjustments.

    NASA Astrophysics Data System (ADS)

    Petit, Carole; Cassol, Davide; Rolland, Yann; Saillard, Marianne

    2016-04-01

    Southern French Alps, and especially the external crystalline massifs, show evidences of rapid river incision featured by deeply incised gorges and widespread active landslides. The onset of rapid incision is not precisely dated, but cosmogenic nuclide dating of river polished profiles evidences rapid incision (of the order of 2-3 mm.yr-1) since 20 ka. These data suggest that it may be related to temperature and runoff increase due to glacier melting after le last glacial maximum (LGM). In this study, we use river longitudinal profiles from tributaries of the Tinée River, in the Argentera-Mercantour crystalline massif, to determine recent incision rate (IR) variations through time with the inversion method of Goren et al. (2014). Overall, the background IR is of approximately 5 mm.yr-1, in agreement with recent IR estimates from cosmogenic nuclide dating in the Tinée River. Incision rate histories of all tributaries show periodic pulses of large IR that could be correlated to quaternary interglacials and interstadials, based on the comparison with global temperature curves. However, some tributaries show very large IR in the Holocene period, whereas others show a recent (post 10 ka) IR decrease. We suggest that local internal adjustments, possibly in relation with meander migration of the main stem, are responsible for these different behaviors.

  15. Brachytherapy for early oral tongue cancer: low dose rate to high dose rate.

    PubMed

    Yamazaki, Hideya; Inoue, Takehiro; Yoshida, Ken; Yoshioka, Yasuo; Furukawa, Souhei; Kakimoto, Naoya; Shimizutani, Kimishige; Inoue, Toshihiko

    2003-03-01

    To examine the compatibility of low dose rate (LDR) with high dose rate (HDR) brachytherapy, we reviewed 399 patients with early oral tongue cancer (T1-2N0M0) treated solely by brachytherapy at Osaka University Hospital between 1967 and 1999. For patients in the LDR group (n = 341), the treatment sources consisted of Ir-192 pin for 227 patients (1973-1996; irradiated dose, 61-85 Gy; median, 70 Gy), Ra-226 needle for 113 patients (1967-1986; 55-93 Gy; median, 70 Gy). Ra-226 and Ir-192 were combined for one patient. Ir-192 HDR (microSelectron-HDR) was used for 58 patients in the HDR group (1991-present; 48-60 Gy; median, 60 Gy). LDR implantations were performed via oral and HDR via a submental/submandibular approach. The dose rates at the reference point for the LDR group were 0.30 to 0.8 Gy/h, and for the HDR group 1.0 to 3.4 Gy/min. The patients in the HDR group received a total dose of 48-60 Gy (8-10 fractions) during one week. Two fractions were administered per day (at least a 6-h interval). The 3- and 5-year local control rates for patients in the LDR group were 85% and 80%, respectively, and those in the HDR group were both 84%. HDR brachytherapy showed the same lymph-node control rate as did LDR brachytherapy (67% at 5 years). HDR brachytherapy achieved the same locoregional result as did LDR brachytherapy. A converting factor of 0.86 is applicable for HDR in the treatment of early oral tongue cancer.

  16. 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,

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

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...-day episode payment rate for case-mix and area wage levels. 484.220 Section 484.220 Public Health... Calculation of the adjusted national prospective 60-day episode payment rate for case-mix and area wage levels... case-mix using a case-mix index to explain the relative resource utilization of different patients....

  18. 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.

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

    PubMed Central

    2011-01-01

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

  20. 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

  1. Adjustment on the Type I Error Rate for a Clinical Trial Monitoring for both Intermediate and Primary Endpoints

    PubMed Central

    Halabi, Susan

    2013-01-01

    In many clinical trials, a single endpoint is used to answer the primary question and forms the basis for monitoring the experimental therapy. Many trials are lengthy in duration and investigators are interested in using an intermediate endpoint for an accelerated approval, but will rely on the primary endpoint (such as, overall survival) for the full approval of the drug by the Food and Drug Administration. We have designed a clinical trial where both intermediate (progression-free survival, (PFS)) and primary endpoints (overall survival, (OS)) are used for monitoring the trial so the overall type I error rate is preserved at the pre-specified alpha level of 0.05. A two-stage procedure is used. In the first stage, the Bonferroni correction was used where the global type I error rate was allocated to each of the endpoints. In the next stage, the O’Brien-Fleming approach was used to design the boundary for the interim and final analysis for each endpoint. Data were generated assuming several parametric copulas with exponential marginals. Different degrees of dependence, as measured by Kendall’s τ, between OS and PFS were assumed: 0 (independence) 0.3, 0.5 and 0.70. This approach is applied to an example in a prostate cancer trial. PMID:24466469

  2. 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

  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. Cancer Rates by Race/Ethnicity and Sex

    MedlinePlus

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

  5. 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

  6. Adjusting lung cancer risks for temporal and spatial variations in radon concentration in dwellings in Gansu Province, China.

    PubMed

    Lubin, J H; Wang, Z Y; Wang, L D; Boice, J D; Cui, H X; Zhang, S R; Conrath, S; Xia, Y; Shang, B; Cao, J S; Kleinerman, R A

    2005-05-01

    Our recent study in Gansu Province, China reported an increasing risk of lung cancer with increasing residential radon concentration that was consistent with previous pooled analyses and with meta-analyses of other residential studies (Wang et al., Am. J. Epidemiol. 155, 554-564, 2002). Dosimetry used current radon measurements (1-year track-etch detectors) in homes to characterize concentrations for the previous 30 years, resulting in uncertainties in exposure and possibly reduced estimates of disease risk. We conducted a 3-year substudy in 55 houses to model the temporal and spatial variability in radon levels and to adjust estimates of radon risk. Temporal variation represented the single largest source of uncertainty, suggesting the usefulness of multi-year measurements to assess this variation; however, substantial residual variation remained unexplained. The uncertainty adjustment increased estimates of the excess odds ratio by 50-100%, suggesting that residential radon studies using similar dosimetry may also underestimate radon effects. These results have important implications for risk assessment.

  7. Quality-of-Life-Adjusted Survival Analysis of Concurrent Chemo Radiotherapy for Locally Advanced (Nonmetastatic) Nasopharyngeal Cancer

    SciTech Connect

    Gao Fei; Wee, Joseph; Wong, Hwee Bee; Machin, David

    2010-10-01

    Purpose: To assess whether the benefits of adding cisplatin (CDDP) concurrent with radiotherapy, followed by adjuvant CDDP and fluorouracil, justifies the toxicity cost for nasopharyngeal cancer (NPC) using the quality-adjusted time without symptoms or toxicity (Q-TWiST) approach. Methods and Materials: One hundred seven patients treated with radiotherapy (RT) and 111 with concurrent chemotherapy and radiotherapy (CRT) were analyzed. The overall survival was divided into three health states: time on active treatment only, during which any subjective nonhematologic toxic event of grade > = 3 was reported; time without symptoms of disease relapse; or treatment and time following first disease RELapse. The relative advantage of CRT and RT was examined by conducting the analysis cumulatively at restriction times 3, 6, 24, 36, 48 months. Results: At 48 months, the improvement in disease-free survival was 14.4% for CRT, whereas that for overall survival was 18.9%. The differences in Q-TWiST were -0.4, -0.7, 0.1, 1.6, and 3.6 months at 3, 6, 24, 36, and 48 months, respectively, with positive differences favoring CRT. At 24 months, the difference in Q-TWiST began to favor CRT. At 36 months, CRT may be the preferred option from the patient's viewpoint if the time spent in the REL state is valued to be <0.83, with the value of perfect health being 1. Finally, Q-TWiST accumulated within 48 months indicated a significant advantage in quality-adjusted survival time for CRT (p = 0.020). Conclusion: Irrespective of how patients valued periods of toxicity and delayed disease progression, concurrent chemotherapy and radiotherapy offered NPC patients significantly more quality-adjusted survival than radiotherapy alone in the long term.

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

    PubMed

    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

    2014-07-01

    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 m(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.

  9. 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

  10. 75 FR 9964 - Order Making Fiscal Year 2010 Mid-Year Adjustment to the Fee Rates Applicable Under Sections 31(b...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-04

    ... FR 21018 (May 6, 2009). Based on data provided by the national securities exchanges and the national... COMMISSION Order Making Fiscal Year 2010 Mid-Year Adjustment to the Fee Rates Applicable Under Sections 31(b... amount of sales for fiscal year 2010 calculated by the Commission in its Order Making Fiscal 2010...

  11. Estimate of overdiagnosis of breast cancer due to mammography after adjustment for lead time. A service screening study in Italy

    PubMed Central

    Paci, Eugenio; Miccinesi, Guido; Puliti, Donella; Baldazzi, Paola; De Lisi, Vincenzo; Falcini, Fabio; Cirilli, Claudia; Ferretti, Stefano; Mangone, Lucia; Finarelli, Alba Carola; Rosso, Stefano; Segnan, Nereo; Stracci, Fabrizio; Traina, Adele; Tumino, Rosario; Zorzi, Manuel

    2006-01-01

    Introduction Excess of incidence rates is the expected consequence of service screening. The aim of this paper is to estimate the quota attributable to overdiagnosis in the breast cancer screening programmes in Northern and Central Italy. Methods All patients with breast cancer diagnosed between 50 and 74 years who were resident in screening areas in the six years before and five years after the start of the screening programme were included. We calculated a corrected-for-lead-time number of observed cases for each calendar year. The number of observed incident cases was reduced by the number of screen-detected cases in that year and incremented by the estimated number of screen-detected cases that would have arisen clinically in that year. Results In total we included 13,519 and 13,999 breast cancer cases diagnosed in the pre-screening and screening years, respectively. In total, the excess ratio of observed to predicted in situ and invasive cases was 36.2%. After correction for lead time the excess ratio was 4.6% (95% confidence interval 2 to 7%) and for invasive cases only it was 3.2% (95% confidence interval 1 to 6%). Conclusion The remaining excess of cancers after individual correction for lead time was lower than 5%. PMID:17147789

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

    PubMed Central

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

    2015-01-01

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

  13. Siblings' Response to a Survivor of Childhood Cancer: A Review of the Literature on What Leads to Healthy Adjustment or Maladjustment.

    ERIC Educational Resources Information Center

    Hamilton, Todd Lee

    This paper reviews the research on how siblings respond to another sibling who has survived childhood cancer. The paper examines the siblings' ability to cope, adjust, and adapt to this stressor. Relevant interventions are also discussed. The research indicates that although siblings may experience heightened emotional and behavioral problems,…

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

    PubMed

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

    2016-01-01

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

  15. 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.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

  18. 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

  19. Rate of cervical cancer screening associated with immigration status and number of years since immigration in Ontario, Canada.

    PubMed

    Khadilkar, Amole; Chen, Yue

    2013-04-01

    Cervical cancer screening is a vital public health measure intended to reduce the morbidity and mortality from what is a largely preventable cancer. Previous Canadian studies have documented that immigrants have significantly lower Papanicolaou (Pap) testing rates than women born in Canada. However, the impact of number of years since immigration is less clear. Data were taken from the 2007-2008 Canadian Community Health Survey. Responses from 16, 706 women living in Ontario, Canada were included. The focus was on self-reported Pap testing rates within the last 3 years, immigrant status and number of years since immigration. A robust Poisson regression model was used to determine prevalence ratios (PR) with 95 % confidence intervals (CIs) after adjustment for covariates. The results demonstrated that recent immigrant women (less than 10 years in Canada) were less likely to have had a Pap test in the past 3 years than those who were Canadian-born (PR = 0.77; 95 % CI: 0.71, 0.84). In contrast, immigrants who had lived in Canada for 10 years or longer showed similar compliance with recommended Pap testing intervals as non-immigrants. Higher income, higher level of education, younger age and being married were independently associated with better Pap testing rates. A strategy targeting recent immigrants to Canada is needed to promote Pap testing in this population and reduce their risk of invasive cervical cancer.

  20. Risk Factors and Control Strategies for the Rapidly Rising Rate of Breast Cancer in Korea

    PubMed Central

    Park, Sue K.; Kim, Yeonju; Kang, Daehee; Jung, En-Joo

    2011-01-01

    Due to the aging population and tremendous changes in life style over the past decades, cancer has been the leading cause of death in Korea. The incidence rate of breast cancer is the second highest in Korea, and it has shown an annual increase of 6.8% for the past 6 years. The major risk factors of breast cancer in Korean women are as follows: Early menarche, late menopause, late full-term pregnancy (FTP), and low numbers of FTP. Height and body mass index increased the risk of breast cancer in postmenopausal women only. There are ethnic variations in breast cancer due to the differences in genetic susceptibility or exposure to etiologic agent. With the epidemiological evidences on the possibility of further increase of breast cancer in Korea, the Korean Government began implementing the National Cancer Screening Program against breast cancer in 2002. Five-year survival rates for female breast cancer have improved significantly from 78.0% in early 1993-1995 to 90.0% in 2004-2008. This data indicate that improvement of the survival rate may be partially due to the early diagnosis of breast cancer as well as the increased public awareness about the significance of early detection and organized cancer screening program. The current primary prevention programs are geared towards strengthening national prevention campaigns. In accordance with the improvement in 5-year survival rate, the overall cancer mortality has started to decrease. However, breast cancer death rate and incidence rates are still increasing, which need further organized effort by the Korean Government. PMID:21847401

  1. 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.

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

    PubMed

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

    2014-01-01

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

  3. 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

  4. 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.

  5. Anal Cancer Rates Rising in Many Parts of The World

    MedlinePlus

    ... Services, or federal policy. More Health News on: Health Disparities HPV Recent Health News Related MedlinePlus Health Topics Anal Cancer Health Disparities HPV About MedlinePlus Site Map FAQs Contact Us ...

  6. Appearance concerns and psychosocial adjustment following head and neck cancer: A cross-sectional study and nine-month follow-up.

    PubMed

    Clarke, Sally-Ann; Newell, Robert; Thompson, Andrew; Harcourt, Diana; Lindenmeyer, Antje

    2014-01-01

    Psychosocial difficulties have been reported in head and neck cancer (HNC) patients, yet only few studies have assessed the impact of altered appearance following HNC treatment using theoretically selected measures of appearance-related distress. This study investigated appearance-related adjustment following HNC, and demographic and socio-cognitive predictors of adjustment. HNC patients (n=49) completed baseline questionnaires and a nine-month postal follow-up (n=20). Participants showed considerable variation in appearance-related adjustment, with females reporting higher levels of appearance-related distress (derriford appearance scale [DAS-24]) than females in the general population and male HNC survivors. Depression scores on the hospital anxiety and depression scale were higher than UK norms whilst anxiety was similar to UK norms. There were no significant differences between baseline and follow-up data. Fear of negative evaluation (a central feature of social anxiety) was a significant predictor of appearance-related adjustment at baseline, whilst dispositional optimism was a significant predictor of appearance-related adjustment at baseline and follow-up. Qualitative responses showed themes of appearance and disability, and coping strategies. Findings suggest that appearance-related adjustment post-HNC varies considerably and psychosocial services working with HNC patients should consider this broad pattern of response. Future research to examine the role of socio-cognitive predictors of appearance-related adjustment could progress development of effective psychological interventions.

  7. Study of device use adjusted rates in health care-associated infections after implementation of "bundles" in a closed-model medical intensive care unit.

    PubMed

    Venkatram, Sindhaghatta; Rachmale, Sonal; Kanna, Balavenkatesh

    2010-03-01

    "Bundles" strategies improve health care-associated infection (HCAI) rates in medical intensive care units (MICUs). However, few studies have analyzed HCAI rates adjusted for the device removal component of the bundles. An observational study of adult MICU patients while using bundles to prevent HCAIs associated with endovascular catheters, mechanical ventilation, and urinary tract catheters was conducted. The HCAI rates, unadjusted and adjusted for device use, were calculated using incidence rate ratios (unadjusted IRRs [uIRR] and adjusted IRRs [aIRR], respectively). Among 4550 study patients, HCAIs declined from 47 in 2004 to 10 in 2005, 8 in 2006, and 3 in 2007. Catheter-related blood stream infection (CRBSI) rates decreased from 10.77 to 1.67 per 1000 central line days (uIRR, 0.155; 95% confidence interval [CI], 0.13-0.18; P < .0001). Foley-related urinary tract infections (CA-UTI) decreased from 6.23 to 0.63 per 1000 device days (uIRR, 0.1; 95% CI, 0.08-0.19; P < .0001). Ventilator-associated pneumonia (VAP) per 1000 ventilator days diminished from 2.17 to 0.62 (uIRR, 0.29; 95% CI, 0.21-0.38; P < .0001). After adjustment for device use, aIRRs of CRBSI (0.14; 95% CI, 0.11-0.18), UTI (0.09; 95% CI, 0.06-0.12), and VAP (0.33; 95% CI, 0.22-0.47) declined significantly (P < .00001). Implementing comprehensive bundle strategies reduces HCAI beyond the impact of device removal.

  8. Impacts of land use on spatial distribution of mortality rates of cancers caused by naturally occurring asbestos.

    PubMed

    Wei, Binggan; Jia, Xianjie; Ye, Bixiong; Yu, Jiangping; Zhang, Biao; Zhang, Xiuwu; Lu, Rongan; Dong, Tingrong; Yang, Linsheng

    2012-09-01

    This study investigated the spatial distributions of mortality rates of six cancers: mesothelioma, lung cancer, intestinal cancer, nasopharyngeal and laryngeal cancer, liver cancer, and stomach cancer in Dayao using Geographic Information Systems. Relationships between the mortality rates of the six cancers and land use patterns were investigated by Pearson Correlation Coefficients. The results indicated that the mortality rates of nasopharyngeal and laryngeal cancer, lung cancer, intestinal cancer, and mesothelioma were significantly associated with outcropped asbestos. Both the proportions of farmland and urban area were positively related to the mortality rates of nasopharyngeal and laryngeal cancer, lung cancer, intestinal cancer, and mesothelioma, and significant negative correlations were found between the proportion of forestland and nasopharyngeal and laryngeal cancer and intestinal cancer. It can be concluded that naturally occurring asbestos may significantly elevate the mortality rates of nasopharyngeal and laryngeal cancer, intestinal cancer, lung cancer, and mesothelioma. Moreover, higher proportions of farmland, urban area, and lower proportions of forested land may elevate the mortality rate of the four cancers.

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  11. Risk adjustment models for interhospital comparison of CS rates using Robson’s ten group classification system and other socio-demographic and clinical variables

    PubMed Central

    2012-01-01

    Background Caesarean section (CS) rate is a quality of health care indicator frequently used at national and international level. The aim of this study was to assess whether adjustment for Robson’s Ten Group Classification System (TGCS), and clinical and socio-demographic variables of the mother and the fetus is necessary for inter-hospital comparisons of CS rates. Methods The study population includes 64,423 deliveries in Emilia-Romagna between January 1, 2003 and December 31, 2004, classified according to theTGCS. Poisson regression was used to estimate crude and adjusted hospital relative risks of CS compared to a reference category. Analyses were carried out in the overall population and separately according to the Robson groups (groups I, II, III, IV and V–X combined). Adjusted relative risks (RR) of CS were estimated using two risk-adjustment models; the first (M1) including the TGCS group as the only adjustment factor; the second (M2) including in addition demographic and clinical confounders identified using a stepwise selection procedure. Percentage variations between crude and adjusted RRs by hospital were calculated to evaluate the confounding effect of covariates. Results The percentage variations from crude to adjusted RR proved to be similar in M1 and M2 model. However, stratified analyses by Robson’s classification groups showed that residual confounding for clinical and demographic variables was present in groups I (nulliparous, single, cephalic, ≥37 weeks, spontaneous labour) and III (multiparous, excluding previous CS, single, cephalic, ≥37 weeks, spontaneous labour) and IV (multiparous, excluding previous CS, single, cephalic, ≥37 weeks, induced or CS before labour) and to a minor extent in groups II (nulliparous, single, cephalic, ≥37 weeks, induced or CS before labour) and IV (multiparous, excluding previous CS, single, cephalic, ≥37 weeks, induced or CS before labour). Conclusions The TGCS classification is useful for

  12. 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.

  13. 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

    ... to workers subject to the Construction Wage Rate Requirements statute. (End of clause) ... 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...

  14. 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

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

    PubMed

    2016-01-01

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

  16. TFF3 and survivin expressions associate with a lower survival rate in gastric cancer.

    PubMed

    Meng, Jia-Rong; Tang, Hui-Zhong; Zhou, Kai-Zong; Shen, Wu-Hong; Guo, He-Yi

    2013-11-01

    Trefoil factor 3 (TFF3) and survivin with functions of inhibiting apoptosis are involved in the gastric cancer by overexpression. The purpose of this study is to examine the expression of TFF3 and survivin in patients' tissue samples with gastric cancer and analyze the relationship between the protein expression and the different clinical records. By studying the expressions of TFF3 and survivin in gastric cancer through immunohistochemical staining and examining the survival rate via Kaplan-Meier analysis for gastric cancer patients, we found that the TFF3 and survivin positive expressions have a significant relationship with the lower survival rate comparing to that of negative expressions in the analyzed patients (P < 0.05). And moreover, patients with double positive TFF3 and survivin expressions have the lowest survival rate. TFF3 or survivin positive expression correlates with the lymph node metastasis, metastasis, and TNM stages of gastric cancer. Survival analysis indicates that survival rate has a close relationship with the age, tumor histology, tumor differentiation, degree of infiltration, lymph node metastasis, distant metastasis, and TNM stages (P < 0.01). Our data suggest that TFF3 and survivin expressions play a vital role in gastric cancer development, and these two proteins are important markers for prognosis in gastric cancer. Patients with gastric cancer can increase the survival rate through an earlier diagnosis and appropriate treatment.

  17. 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.

  18. Rate and classification of interval cancers in the breast screening programme.

    PubMed Central

    Sylvester, P. A.; Kutt, E.; Baird, A.; Vipond, M. N.; Webb, A. J.; Farndon, J. R.

    1997-01-01

    There has been concern about the number of interval cancers which have been detected within the National Breast Screening Programme. A series of 134 women presenting with interval cancers was studied by prospective audit and the rate and radiological classification of the tumours determined. The cancers were classified as true (67), false-negative (22), unclassifiable (28), occult (12), and minimal sign (5). The interval cancer rate did not achieve the new National Guidelines in either the first 2 years or the 3rd interval year. The false-negative cancers presented mainly in the 1st interval year, whereas the true cancers were predominantly confined to the 2nd and 3rd years. These data suggest that alterations to the screening programme may be beneficial. It may be, however, that the programme is still on the learning curve and this should be taken into account when interpreting these data. PMID:9244072

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

    ERIC Educational Resources Information Center

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

    2000-01-01

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

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

    PubMed

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

    2015-02-01

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

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

    PubMed

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

    2015-02-01

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

  2. 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.

  3. 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

    ... Return Method Rate of return for a period may be calculated by computing the net performance divided by the beginning net asset value for each trading day in the period and compounding each daily rate of... commodity pool operator or commodity trading advisor may present to the Commission proposals regarding...

  4. 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

    ... Return Method Rate of return for a period may be calculated by computing the net performance divided by the beginning net asset value for each trading day in the period and compounding each daily rate of... commodity pool operator or commodity trading advisor may present to the Commission proposals regarding...

  5. 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

    ... Return Method Rate of return for a period may be calculated by computing the net performance divided by the beginning net asset value for each trading day in the period and compounding each daily rate of... commodity pool operator or commodity trading advisor may present to the Commission proposals regarding...

  6. 75 FR 70744 - Fiscal Year (FY) 2012-2013 Proposed Power Rate Adjustments Public Hearing and Opportunities for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-18

    ... information about costs, load and resource forecasting, generation inputs pricing, segmentation, revenue... Public customers serving new large single loads. BPA is forecasting no sales at the NR rate in the... governed by BPA's Procedures Governing Bonneville Power Administration Rate Hearings, 51 FR ] 7611...

  7. 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

    ... Return Method Rate of return for a period may be calculated by computing the net performance divided by the beginning net asset value for each trading day in the period and compounding each daily rate of... commodity pool operator or commodity trading advisor may present to the Commission proposals regarding...

  8. 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

    ... Return Method Rate of return for a period may be calculated by computing the net performance divided by the beginning net asset value for each trading day in the period and compounding each daily rate of... commodity pool operator or commodity trading advisor may present to the Commission proposals regarding...

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

    PubMed

    Louchini, R; Goggin, P; Steben, M

    2008-01-01

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

  10. 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

  11. Delay Adjusted Incidence Infographic

    Cancer.gov

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

  12. 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.

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

    PubMed

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

    2014-07-01

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

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

    PubMed

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

    2014-07-01

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

  15. 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.

  16. 5 CFR 9701.337 - Treatment of employees whose rate of pay falls below the minimum adjusted rate of their band.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

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

    PubMed

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

    2015-06-01

    A fast rise-rate, variable mass-bit gas puff valve based on the diamagnetic repulsion principle was designed, built, and experimentally characterized. The ability to hold the pressure rise-rate nearly constant while varying the total overall mass bit was achieved via a movable mechanical restrictor that is accessible while the valve is assembled and pressurized. The rise-rates and mass-bits were measured via piezoelectric pressure transducers for plenum pressures between 10 and 40 psig and restrictor positions of 0.02-1.33 cm from the bottom of the linear restrictor travel. The mass-bits were found to vary linearly with the restrictor position at a given plenum pressure, while rise-rates varied linearly with plenum pressure but exhibited low variation over the range of possible restrictor positions. The ability to change the operating regime of a pulsed coaxial plasma deflagration accelerator by means of altering the valve parameters is demonstrated. PMID:26133835

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

    PubMed

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

    2015-06-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2015-06-01

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

  20. 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.

  1. 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

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

    PubMed Central

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

    2016-01-01

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

  3. 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

  4. 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.

  5. Resource utilization. High dose rate versus low dose rate brachytherapy for gynecologic cancer.

    PubMed

    Bastin, K; Buchler, D; Stitt, J; Shanahan, T; Pola, Y; Paliwal, B; Kinsella, T

    1993-06-01

    A comparative analysis of anesthesia use, perioperative morbidity and mortality, capital, and treatment cost of high dose rate versus low dose rate intracavitary brachytherapy for gynecologic malignancy is presented. To assess current anesthesia utilization, application location, and high dose rate afterloader availability for gynecologic brachytherapy in private and academic practices, a nine-question survey was sent to 150 radiotherapy centers in the United States, of which 95 (63%) responded. Of these 95 respondents, 95% used low dose rate brachytherapy, and 18% possessed high dose rate capability. General anesthesia was used in 95% of programs for tandem + ovoid and in 31% for ovoids-only placement. Differences among private and academic practice respondents were minimal. In our institution, a cost comparison for low dose rate therapy (two applications with 3 hospital days per application, operating and recovery room use, spinal anesthesia, radiotherapy) versus high dose rate treatment (five outpatient departmental applications, intravenous anesthesia without an anesthesiologist, radiotherapy) revealed a 244% higher overall charge for low dose rate treatment, primarily due to hospital and operating room expenses. In addition to its ability to save thousands of dollars per intracavitary patient, high dose rate therapy generated a "cost-shift," increasing radiotherapy departmental billings by 438%. More importantly, perioperative morbidity and mortality in our experience of 500+ high dose rate applications compared favorably with recently reported data using low dose rate intracavitary treatment. Capital investment, maintenance requirements, and depreciation costs for high dose rate capability are reviewed. Application of the defined "revenue-cost ratio" formula demonstrates the importance of high application numbers and consistent reimbursement for parity in high dose rate operation. Logically, inadequate third-party reimbursement (e.g., Medicare) reduces high

  6. [Structural adjustment, cultural adjustment?].

    PubMed

    Dujardin, B; Dujardin, M; Hermans, I

    2003-12-01

    Over the last two decades, multiple studies have been conducted and many articles published about Structural Adjustment Programmes (SAPs). These studies mainly describe the characteristics of SAPs and analyse their economic consequences as well as their effects upon a variety of sectors: health, education, agriculture and environment. However, very few focus on the sociological and cultural effects of SAPs. Following a summary of SAP's content and characteristics, the paper briefly discusses the historical course of SAPs and the different critiques which have been made. The cultural consequences of SAPs are introduced and are described on four different levels: political, community, familial, and individual. These levels are analysed through examples from the literature and individual testimonies from people in the Southern Hemisphere. The paper concludes that SAPs, alongside economic globalisation processes, are responsible for an acute breakdown of social and cultural structures in societies in the South. It should be a priority, not only to better understand the situation and its determining factors, but also to intervene and act with strategies that support and reinvest in the social and cultural sectors, which is vital in order to allow for individuals and communities in the South to strengthen their autonomy and identify.

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  9. 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.

  10. 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.

  11. 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.

  12. 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

  13. 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

  14. 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.

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

    PubMed Central

    Richardson, Richard B

    2013-01-01

    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

  16. Cancer radiotherapy based on femtosecond IR laser-beam filamentation yielding ultra-high dose rates and zero entrance dose.

    PubMed

    Meesat, Ridthee; Belmouaddine, Hakim; Allard, Jean-François; Tanguay-Renaud, Catherine; Lemay, Rosalie; Brastaviceanu, Tiberius; Tremblay, Luc; Paquette, Benoit; Wagner, J Richard; Jay-Gerin, Jean-Paul; Lepage, Martin; Huels, Michael A; Houde, Daniel

    2012-09-18

    Since the invention of cancer radiotherapy, its primary goal has been to maximize lethal radiation doses to the tumor volume while keeping the dose to surrounding healthy tissues at zero. Sadly, conventional radiation sources (γ or X rays, electrons) used for decades, including multiple or modulated beams, inevitably deposit the majority of their dose in front or behind the tumor, thus damaging healthy tissue and causing secondary cancers years after treatment. Even the most recent pioneering advances in costly proton or carbon ion therapies can not completely avoid dose buildup in front of the tumor volume. Here we show that this ultimate goal of radiotherapy is yet within our reach: Using intense ultra-short infrared laser pulses we can now deposit a very large energy dose at unprecedented microscopic dose rates (up to 10(11) Gy/s) deep inside an adjustable, well-controlled macroscopic volume, without any dose deposit in front or behind the target volume. Our infrared laser pulses produce high density avalanches of low energy electrons via laser filamentation, a phenomenon that results in a spatial energy density and temporal dose rate that both exceed by orders of magnitude any values previously reported even for the most intense clinical radiotherapy systems. Moreover, we show that (i) the type of final damage and its mechanisms in aqueous media, at the molecular and biomolecular level, is comparable to that of conventional ionizing radiation, and (ii) at the tumor tissue level in an animal cancer model, the laser irradiation method shows clear therapeutic benefits. PMID:22927378

  17. 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…

  18. 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…

  19. Screening for cervical cancer in French Guiana: screening rates from 2006 to 2011.

    PubMed

    Douine, M; Roué, T; Lelarge, C; Adenis, A; Thomas, N; Nacher, M

    2015-12-01

    In French Guiana, the age-standardized incidence rate of cervical cancer is four times higher than in France and the mortality rate 5.5 times higher. A survival study revealed that stage at diagnosis was the main factor influencing the prognosis, showing that early detection is crucial to increase cervical cancer survival. The present study aimed at evaluating the cervical cancer screening rate between 2006 and 2011 by age and for a 3-year period in French Guiana. All pap smears realised in French Guiana were analysed in two laboratories allowing exhaustive review of screening data. The screening rate was estimated at about 54% from 2006 to 2011, with a statistical difference between coastal and rural area (56.3% versus 18.7%). Although the methodological difference did not allow comparisons with metropolitan France, these results could be used to evaluate the impact of organised cervical cancer screening by the French Guiana Association for Organized Screening of Cancers which has been implemented in French Guiana since 2012. PMID:26608273

  20. 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

  1. 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.

  2. 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.

  3. 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

  4. 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

  5. High-dose-rate pre-operative endorectal brachytherapy for patients with rectal cancer

    PubMed Central

    Devic, Slobodan

    2015-01-01

    High-dose-rate endorectal brachytherapy (HDREBT) is an image guided brachytherapy treatment for patients with rectal cancer. It is based on tumor imaging with magnetic resonance in particular, which is used to choose eligible patients and improve tumor visualization. Treatment planning is performed using 3D CT simulation and treatment planning. The treatment is given on an outpatient basis and requires minimal local anesthesia. The validation of the technique was carried out through a preoperative study and is now explored as part of a radical treatment for early rectal cancer or as a boost modality. We describe technical aspects of the HDREBT and we discuss the ongoing institutional review board approved studies exploring the clinical applications of this treatment modality for patients with rectal cancer: 1) as a neoadjuvant treatment for patients with operable rectal tumor; 2) as a option to improve local control in patients with newly diagnosed rectal cancer but with previous pelvic radiation. PMID:26034500

  6. Adaptive upstream rate adjustment by RSOA-ONU depending on different injection power of seeding light in standard-reach and long-reach PON systems

    NASA Astrophysics Data System (ADS)

    Yeh, C. H.; Chow, C. W.; Shih, F. Y.; Pan, C. L.

    2012-08-01

    The wavelength division multiplexing-time division multiplexing (WDM-TDM) passive optical network (PON) using reflective semiconductor optical amplifier (RSOA)-based colorless optical networking units (ONUs) is considered as a promising candidate for the realization of fiber-to-the-home (FTTH). And this architecture is actively considered by Industrial Technology Research Institute (ITRI) for the realization of FTTH in Taiwan. However, different fiber distances and optical components would introduce different power budgets to different ONUs in the PON. Besides, due to the aging of optical transmitter (Tx), the power decay of the distributed optical carrier from the central office (CO) could also reduce the injection power into each ONU. The situation will be more severe in the long-reach (LR) PON, which is considered as an option for the future access. In this work, we investigate a WDM-TDM PON using RSOA-based ONU for upstream data rate adjustment depending on different continuous wave (CW) injection powers. Both standard-reach (25 km) and LR (100 km) transmissions are evaluated. Moreover, a detail analysis of the upstream signal bit-error rate (BER) performances at different injection powers, upstream data rates, PON split-ratios under stand-reach and long-reach is presented.

  7. Changes in emotion regulation and psychological adjustment following use of a group psychosocial support program for women recently diagnosed with breast cancer.

    PubMed

    Cameron, Linda D; Booth, Roger J; Schlatter, Melanie; Ziginskas, Danute; Harman, John E

    2007-03-01

    This study assesses the efficacy of a group intervention in altering emotion regulation processes and promoting adjustment in women with breast cancer. Using a design with 10 alternating phases of availability of the intervention versus standard care, we assessed women participating in one of three conditions: a 12-week group intervention (N = 54); a decliner group who refused the intervention (N = 56), and a standard care group who were not offered the intervention (N = 44). The intervention included training in relaxation, guided imagery, meditation, emotional expression, and exercises promoting control beliefs and benefit-finding. Emotion regulation processes and adjustment were assessed at baseline (following diagnosis), 4 months (corresponding with the end of the intervention), 6 months, and 12 months. At 4 months, intervention participants (compared to decliners and standard care participants) reported greater increases in use of relaxation-oriented techniques, perceived control, emotional well-being, and coping efficacy, and, greater decreases in perceived risk of recurrence, cancer worry, and anxiety. Intervention participants also reported relatively greater decreases in emotional suppression from baseline to 12 months, suggesting that the intervention had a delayed impact on these tendencies. The findings suggest an emotion regulation intervention can beneficially influence emotional experiences and regulation over the first year following diagnosis.

  8. ``In Vivo'' Dosimetry in High Dose Rate Brachytherapy for Cervical Cancer Treatments

    NASA Astrophysics Data System (ADS)

    González-Azcorra, S. A.; Mota-García, A.; Poitevín-Chacón, M. A.; Santamaría-Torruco, B. J.; Rodríguez-Ponce, M.; Herrera-Martínez, F. P.; Gamboa de Buen, I.; Ruíz-Trejo, C.; Buenfil, A. E.

    2008-08-01

    In this prospective study, rectal dose was measured "in vivo" using TLD-100 crystals (3×3×1 mm3), 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 Cancerología (INCan).

  9. Tumor growth rate of invasive breast cancers during wait times for surgery assessed by ultrasonography.

    PubMed

    Lee, Su Hyun; Kim, Young-Seon; Han, Wonshik; Ryu, Han Suk; Chang, Jung Min; Cho, Nariya; Moon, Woo Kyung

    2016-09-01

    Several studies suggest that delay in the surgical treatment of breast cancer is significantly associated with lower survival. This study evaluated the tumor growth rate (TGR) of invasive breast cancers during wait times for surgery quantitatively using ultrasonography (US) and identified clinicopathologic factors associated with TGR.This retrospective study was approved by our institutional review board and the requirement for written informed consent was waived. Between August 2013 and September 2014, a total of 323 unifocal invasive breast cancers in 323 women with serial US images at the time of diagnosis and surgery were included. Tumor diameters and volumes were measured using 2-orthogonal US images. TGR during wait times for surgery was quantified as specific growth rates (SGR; %/day) and was compared with clinicopathologic variables using univariate and multivariate analyses.Median time from diagnosis to surgery was 31 days (range, 8-78 days). Maximum tumor diameters and volumes at the time of surgery (mean, 15.6 mm and 1.6 cm) were significantly larger than at diagnosis (14.7 mm and 1.3 cm) (P < 0.001). On multivariate analysis, surrogate molecular subtype was a significant independent factor of SGR (P = 0.001); triple negative cancers showed the highest SGR (1.003%/day) followed by HER2-positive (0.859 %/day) and luminal cancers (luminal B, 0.208 %/day; luminal A, 0.175%/day) (P < 0.001). Clinical T stage was more frequently upgraded in nonluminal (triple negative, 18% [12/67]; HER2-positive, 14% [3/22]) than luminal cancers (luminal B, 3% [1/30]; luminal A, 2% [4/204]) (P < 0.001).Invasive breast cancers with aggressive molecular subtypes showed faster TGR and more frequent upgrading of clinical T stage during wait times for surgery. PMID:27631256

  10. Acculturation, inner peace, cancer self-efficacy, and self-rated health among Latina breast cancer survivors.

    PubMed

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

    2014-11-01

    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. 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…

  12. Differences in vitamin D status may account for unexplained disparities in cancer survival rates between African and white Americans

    PubMed Central

    Grant, William B.; Peiris, Alan N.

    2012-01-01

    Considerable disparities in cancer survival rates exist between African Americans (AAs) and white Americans (WAs). Various factors such as differences in socioeconomic status (SES), cancer stage at time of diagnosis, and treatment—which this analysis considers primary explanatory factors—have accounted for many of these differences. An additional factor not usually considered is vitamin D. Previous studies have inversely correlated higher solar ultraviolet-B (UVB) doses and serum 25-hydroxyvitamin D (25(OH)D) concentrations with incidence and/or mortality rates for about 20 types of cancer and improved survival rates for eight types of cancer. Because of darker skin pigmentation, AAs have 40% lower serum 25(OH)D concentrations than WAs. This study reviews the literature on disparities in cancer survival between AAs and WAs. The journal literature indicates that there are disparities for 13 types of cancer after consideration of SES, stage at diagnosis and treatment: bladder, breast, colon, endometrial, lung, ovarian, pancreatic, prostate, rectal, testicular, and vaginal cancer; Hodgkin lymphoma and melanoma. Solar UVB doses and/or serum 25(OH)D concentrations have been reported inversely correlated with incidence and/or mortality rates for all of these cancers. This finding suggests that future studies should consider serum 25(OH)D concentrations in addressing cancer survival disparities through both measurements of serum 25(OH)D concentrations and increasing serum 25(OH)D concentrations of those diagnosed with cancer, leading to improved survival rates and reduced disparities. PMID:22928063

  13. Secondary cancer-incidence risk estimates for external radiotherapy and high-dose-rate brachytherapy in cervical cancer: phantom study.

    PubMed

    Lee, Boram; Ahn, Sung Hwan; Kim, Hyeyoung; Son, Jaeman; Sung, Jiwon; Han, Youngyih; Huh, Seung Jae; Kim, Jin Sung; Kim, Dong Wook; Yoon, Myonggeun

    2016-01-01

    This study was designed to estimate radiation-induced secondary cancer risks from high-dose-rate (HDR) brachytherapy and external radiotherapy for patients with cervical cancer based on measurements of doses absorbed by various organs. Organ doses from HDR brachytherapy and external radiotherapy were measured using glass rod dosimeters. Doses to out-of-field organs were measured at various loca-tions inside an anthropomorphic phantom. Brachytherapy-associated organ doses were measured using a specialized phantom that enabled applicator insertion, with the pelvis portion of the existing anthropomorphic phantom replaced by this new phantom. Measured organ doses were used to calculate secondary cancer risk based on Biological Effects of Ionizing Radiation (BEIR) VII models. In both treatment modalities, organ doses per prescribed dose (PD) mostly depended on the distance between organs. The locations showing the highest and lowest doses were the right kidney (external radiotherapy: 215.2 mGy; brachytherapy: 655.17 mGy) and the brain (external radiotherapy: 15.82 mGy; brachytherapy: 2.49 mGy), respectively. Organ doses to nearby regions were higher for brachytherapy than for external beam therapy, whereas organ doses to distant regions were higher for external beam therapy. Organ doses to distant treatment regions in external radiotherapy were due primarily to out-of-field radiation resulting from scattering and leakage in the gantry head. For brachytherapy, the highest estimated lifetime attributable risk per 100,000 population was to the stomach (88.6), whereas the lowest risks were to the brain (0.4) and eye (0.4); for external radiotherapy, the highest and lowest risks were to the thyroid (305.1) and brain (2.4). These results may help provide a database on the impact of radiotherapy-induced secondary cancer incidence dur-ing cervical cancer treatment, as well as suggest further research on strategies to counteract the risks of radiotherapy-associated secondary

  14. The Effect of Administrative Boundaries and Geocoding Error on Cancer Rates in California

    PubMed Central

    Goldberg, Daniel W.; Cockburn, Myles G.

    2012-01-01

    Geocoding is often used to produce maps of disease rates from the diagnosis addresses of incident cases to assist with disease surveillance, prevention, and control. In this process, diagnosis addresses are converted into latitude/longitude pairs which are then aggregated to produce rates at varying geographic scales such as Census tracts, neighborhoods, cities, counties, and states. The specific techniques used within geocoding systems have an impact on where the output geocode is located and can therefore have an effect on the derivation of disease rates at different geographic aggregations. This paper investigates how county-level cancer rates are affected by the choice of interpolation method when case data are geocoded to the ZIP code level. Four commonly used areal unit interpolation techniques are applied and the output of each is used to compute crude county-level five-year incidence rates of all cancers in California. We found that the rates observed for 44 out of the 58 counties in California vary based on which interpolation method is used, with rates in some counties increasing by nearly 400% between interpolation methods. PMID:22469490

  15. Major lessons learned from a nationally-based community-academic partnership: addressing sibling adjustment to childhood cancer.

    PubMed

    Long, Kristin A; Goldish, Melanie; Lown, E Anne; Ostrowski, Nancy L; Alderfer, Melissa A; Marsland, Anna L; Ring, Sandra; Skala, Suzanne; Ewing, Linda J

    2015-03-01

    Prolonged, intensive treatment protocols for childhood cancer disrupt family routines and daily functioning, with effects extending to all family members. Despite their unique needs, siblings of children with cancer receive limited attention from community organizations and researchers. Community-academic partnerships may foster research that effectively assesses and addresses siblings' unmet needs. In this article, "community" refers to siblings of children with cancer who participate in SuperSibs!, a national nonprofit organization for siblings of children with cancer. This article (a) describes a replicable model for successful community-academic partnerships: the Sibling Research Advisory Board (SRAB) and (b) articulates "lessons learned" from this partnership, including documenting the ability to recruit a representative sample through a community organization. Lessons emerged from an iterative process of discussion and revision that involved all SRAB members. This case study describes approaches to overcoming practical obstacles in community-partnered research planning and implementation. To meet the common goals of identifying and addressing unmet sibling needs, SRAB partners learned to establish a common language, identify each team member's unique expertise, and acknowledge differences in approach (e.g., methodology, pace of accomplishment) between research and community service. SRAB's ability to recruit a representative sample was achieved through close collaboration with SuperSibs! and implementation of active recruitment strategies to overcome barriers to research participation. Protection of community member privacy was emphasized alongside methodological rigor. Community-academic partnerships enable research with high-need, hard-to-access populations. Proactively identifying and addressing common pitfalls of community-academic partnerships promotes community engagement and acceptability and facilitates high-quality research.

  16. 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

  17. A systematic review of patient-rated measures of radiodermatitis in breast cancer radiotherapy

    PubMed Central

    Schnur, Julie B.; Love, Bianca; Scheckner, Bari L.; Green, Sheryl; Wernicke, A. Gabriella; Montgomery, Guy H.

    2013-01-01

    During breast cancer radiotherapy, nearly all patients will experience radiodermatitis. Study objectives were to: 1) systematically review the literature on radiodermatitis and breast cancer; 2) summarize and describe patient-rated radiodermatitis measures; 3) determine whether consensus exists regarding subjective radiodermatitis measurement; and 4) provide recommendations for future research. PubMed and CINAHL were searched from their inception through August 2009. Study inclusion/exclusion criteria were: full abstract available; manuscript in English; focused on radiodermatitis resulting from breast cancer radiotherapy, and described a patient-rated empirical assessment of radiodermatitis. Three reviewers examined abstracts, and decisions about inclusion were reached by consensus. 22/237 mutually identified studies met selection criteria. Using a standardized abstraction form, three authors independently extracted relevant information. Results indicated that: 1) only 9% of the studies reviewed included a patient-rated measure; 2) generally, extant scales are very brief and focus almost exclusively on physical reactions, and 3) there is no “gold standard” measure of patient-rated radiodermatitis at this time. We conclude that significantly more research is needed to determine the best (most valid, reliable, sensitive, comprehensive) measure(s) to evaluate the experience of radiodermatitis from the patient’s perspective, and that further scale development efforts are needed. PMID:20838323

  18. [Recurrence and survival rate of advanced gastric cancer after preoperative intraarterial EAP I injection therapy].

    PubMed

    Takeuchi, K; Taniguchi, H; Miyata, K; Koyama, H; Tanaka, H; Ueshima, Y; Okano, S; Oguro, A; Itoh, A; Sawai, K

    1993-08-01

    In our department, curative operations were performed for 32 patients with advanced gastric cancer from April 1989 to August 1990. Preoperative intra-arterial injection therapy with etoposide (100 mg), pirarubicin (20 mg) and cisplatin (20 mg) was given 18 patients. Recurrence and survival rate were investigated. The survival rate of patients with preoperative intra-arterial injection therapy 45 months after operation was 59.2%, while that of patients without preoperative intra-arterial injection therapy was 75.8%. There were no significant differences between these two groups. Three lymph node recurrences were seen in patients with preoperative intra-arterial injection therapy (recurrence rate, 16.7%). Four recurrences were observed in patients without preoperative injection therapy (peritoneal dissemination 2, liver 1, local 1; recurrence rate, 28.6%). We earlier reported that preoperative intra-arterial cisplatin (40 or 60 mg) injection therapy may reduce the incidence of lymph node recurrence and liver metastasis but may not be effective to prevent postoperative peritoneal recurrence, while no peritoneal dissemination was observed in patients with preoperative intra-arterial EAP I injection therapy. Thus, it was concluded that further study of combination and dose of anti-cancer drug may improve effectiveness of preoperative intra-arterial injection therapy for gastric cancer.

  19. 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.

  20. Comparison of time-tradeoff utilities and rating scale values of cancer patients and their relatives: evidence for a possible plateau relationship.

    PubMed

    O'Leary, J F; Fairclough, D L; Jankowski, M K; Weeks, J C

    1995-01-01

    Because they are easy to administer, rating scales are often used as proxies for utility measures. The authors investigated the relationship between time-tradeoff utilities and rating scale values in two populations: 124 cancer patients asked to evaluate their current states of health and 102 relatives and close friends of cancer patients asked to evaluate health-state scenarios. None of the models tested effectively described the relationship between individual patients' rating scale values and time-tradeoff utilities for their current states of health. In contrast, both a plateau and a power-function model explained the variability in the responses of the relatives reasonably well (R2 = 0.56 and R2 = 0.58, respectively). Given that many respondents who were unwilling to trade off any time assigned rating scale values of well below 100, a plateau model may represent the best approach to adjusting rating scale values for health-state scenarios when it is not feasible to elicit time-tradeoff utilities. PMID:7783573

  1. 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.

  2. 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

  3. 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.

  4. Disparities in Cervical Cancer Mortality Rates as Determined by the Longitudinal Hyperbolastic Mixed-Effects Type II Model

    PubMed Central

    Tabatabai, Mohammad A.; Kengwoung-Keumo, Jean-Jacques; Eby, Wayne M.; Bae, Sejong; Guemmegne, Juliette T.; Manne, Upender; Fouad, Mona; Partridge, Edward E.; Singh, Karan P.

    2014-01-01

    Background The main purpose of this study was to model and analyze the dynamics of cervical cancer mortality rates for African American (Black) and White women residing in 13 states located in the eastern half of the United States of America from 1975 through 2010. Methods The cervical cancer mortality rates of the Surveillance, Epidemiology, and End Results (SEER) were used to model and analyze the dynamics of cervical cancer mortality. A longitudinal hyperbolastic mixed-effects type II model was used to model the cervical cancer mortality data and SAS PROC NLMIXED and Mathematica were utilized to perform the computations. Results Despite decreasing trends in cervical cancer mortality rates for both races, racial disparities in mortality rates still exist. In all 13 states, Black women had higher mortality rates at all times. The degree of disparities and pace of decline in mortality rates over time differed among these states. Determining the paces of decline over 36 years showed that Tennessee had the most rapid decline in cervical cancer mortality for Black women, and Mississippi had the most rapid decline for White Women. In contrast, slow declines in cervical cancer mortality were noted for Black women in Florida and for White women in Maryland. Conclusions In all 13 states, cervical cancer mortality rates for both racial groups have fallen. Disparities in the pace of decline in mortality rates in these states may be due to differences in the rates of screening for cervical cancers. Of note, the gap in cervical cancer mortality rates between Black women and White women is narrowing. PMID:25226583

  5. Regulating the Rate of Molecular Self-Assembly for Targeting Cancer Cells.

    PubMed

    Zhou, Jie; Du, Xuewen; Xu, Bing

    2016-05-01

    Besides tight and specific ligand-receptor interactions, the rate regulation of the formation of molecular assemblies is one of fundamental features of cells. But the latter receives little exploration for developing anticancer therapeutics. Here we show that a simple molecular design of the substrates of phosphatases-tailoring the number of phosphates on peptidic substrates-is able to regulate the rate of molecular self-assembly of the enzyme reaction product. Such a rate regulation allows selective inhibition of osteosarcoma cells over hepatocytes, which promises to target cancer cells in a specific organ. Moreover, our result reveals that the direct measurement of the rate of the self-assembly in a cell-based assay provides precise assessment of the cell targeting capability of self-assembly. This work, as the first report establishing rate regulation of a multiple-step process to inhibit cells selectively, illustrates a fundamentally new approach for controlling the fate of cells.

  6. Expected indoor sup 222 Rn levels in counties with very high and very low lung cancer rates

    SciTech Connect

    Cohen, B.L. )

    1989-12-01

    Counties in the US with high lung cancer rates should have higher average {sup 222}Rn levels than counties with low lung cancer rates, assuming the average {sup 222}Rn level in a county is not correlated with other factors that cause lung cancer. The magnitude of this effect was calculated, using the absolute risk model, the relative risk model, and an intermediate model, for females who died in 1950-1969. The results were similar for all three models. We concluded that, ignoring migration, the average Rn level in the highest lung cancer counties should be about three times higher than in the lowest lung cancer counties according to the theory. Preliminary data are presented indicating that the situation is quite the opposite: The average Rn level in the highest lung cancer counties was only about one-half that in the lowest lung cancer counties.

  7. 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.

  8. An examination of differential follow-up rates in cervical cancer screening.

    PubMed

    Fox, P; Amsberger, P; Zhang, X

    1997-06-01

    The purpose of this study was to test the hypothesis that follow-up rates for women with abnormal cervical cancer screening results vary by age, ethnicity, and initial screening results in California's Breast and Cervical Cancer Control Program. The sample consisted of women in the screening program who received an abnormal cervical screening result (N = 1.738). Bivariate and logistic regression analyses were utilized to examine variables that account for differences in follow-up rates among these women. Bivariate analysis showed significant differences by age, race/ethnicity, initial screening results, and urban/rural residence. In logistic regression analysis, these variables also retained significance. Severity of diagnosis was a highly significant predictor of follow-up. Women of color, older women, and women with less severe diagnoses should be targeted as groups needing assistance in adhering to follow-up recommendations. PMID:9178119

  9. 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

  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. 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.

  12. Development and pilot testing of an online intervention to support young couples' coping and adjustment to breast cancer.

    PubMed

    Fergus, K D; McLeod, D; Carter, W; Warner, E; Gardner, S L; Granek, L; Cullen, K I

    2014-07-01

    Couplelinks is an original, professionally facilitated online intervention tailored to the unique challenges facing young women with breast cancer and their male partners. The purpose of this evaluation was to determine the feasibility and acceptability of the intervention and areas for improvement. Sixteen couples were sequentially enrolled over an 18-month period. Couples provided feedback via a treatment satisfaction survey, and post-treatment interviews with a sub-group of participants. Qualitative information was analysed for themes relevant to the program's acceptability, perceived benefits and limitations, and directions for improvement. Of the 16 couples who enrolled, six completed four modules or less, and 10 completed the entire program. Completers reported satisfaction with the program overall, as well as with the website useability and professional facilitation. Reported benefits were: enhanced communication and self-other knowledge; creation of opportunities for meaningful, cancer-related discussion; affirmation of relationship strengths; and a greater sense of closeness between partners. The main reported limitation was how program participation disrupted the couple's usual routine. Themes related to non-completion suggest that partners with particularly elevated relational or illness-related distress, or with differential levels of motivation, are less likely to finish. These findings have led to targeted improvements to the website and intervention protocol. PMID:24472013

  13. Systemic mesenchymal stem cells reduce growth rate of cisplatin-resistant ovarian cancer.

    PubMed

    Zhu, Pengfei; Chen, Mo; Wang, Li; Ning, Yanxia; Liang, Jie; Zhang, Hao; Xu, Congjian; Chen, Sifeng; Yao, Liangqing

    2013-01-01

    Epithelial ovarian cancer is one of the most malignant cancers in women and resistant to chemotherapy is the major obstacle for the five-year survival rate. Cisplatin is one of the effective anticancer drug used in the ovarian cancer. To find a good strategy to cure the tumors which is resistant to cisplatin, the cisplatin-resistant 3SKOV3 cells were selected from SKOV-3 ovarian cancer cells. Furthermore, the isolated mesenchymal stem cells were infused systemically to try to cure the transplanted tumor induced by 3SKOV3 cells in nude mice. The morphology and cell membrane CD44 expression were investigated by microscope and flow cytometry. The biological behaviors of resistant 3SKOV3 and its parental SKOV3 cells, including proliferation, adhesion, and cell cycle were determined by CCK8, absorbance assay and FCM methods. The transplanted tumors were set up in nude mice with 3SKOV3 cells injection. The growth rate of transplanted tumors was detected following with MSCs injection. The 3SKOV3 cells have different morphologic manifestation and expressed high level of CD44 molecule. At the same time, 3SKOV3 cells have less adhesion ability and less S-phase ratio. The isolated MSCs from bone marrow could inhibit the growth of transplanted tumor via systemic injection. The cisplatin-resistant 3SKOV3 cells have the different biological behaviors as its parental SKOV3 cells. The present study indicated that systemic MSCs have the therapeutic role on ovarian cancer. However, further investigations are in progress to elucidate the underlying mechanism.

  14. Risk factors for breast cancer in a population with high incidence rates

    PubMed Central

    Wrensch, Margaret; Chew, Terri; Farren, Georgianna; Barlow, Janice; Belli, Flavia; Clarke, Christina; Erdmann, Christine A; Lee, Marion; Moghadassi, Michelle; Peskin-Mentzer, Roni; Quesenberry, Charles P; Souders-Mason, Virginia; Spence, Linda; Suzuki, Marisa; Gould, Mary

    2003-01-01

    Background This report examines generally recognized breast cancer risk factors and years of residence in Marin County, California, an area with high breast cancer incidence and mortality rates. Methods Eligible women who were residents of Marin County diagnosed with breast cancer in 1997–99 and women without breast cancer obtained through random digit dialing, frequency-matched by cases' age at diagnosis and ethnicity, participated in either full in-person or abbreviated telephone interviews. Results In multivariate analyses, 285 cases were statistically significantly more likely than 286 controls to report being premenopausal, never to have used birth control pills, a lower highest lifetime body mass index, four or more mammograms in 1990–94, beginning drinking after the age of 21, on average drinking two or more drinks per day, the highest quartile of pack-years of cigarette smoking and having been raised in an organized religion. Cases and controls did not significantly differ with regard to having a first-degree relative with breast cancer, a history of benign breast biopsy, previous radiation treatment, age at menarche, parity, use of hormone replacement therapy, age of first living in Marin County, or total years lived in Marin County. Results for several factors differed for women aged under 50 years or 50 years and over. Conclusions Despite similar distributions of several known breast cancer risk factors, case-control differences in alcohol consumption suggest that risk in this high-risk population might be modifiable. Intensive study of this or other areas of similarly high incidence might reveal other important risk factors proximate to diagnosis. PMID:12817999

  15. [How do parents adjust to a child with cancer? A clinical study of the psychosocial status of parents of children with cancer].

    PubMed

    Boesenecker, U; Hoffmeister, M; Niethammer, D

    1992-06-01

    As chronic life-threatening diseases, cancer or leukemia in children generates an extreme situation for the family involved that can go on for years. Psychosocial care for all family members by a pediatric oncologist should be integrated into the treatment plan, as this is both helpful and necessary.

  16. Chemotherapy Response Rates among Endometrial Cancer Patients with Elevated Serum Platelets

    PubMed Central

    Kizer, Nora T.; Hatem, Hatem; Nugent, Elizabeth K.; Zhou, Gongfu; Moore, Kathleen; Heller, Paul; Mutch, David G.; Thaker, Premal H.

    2015-01-01

    Objective This retrospective study evaluates the influence of serum platelet count on chemotherapy response rates among women with endometrial cancer. Methods From three separate cancer centers, a total of 318 patients with endometrial cancer who received post-operative chemotherapy between June 1999 and October 2009 were retrospectively identified. Endometrioid, serous, clear cell, and carcinosarcoma histologies were included. Subjects were classified as having an elevated platelet count if their serum platelet count was greater than 400 × 109/L at the time of initial diagnosis. Primary outcome was chemotherapy response, classified as either complete or partial/refractory. Secondary outcomes were disease free and disease specific survival (DFS, DSS). Chi-square and Student t-tests were performed as appropriate. Kaplan-Meier curves and Cox proportional hazards models were used to assess serum platelet effect on survival. Results There were 125 deaths, 76 recurrences, and 48 disease progressions. Of the total group, 53 (16.7%) were categorized as having an elevated platelet count. An elevated platelet count was associated with a lower chemotherapy response rate in univariate analysis (HR 2.8; 95% CI 1.46, 5.38; p <0.01). Multivariate analysis showed elevated platelets to be independently associated with decreased DFS (HR 2.24; 95% CI 1.26, 3.98; p<0.01) but not DSS (HR 1.03, 95%CI 0.56, 1.88, p=0.93). Conclusions Endometrial cancer patients with an elevated serum platelet count > 400 × 109/L may have lower chemotherapy response rates and are at increased risk for recurrence when compared to patients with a count within normal range. PMID:26098089

  17. Survival benefit and additional value of preoperative chemoradiotherapy in resectable gastric and gastro-oesophageal junction cancer: a direct and adjusted indirect comparison meta-analysis.

    PubMed

    Kumagai, K; Rouvelas, I; Tsai, J A; Mariosa, D; Lind, P A; Lindblad, M; Ye, W; Lundell, L; Schuhmacher, C; Mauer, M; Burmeister, B H; Thomas, J M; Stahl, M; Nilsson, M

    2015-03-01

    Several phase I/II studies of chemoradiotherapy for gastric cancer have reported promising results, but the significance of preoperative radiotherapy in addition to chemotherapy has not been proven. In this study, a systematic literature search was performed to capture survival and postoperative morbidity and mortality data in randomised clinical studies comparing preoperative (chemo)radiotherapy or chemotherapy versus surgery alone, or preoperative chemoradiotherapy versus chemotherapy for gastric and/or gastro-oesophageal junction (GOJ) cancer. Hazard ratios (HRs) for overall mortality were extracted from the original studies, individual patient data provided from the principal investigators of eligible studies or the earlier published meta-analysis. The incidences of postoperative morbidities and mortalities were also analysed. In total 18 studies were eligible and data were available from 14 of these. The meta-analysis on overall survival yielded HRs of 0.75 (95% CI 0.65-0.86, P < 0.001) for preoperative (chemo)radiotherapy and 0.83 (95% CI 0.67-1.01, P = 0.065) for preoperative chemotherapy when compared to surgery alone. Direct comparison between preoperative chemoradiotherapy and chemotherapy resulted in an HR of 0.71 (95% CI 0.45-1.12, P = 0.146). Combination of direct and adjusted indirect comparisons yielded an HR of 0.86 (95% CI 0.69-1.07, P = 0.171). No statistically significant differences were seen in the risk for postoperative morbidity or mortality between preoperative treatments and surgery alone, or preoperative (chemo)radiotherapy and chemotherapy. Preoperative (chemo)radiotherapy for gastric and GOJ cancer showed significant survival benefit over surgery alone. In comparisons between preoperative chemotherapy and (chemo)radiotherapy, there is a trend towards improved survival when adding radiotherapy, without increased postoperative morbidity or mortality.

  18. The thickness history of the northern sector of the Laurentide Ice Sheet: an assessment of glacial isostatic adjustment models, sea-level measurements, and vertical land motion rates

    NASA Astrophysics Data System (ADS)

    Simon, K. M.; James, T. S.; Henton, J. A.; Dyke, A.

    2014-12-01

    The fit of glacial isostatic adjustment (GIA) model predictions to 24 relative sea-level histories and an additional 18 present-day GPS-measured vertical land motion rates constrains the thickness and volume history of the central and northern Laurentide Ice Sheet. The predictions of the best-fit GIA model indicate respective peak ice thicknesses west and east of Hudson Bay of 3.4-3.6 km and approximately 4 km. These values represent, respectively, a large decrease, and a moderate increase, to the load thickness compared to ICE-5G. This result is generally consistent with other GIA studies focussing on space-geodetic constraints. The large reduction to the ice load west of Hudson Bay also reduces the vertical mantle response along the margins of the load centre, which improves the fit to relative sea-level data from the southern Canadian Arctic Archipelago. The fit of GIA model predictions to relative sea-level data from the Baffin Sector of the Laurentide Ice Sheet indicate peak ice thicknesses there of 1.2-1.3 km, a modest reduction compared to ICE-5G. On Baffin Island, the modelled elastic crustal response of the Earth to present-day ice mass changes is large. Accounting for this effect improves the agreement between GPS measurements of vertical crustal motion and the GIA model predictions. However, work is needed to incorporate more detailed observations and modelling of present-day changes to glaciers and ice caps. Overall, the fit to the data is most strongly improved in the region west of Hudson Bay (the χ2 RSL misfit is reduced by a factor of ~4) although the entire revised reconstruction for the central and northern Laurentide Ice Sheet provides an improved fit to both the regional RSL data (the cumulative χ2 misfit is reduced by a factor of >2) and the GPS data (the RMS misfit is reduced by a factor of 9).

  19. Prenatal multivitamin supplementation and rates of pediatric cancers: a meta-analysis.

    PubMed

    Goh, Y I; Bollano, E; Einarson, T R; Koren, G

    2007-05-01

    Prenatal supplementation of folic acid has been shown to decrease the risk of several congenital malformations. Several studies have recently suggested a potential protective effect of folic acid on certain pediatric cancers. The protective role of prenatal multivitamins has not been elucidated. We conducted a systematic review and meta-analysis to assess the potential protective effect of prenatal multivitamins on several pediatric cancers. Medline, PubMed, EMBASE, Toxline, Healthstar, and Cochrane databases were searched for studies published in all languages from 1960 to July 2005 on multivitamin supplementation and pediatric cancers. References from all articles collected were reviewed for additional articles. Two blinded independent reviewers assessed the articles for inclusion and exclusion. Rates of cancers in women supplemented with multivitamins were compared with unsupplemented women using a random effects model. Sixty-one articles were identified in the initial search, of which, seven articles met the inclusion criteria. There was an apparent protective effect for leukemia (odds ratio (OR)=0.61, 95% confidence interval (CI)=0.50-0.74), pediatric brain tumors (OR=0.73, 95% CI=0.60-0.88) and neuroblastoma (OR=0.53, 95% CI=0.42-0.68). In conclusion, maternal ingestion of prenatal multivitamins is associated with a decreased risk for pediatric brain tumors, neuroblastoma, and leukemia. Presently, it is not known which constituent(s) among the multivitamins confer this protective effect. PMID:17314929

  20. Report of a consensus meeting on focal low dose rate brachytherapy for prostate cancer.

    PubMed

    Langley, Stephen; Ahmed, Hashim U; Al-Qaisieh, Bashar; Bostwick, David; Dickinson, Louise; Veiga, Francisco Gomez; Grimm, Peter; Machtens, Stefan; Guedea, Ferran; Emberton, Mark

    2012-02-01

    What's known on the subject? and What does the study add? Whole gland brachytherapy has been used to successfully treat prostate cancer but the protocol for focal therapy has not previously been established. The consensus findings provide guidance on patient selection for focal brachytherapy as well as recommendations for conducting therapy and patient follow-up. Low dose rate prostate brachytherapy is an effective treatment for localized prostate cancer. Recently, it has been considered for use in a focused manner whereby treatment is targeted only to areas of prostate cancer. The objective of focal brachytherapy is to provide effective cancer control for low-risk disease but with reduced genitourinary and rectal side-effects in a cost-effective way. We report on the outputs of a consensus meeting of international experts in brachytherapy and focal therapy convened to consider the feasibility and potential development of focal brachytherapy. A number of factors were considered for focal brachytherapy including optimal patient selection, disease characterization and localization, treatment protocols and outcome measures. The consensus meeting also addressed the design of a clinical trial that would assess the oncological outcomes and side-effect profiles resulting from focal brachytherapy. PMID:22239224

  1. 25 CFR 171.565 - How will I know if BIA plans to adjust my annual operation and maintenance assessment rate?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... OF THE INTERIOR LAND AND WATER IRRIGATION OPERATION AND MAINTENANCE Financial Matters: Assessments, Billing, and Collections § 171.565 How will I know if BIA plans to adjust my annual operation...

  2. Contralateral prophylactic mastectomy rate stable at major Canadian breast cancer center

    PubMed Central

    Roberts, Amanda; Sandhu, Lakhbir; Cil, Tulin D; Hofer, Stefan O P; Zhong, Toni

    2016-01-01

    AIM: To examine trends of contralateral prophylactic mastectomy (CPM) rates at a Canadian academic breast cancer center. METHODS: A single-institution retrospective cohort study was completed. Women of any age who underwent at least a unilateral mastectomy (UM) for primary unilateral breast carcinoma between January 1, 2004 and December 31, 2010 were included. Patients who underwent CPM on the same day as UM were isolated to create two distinct cohorts. Patient and procedure characteristics were compared across groups using R software (version 3.1.0). The percentage of CPMs per year was determined. The Cochrane-Armitage test was used to assess the trend of CPMs over time. A P value of < 0.05 was considered significant. RESULTS: A total of 811 women met the inclusions/exclusion criteria; 759 (93.6%) underwent UM alone and 52 (6.4%) underwent UM with immediate CPM. The absolute number of procedures (UM and UM + CPM) increased over time, from 83 in 2004 to 147 in 2010 reflecting an increase in mastectomy volume. Annual CPM rates did not increase over time (P = 0.7) and varied between 2.6% to 10.7%. Family history of breast cancer [OR 3.6 (1.8-7.3)] and immediate reconstruction [10.0 (5.2-19.3)] were both significantly associated with CPM. Women who underwent CPM were younger (median age CPM 49 years vs UM 52 years, P < 0.0001) but age less than 50 years was not statistically associated with increased rates of CPM. CONCLUSION: CPM rates from 2004 to 2010 at a high-volume Canadian breast cancer center did not increase over time, in contrast to trends observed in the United States. PMID:27298770

  3. Prostate Cancer Biochemical Recurrence Rates After Robotic-Assisted Laparoscopic Radical Prostatectomy

    PubMed Central

    Ginzburg, Serge; Nevers, Thomas; Staff, Ilene; Tortora, Joseph; Champagne, Alison; Kesler, Stuart S.; Laudone, Vincent P.

    2012-01-01

    Background and Objectives: To determine prostate cancer biochemical recurrence rates with respect to surgical margin (SM) status for patients undergoing robotic-assisted laparoscopic radical prostatectomy (RALP). Methods: IRB-approved radical prostatectomy database was queried. Patients were stratified as low, intermediate, and high risk according to D’Amico's risk classification. Postoperative prostate-specific antigen (PSA) values were obtained every 3 mo for the first year, then biannually and annually thereafter. Biochemical recurrence was defined as ≥0.2ng/mL. Patients receiving adjuvant or salvage treatment were included. Positive surgical margin was defined as presence of cancer cells at inked resection margin in the final specimen. Margin presence (negative/positive), margin multiplicity (single/multiple), and margin length (≤3mm focal and >3mm extensive) were noted. Kaplan-Meier curves of biochemical recurrence-free survival (BRFS) as a function of SM were generated. Forward stepwise multivariate Cox regression was performed, with preoperative PSA, Gleason score, pathologic stage, prostate gland weight, and SM as covariates. Results: At our institution, 1437 patients underwent RALP (2003-2009). Of these, 1159 had sufficient data and were included in our analysis. Mean follow-up was 16 mo. Kaplan-Meier curves demonstrated significant increase in BRFS in low-risk and intermediate-risk groups with negative SM. Overall BRFS at 5 y was 72%. Gleason score, pathologic stage, and SM status were significant prognostic factors in multivariate analysis. Conclusions: Negative surgical margins resulted in lower biochemical recurrence rates for low-risk and intermediate-risk groups. Multifocal and longer positive margins were associated with higher biochemical recurrence rates compared with unifocal and shorter positive margins. Documenting biochemical recurrence rates for RALP is important, because this treatment for localized prostate cancer is validated. PMID

  4. 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

  5. Mutational Biases Drive Elevated Rates of Substitution at Regulatory Sites across Cancer Types.

    PubMed

    Kaiser, Vera B; Taylor, Martin S; Semple, Colin A

    2016-08-01

    Disruption of gene regulation is known to play major roles in carcinogenesis and tumour progression. Here, we comprehensively characterize the mutational profiles of diverse transcription factor binding sites (TFBSs) across 1,574 completely sequenced cancer genomes encompassing 11 tumour types. We assess the relative rates and impact of the mutational burden at the binding sites of 81 transcription factors (TFs), by comparing the abundance and patterns of single base substitutions within putatively functional binding sites to control sites with matched sequence composition. There is a strong (1.43-fold) and significant excess of mutations at functional binding sites across TFs, and the mutations that accumulate in cancers are typically more disruptive than variants tolerated in extant human populations at the same sites. CTCF binding sites suffer an exceptionally high mutational load in cancer (3.31-fold excess) relative to control sites, and we demonstrate for the first time that this effect is seen in essentially all cancer types with sufficient data. The sub-set of CTCF sites involved in higher order chromatin structures has the highest mutational burden, suggesting a widespread breakdown of chromatin organization. However, we find no evidence for selection driving these distinctive patterns of mutation. The mutational load at CTCF-binding sites is substantially determined by replication timing and the mutational signature of the tumor in question, suggesting that selectively neutral processes underlie the unusual mutation patterns. Pervasive hyper-mutation within transcription factor binding sites rewires the regulatory landscape of the cancer genome, but it is dominated by mutational processes rather than selection. PMID:27490693

  6. 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.

  7. 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.

  8. 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.

  9. Predicting cancer rates in astronauts from animal carcinogenesis studies and cellular markers.

    PubMed

    Williams, J R; Zhang, Y; Zhou, H; Osman, M; Cha, D; Kavet, R; Cuccinotta, F; Dicello, J F; Dillehay, L E

    1999-12-01

    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

  10. 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

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

    PubMed Central

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

    2016-01-01

    Obese premenopausal women with breast cancer have poorer prognosis for long term survival, in part because their tumors are larger at the time of diagnosis than are found in normal weight women. Whether larger tumor mass is due to obesity-related barriers to detection or to effects on tumor biology is not known. This study used polygenic models for obesity and breast cancer to deconstruct this question with the objective of determining whether cell autonomous mechanisms contribute to the link between obesity and breast cancer burden. Assessment of the growth rates of 259 chemically induced mammary carcinomas from rats sensitive to dietary induced obesity (DS) and of 143 carcinomas from rats resistant (DR) to dietary induced obesity revealed that tumors in DS rats grew 1.8 times faster than in DR rats. This difference may be attributed to alterations in cell cycle machinery that permit more rapid tumor cell accumulation. DS tumors displayed protein expression patterns consistent with reduced G1/S checkpoint inhibition and a higher threshold of factors required for execution of the apoptotic cell death pathway. These mechanistic insights identify regulatory targets for life style modifications or pharmacological interventions designed to disrupt the linkage between obesity and tumor burden. PMID:27077880

  12. Association of soil arsenic and nickel exposure with cancer mortality rates, a town-scale ecological study in Suzhou, China.

    PubMed

    Chen, Kai; Liao, Qi Lin; Ma, Zong Wei; Jin, Yang; Hua, Ming; Bi, Jun; Huang, Lei

    2015-04-01

    Heavy metals and arsenic are well-known carcinogens. However, few studies have examined whether soil heavy metals and arsenic concentrations associate with cancer in the general population. In this ecological study, we aimed to evaluate the association of heavy metals and arsenic in soil with cancer mortality rates during 2005-2010 in Suzhou, China, after controlling for education and smoking prevalence. In 2005, a total of 1683 soil samples with a sampling density of one sample every 4 km(2) were analyzed. Generalized linear model with a quasi-Poisson regression was applied to evaluate the association between town-scale cancer mortality rates and soil heavy metal concentrations. Results showed that soil arsenic exposure had a significant relationship with colon, gastric, kidney, lung, and nasopharyngeal cancer mortality rates and soil nickel exposure was significantly associated with liver and lung cancer. The associations of soil arsenic and nickel exposure with colon, gastric, kidney, and liver cancer in male were higher than those in female. The observed associations of soil arsenic and nickel with cancer mortality rates were less sensitive to alternative exposure metrics. Our findings would contribute to the understanding of the carcinogenic effect of soil arsenic and nickel exposure in general population. PMID:25410308

  13. 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.

  14. 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…

  15. 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…

  16. 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.

  17. 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.

  18. Salvage high-dose-rate (HDR) brachytherapy for recurrent head-and-neck cancer

    SciTech Connect

    Hepel, Jaroslaw T.; Syed, A.M. Nisar . E-mail: bvigil@memnet.org; Puthawala, Ajmel; Sharma, Anil; Frankel, Paul

    2005-08-01

    Background: A significant portion of head-and-neck cancer patients will develop persistent or recurrent disease after definitive treatment. Radiation therapy is often used as definitive therapy or as an adjunct to surgery. Recurrent cancer of the head and neck in the previously irradiated field is, thus, a common occurrence and poses a therapeutic challenge. Some studies have evaluated low-dose-rate (LDR) brachytherapy as a therapeutic option, including a large case series with long-term follow-up by our own institution. High-dose-rate (HDR) brachytherapy offers therapeutic advantages over LDR brachytherapy. This study evaluates the local control and outcomes of patients with previously irradiated recurrent head-and-neck cancer treated with HDR interstitial brachytherapy. Methods and Materials: Between 1997 and 2002, 30 patients who received prior radiation therapy for primary tumors of the head and neck were treated for biopsy-proven recurrent disease. All patients received previous radiation as definitive therapy alone or as adjunct to surgery. All patients were inoperable, refused surgery, or had gross residual disease after salvage surgery for their recurrent disease. Thirty-six sites on the 30 patients were implanted by application of high-dose-rate interstitial brachytherapy techniques with mean tumor dose of 34 Gy (18-48 Gy) in twice daily fractions of 300 to 400cGy per fraction. Results: At a minimum follow-up of 12 months, local tumor control was achieved in 69% of implanted sites. Disease-specific survival at 1 and 2 years was 54% and 45%, respectively. Overall survival at 1 and 2 years was 56% and 37%, respectively. Grade 3/4 late complications occurred in 16% of the patients. No fatal complications occurred. Conclusion: HDR brachytherapy can play an important role in the salvage treatment of previously irradiated recurrent head-and-neck cancer. This study shows that comparable results are obtained by HDR brachytherapy with fewer late complications than

  19. Self-rated health and type 2 diabetes risk in the European Prospective Investigation into Cancer and Nutrition-InterAct study: a case-cohort study

    PubMed Central

    Wennberg, Patrik; Rolandsson, Olov; van der A, Daphne L; Spijkerman, Annemieke M W; Kaaks, Rudolf; Boeing, Heiner; Feller, Silke; Bergmann, Manuela M; Langenberg, Claudia; Sharp, Stephen J; Forouhi, Nita; Riboli, Elio; Wareham, Nicholas

    2013-01-01

    Objectives To investigate the association between self-rated health and risk of type 2 diabetes and whether the strength of this association is consistent across five European centres. Design Population-based prospective case-cohort study. Setting Enrolment took place between 1992 and 2000 in five European centres (Bilthoven, Cambridge, Heidelberg, Potsdam and Umeå). Participants Self-rated health was assessed by a baseline questionnaire in 3399 incident type 2 diabetic case participants and a centre-stratified subcohort of 4619 individuals from the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct study which was drawn from a total cohort of 340 234 participants in the EPIC. Primary outcome measure Prentice-weighted Cox regression was used to estimate centre-specific HRs and 95% CIs for incident type 2 diabetes controlling for age, sex, centre, education, body mass index (BMI), smoking, alcohol consumption, energy intake, physical activity and hypertension. The centre-specific HRs were pooled across centres by random effects meta-analysis. Results Low self-rated health was associated with a higher hazard of type 2 diabetes after adjusting for age and sex (pooled HR 1.67, 95% CI 1.48 to 1.88). After additional adjustment for health-related variables including BMI, the association was attenuated but remained statistically significant (pooled HR 1.29, 95% CI 1.09 to 1.53). I2 index for heterogeneity across centres was 13.3% (p=0.33). Conclusions Low self-rated health was associated with a higher risk of type 2 diabetes. The association could be only partly explained by other health-related variables, of which obesity was the strongest. We found no indication of heterogeneity in the association between self-rated health and type 2 diabetes mellitus across the European centres. PMID:23471609

  20. Influence of Preoperative Radiation Field on Postoperative Leak Rates in Esophageal Cancer Patients after Trimodality Therapy

    PubMed Central

    Juloori, Aditya; Tucker, Susan L.; Komaki, Ritsuko; Liao, Zhongxing; Correa, Arlene M.; Swisher, Stephen G.; Hofstetter, Wayne L.; Lin, Steven H.

    2014-01-01

    Introduction Postoperative morbidities, such as anastomotic leaks, are common after trimodality therapy (chemoradiation followed by surgery) for esophageal cancer. We investigated for factors associated with an increased incidence of anastomotic leaks. Methods Data from 285 esophageal cancer patients treated from 2000–2011 with trimodality therapy was analyzed. Anastomotic location relative to preoperative radiation field was assessed using postoperative computed tomographic imaging. Logistic regression was used to evaluate for factors associated with any or clinically relevant (CR) (≥ grade 2) leaks. Results Overall anastomotic leak rate was 11% (31/285), and CR leak rate was 6% (17/285). Multivariable analysis identified body mass index (BMI) (OR 1.09, 95%CI 1.00–1.17; OR 1.11, 95%CI 1.01–1.22), three-field surgery (OR 10.01, 95%CI 3.83–26.21; OR 4.83, 95%CI 1.39–16.71), and within radiation field (“in-field”) anastomosis (OR 5.37, 95%CI 2.21–13.04; OR 8.63, 95%CI 2.90–25.65) as independent predictors of both all grade and CR leaks, respectively. While patients with distal esophageal tumors and Ivor-Lewis surgery had the lowest incidence of all grade (6.5%) and CR leaks (4.2%), most of the leaks were associated with the anastomosis constructed within the field of radiation (in-field: 39% and 30% versus out-of-field: 2.6% and 1.0%, respectively, for total and CR leaks, p<0.0001, Fisher’s Exact test). Conclusions Esophagogastric anastomosis placed within the preoperative radiation field was a very strong predictor for anastomotic leaks in esophageal cancer patients treated with trimodality therapy, among other factors. Surgical planning should include a critical evaluation of the preoperative radiation fields to ensure proper anastomotic placement after chemoradiation therapy. PMID:24736077

  1. 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.

  2. 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.

  3. 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

  4. Cost-Effectiveness of Different Cervical Screening Strategies in Islamic Republic of Iran: A Middle-Income Country with a Low Incidence Rate of Cervical Cancer

    PubMed Central

    Nahvijou, Azin; Daroudi, Rajabali; Tahmasebi, Mamak; Amouzegar Hashemi, Farnaz; Rezaei Hemami, Mohsen; Akbari Sari, Ali; Barati Marenani, Ahmad; Zendehdel, Kazem

    2016-01-01

    Objective Invasive cervical cancer (ICC) is the fourth most common cancer among women worldwide. Cervical screening programs have reduced the incidence and mortality rates of ICC. We studied the cost-effectiveness of different cervical screening strategies in the Islamic Republic of Iran, a Muslim country with a low incidence rate of ICC. Methods We constructed an 11-state Markov model, in which the parameters included regression and progression probabilities, test characteristics, costs, and utilities; these were extracted from primary data and the literature. Our strategies included Pap smear screening and human papillomavirus (HPV) DNA testing plus Pap smear triaging with different starting ages and screening intervals. Model outcomes included lifetime costs, life years gained, quality-adjusted life years (QALY), and incremental cost-effectiveness ratios (ICERs). One-way sensitivity analysis was performed to examine the stability of the results. Results We found that the prevented mortalities for the 11 strategies compared with no screening varied from 26% to 64%. The most cost-effective strategy was HPV screening, starting at age 35 years and repeated every 10 years. The ICER of this strategy was $8,875 per QALY compared with no screening. We found that screening at 5-year intervals was also cost-effective based on GDP per capita in Iran. Conclusion We recommend organized cervical screening with HPV DNA testing for women in Iran, beginning at age 35 and repeated every 10 or 5 years. The results of this study could be generalized to other countries with low incidence rates of cervical cancer. PMID:27276093

  5. A Q-Switched All-Solid-State Single-Longitudinal-Mode Laser with Adjustable Pulse-Width and High Repetition Rate

    NASA Astrophysics Data System (ADS)

    Zhou, Jun; Xu, Shi-Zhong; Hou, Xia; Wei, Hui; Chen, Wei-Biao

    2006-01-01

    A single-longitudinal-mode (SLM) laser-diode pumped Nd: YAG laser with adjustable pulse width is developed by using the techniques of pre-lasing and changing polarization of birefingent crystal. The Q-switching voltage is triggered by the peak of the pre-lasing pulse to achieve the higher stability of output pulse energy. The output energy of more than 1 mJ is obtained with output energy stability of 3% (rms) at 100 Hz. The pulse-width can be adjusted from 30 ns to 300 ns by changing the Q-switching voltage. The probability of putting out single-longitudinal-mode pulses is almost 100%. The laser can be run over four hours continually without mode hopping.

  6. Role of solar UVB irradiance and smoking in cancer as inferred from cancer incidence rates by occupation in Nordic countries

    PubMed Central

    2012-01-01

    A large body of evidence indicates that solar ultraviolet-B (UVB) irradiance and vitamin D reduce the risk of incidence and death for many types of cancer. However, most of that evidence comes from midlatitude regions, where solar UVB doses are generally high in summer. Data on cancer standardized incidence ratios (SIRs) by sex and 54 occupation categories based on 1.4 million male and 1.36 million female cancer cases for 1961–2005 in the five Nordic countries provide the basis for an ecological study of the role of solar UVB in the risk of many types of cancer at high latitudes. Lip cancer SIRs less lung cancer SIRs for men was the best index of solar UVB dose, which was weakly inversely correlated with both melanoma and nonmelanoma skin cancer (NMSC) SIRs. Lung cancer SIRs were used as the index of the effects of smoking. For men, the UVB index was significantly inversely correlated with 14 types of internal cancer—bladder, breast, colon, gallbladder, kidney, laryngeal, liver, lung, oral, pancreatic, pharyngeal, prostate, rectal and small intestine cancer. For women, the same UVB index was inversely correlated with bladder, breast and colon cancer. These results generally agree with findings from other studies. These results provide more support for the UVB-vitamin D-cancer hypothesis and suggest that widespread fear of chronic solar ultraviolet (UV) irradiance may be misplaced. PMID:22928078

  7. Concordance of parent-, teacher- and self-report ratings on the Conners 3 in adolescent survivors of cancer.

    PubMed

    Willard, Victoria W; Conklin, Heather M; Huang, Lu; Zhang, Hui; Kahalley, Lisa S

    2016-09-01

    Survivors of childhood cancer are at risk for attention problems. The objectives of this study were to assess concordance between parent-, teacher-, and self-report ratings on a measure of attention (Conners Rating Scales, 3rd ed.; Conners, 2008) in adolescent survivors of childhood cancer and to examine associations with a performance-based task. The was completed by 80 survivors of pediatric cancer (39 brain tumor, 41 acute lymphoblastic leukemia; ages 12-17; at least 1 year posttreatment; 51.3% male) as well as their parents and 1 teacher. In addition, survivors completed a continuous performance test. Parents and teachers demonstrated moderate agreement on most subscales; however, agreement was weaker than would be expected based on the normative sample. Agreement between self- and proxy ratings was more variable. The strongest associations for all raters were observed on the Learning Problems subscale. There were significant mean differences between parent and teacher ratings, with parents reporting more problems across subscales. Only self-ratings of Inattention were significantly associated with the continuous performance test (omission errors). Agreement across raters in assessment of attentional functioning in adolescent survivors of childhood cancer is modest. Findings support the need to obtain multiple ratings of behavior, including both proxy- and self-report, when assessing youth with cancer, particularly adolescents. (PsycINFO Database Record

  8. Concordance of parent-, teacher- and self-report ratings on the Conners 3 in adolescent survivors of cancer.

    PubMed

    Willard, Victoria W; Conklin, Heather M; Huang, Lu; Zhang, Hui; Kahalley, Lisa S

    2016-09-01

    Survivors of childhood cancer are at risk for attention problems. The objectives of this study were to assess concordance between parent-, teacher-, and self-report ratings on a measure of attention (Conners Rating Scales, 3rd ed.; Conners, 2008) in adolescent survivors of childhood cancer and to examine associations with a performance-based task. The was completed by 80 survivors of pediatric cancer (39 brain tumor, 41 acute lymphoblastic leukemia; ages 12-17; at least 1 year posttreatment; 51.3% male) as well as their parents and 1 teacher. In addition, survivors completed a continuous performance test. Parents and teachers demonstrated moderate agreement on most subscales; however, agreement was weaker than would be expected based on the normative sample. Agreement between self- and proxy ratings was more variable. The strongest associations for all raters were observed on the Learning Problems subscale. There were significant mean differences between parent and teacher ratings, with parents reporting more problems across subscales. Only self-ratings of Inattention were significantly associated with the continuous performance test (omission errors). Agreement across raters in assessment of attentional functioning in adolescent survivors of childhood cancer is modest. Findings support the need to obtain multiple ratings of behavior, including both proxy- and self-report, when assessing youth with cancer, particularly adolescents. (PsycINFO Database Record PMID:27537005

  9. 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.

  10. 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....

  11. Understanding why aspirin prevents cancer and why consuming very hot beverages and foods increases esophageal cancer risk. Controlling the division rates of stem cells is an important strategy to prevent cancer.

    PubMed

    López-Lázaro, Miguel

    2015-01-01

    Cancer is, in essence, a stem cell disease. The main biological cause of cancer is that stem cells acquire DNA alterations during cell division. The more stem cell divisions a tissue accumulates over a lifetime, the higher is the risk of cancer in that tissue. This explains why cancer is diagnosed millions of times more often in some tissues than in others, and why cancer incidence increases so dramatically with age. It may also explain why taking a daily low-dose aspirin for several years reduces the risk of developing and dying from cancer. Since aspirin use reduces PGE2 levels and PGE2 fuels stem cell proliferation, aspirin may prevent cancer by restricting the division rates of stem cells. The stem cell division model of cancer may also explain why regular consumption of very hot foods and beverages increases the risk of developing esophageal cancer. Given that tissue injury activates stem cell division for repair, the thermal injury associated with this dietary habit will increase esophageal cancer risk by inducing the accumulation of stem cell divisions in the esophagus. Using these two examples, here I propose that controlling the division rates of stem cells is an essential approach to preventing cancer. PMID:26682276

  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. 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

  14. 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

  15. First-line erlotinib and fixed dose-rate gemcitabine for advanced pancreatic cancer

    PubMed Central

    Vaccaro, Vanja; Bria, Emilio; Sperduti, Isabella; Gelibter, Alain; Moscetti, Luca; Mansueto, Giovanni; Ruggeri, Enzo Maria; Gamucci, Teresa; Cognetti, Francesco; Milella, Michele

    2013-01-01

    AIM: To investigate activity, toxicity, and prognostic factors for survival of erlotinib and fixed dose-rate gemcitabine (FDR-Gem) in advanced pancreatic cancer. METHODS: We designed a single-arm prospective, multicentre, open-label phase II study to evaluate the combination of erlotinib (100 mg/d, orally) and weekly FDR-Gem (1000 mg/m2, infused at 10 mg/m2 per minute) in a population of previously untreated patients with locally advanced, inoperable, or metastatic pancreatic cancer. Primary endpoint was the rate of progression-free survival at 6 mo (PFS-6); secondary endpoints were overall response rate (ORR), response duration, tolerability, overall survival (OS), and clinical benefit. Treatment was not considered to be of further interest if the PFS-6 was < 20% (p0 = 20%), while a PFS-6 > 40% would be of considerable interest (p1 = 40%); with a 5% rejection error (α = 5%) and a power of 80%, 35 fully evaluable patients with metastatic disease were required to be enrolled in order to complete the study. Analysis of prognostic factors for survival was also carried out. RESULTS: From May 2007 to September 2009, 46 patients were enrolled (male/female: 25/21; median age: 64 years; median baseline carbohydrate antigen 19-9 (CA 19-9): 897 U/mL; locally advanced/metastatic disease: 5/41). PFS-6 and median PFS were 30.4% and 14 wk (95%CI: 10-19), respectively; 1-year and median OS were 20.2% and 26 wk (95%CI: 8-43). Five patients achieved an objective response (ORR: 10.9%, 95%CI: 1.9-19.9); disease control rate was 56.5% (95%CI: 42.2-70.8); clinical benefit rate was 43.5% (95%CI: 29.1-57.8). CA 19-9 serum levels were decreased by > 25% as compared to baseline in 14/23 evaluable patients (63.6%). Treatment was well-tolerated, with skin rash being the most powerful predictor of both longer PFS (P < 0.0001) and OS (P = 0.01) at multivariate analysis (median OS for patients with or without rash: 42 wk vs 15 wk, respectively, Log-rank P = 0.03). Additional predictors of

  16. 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.

  17. Social Network Effects of Nonlifesaving Early-Stage Breast Cancer Detection on Mammography Rates

    PubMed Central

    Parker, Andrew M.

    2014-01-01

    Objectives. We estimated the effect of anecdotes of early-stage, screen-detected cancer for which screening was not lifesaving on the demand for mammography. Methods. We constructed an agent-based model of mammography decisions, in which 10 000 agents that represent women aged 40 to 100 years were linked together on a social network, which was parameterized with a survey of 716 women conducted through the RAND American Life Panel. Our model represents a population in equilibrium, with demographics reflecting the current US population based on the most recent available census data. Results. The aggregate effect of women learning about 1 category of cancers—those that would be detected but would not be lethal in the absence of screening—was a 13.8 percentage point increase in annual screening rates. Conclusions. Anecdotes of detection of early-stage cancers relayed through social networks may substantially increase demand for a screening test even when the detection through screening was nonlifesaving. PMID:25322304

  18. Changes in heart-rate variability of survivors of nasopharyngeal cancer during Tai Chi Qigong practice

    PubMed Central

    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.

    2015-01-01

    [Purpose] To explore the changes in heart-rate variability (HRV) of survivors of nasopharyngeal cancer (NPC) before, during, and after a Tai Chi (TC) Qigong exercise. [Subjects and Methods] Eleven survivors of NPC participated voluntarily in the study. The heart rate of each participant was measured continuously for 1 minute before the TC Qigong intervention, during the 5-minute TC Qigong intervention, and for 1 minute after the intervention, using a Polar heart-rate monitor. Spectral HRV was expressed in terms of normalised low frequency (LF) power, normalised high frequency (HF) power, and the low frequency/high frequency (LF/HF) power ratio. [Results] Both the LF-power and the HF-power components had significant time effects. However, the time effect of the LF/HF power ratio was not significant. Post hoc contrast analysis revealed a significant decrease in LF power and a concomitant increase in HF power during the 4th minute and 5th minute of the TC Qigong exercise. [Conclusion] Five minutes of TC Qigong exercise was found to improve HRV by increasing HF power and decreasing LF power, but these effects were transient. TC Qigong might be an appropriate exercise for improving the ANS function and psychological and cardiac health of survivors of NPC. PMID:26157266

  19. High dose rate endorectal brachytherapy as a neoadjuvant treatment for patients with resectable rectal cancer.

    PubMed

    Vuong, T; Devic, S; Podgorsak, E

    2007-11-01

    In the era of total mesorectal surgery, the issue of radiation toxicity is raised. A novel endocavitary brachytherapy technique was tested as a neoadjuvant treatment for patients with resectable rectal cancer. The objectives of the study were to evaluate the treatment-related toxicity and effects on local recurrence. A dose of 26 Gy was prescribed to the gross tumour volume and intramesorectal deposits seen on magnetic resonance imaging and given over four daily treatments, using the high dose rate delivery system followed by surgery 6-8 weeks later. The study included 93 T3, four T4 and three T2 tumours. Acute proctitis of grade 2 was observed in all patients, but one required transfusion. At a median follow-up time of 60 months, the 5-year actual local recurrence rate was 5%, disease-free survival was 65%, and overall survival was 70%. High dose rate endorectal brachytherapy seems to prevent local recurrence and has a favourable toxicity pattern compared with external beam radiotherapy. PMID:17714925

  20. 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.

  1. 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

  2. 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

  3. The distribution of Yin-Deficient symptoms and their relationship on survival rate in cancer patients with Yin-Deficiency.

    PubMed

    Lin, Shu-Chuan; Chen, Ming-Feng; Li, Tsai-Chung; Hsieh, Yu-Ho; Liu, Shwu-Jiuan

    2008-01-01

    Yin-Deficiency (YD), representing a status of the human body under lack of nutrition and fluid in traditional Chinese medicine, is commonly seen in late stage of cancer patients. It is not known whether the severity of YD related symptoms/signs can predict the survival rate of cancer patients. This study evaluated the distribution of Yin-deficiency symptoms/signs (YDS) in cancer patients with YD, and investigated whether the severity of YDS can predict the survival rate of cancer patients with YD. From 5 January 2007 to 5 May 2007, we selected 43 cancer patients with diagnosis of YD from hospitalized patients and outpatients. The severity of YD was evaluated by a questionnaire. We further estimated the cumulative probabilities of the survival rates over 4 months since the start of study by the Kaplan-Meier product-limit method, and compared the differences among groups with various severities in each symptom/sign with the use of the log-rank test. The results revealed that, the 3 most common YDS were sleeplessness with annoyance, less or non-coated tongue with or without redness and dry mouth. In the survival rate analysis, only 2 parameters, rapidly small pulse (p = 0.002) and less-or non-coated tongue with paleness (p = 0.017), were found to be related to the decrease of cancer patients with YD. This suggests that, both rapidly small pulse and less-or non-coated tongue without redness may be used as predictors for the estimation of survival rate in cancer patients with YD. PMID:18711763

  4. 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

  5. Tissue pattern recognition error rates and tumor heterogeneity in gastric cancer.

    PubMed

    Potts, Steven J; Huff, Sarah E; Lange, Holger; Zakharov, Vladislav; Eberhard, David A; Krueger, Joseph S; Hicks, David G; Young, George David; Johnson, Trevor; Whitney-Miller, Christa L

    2013-01-01

    The anatomic pathology discipline is slowly moving toward a digital workflow, where pathologists will evaluate whole-slide images on a computer monitor rather than glass slides through a microscope. One of the driving factors in this workflow is computer-assisted scoring, which depends on appropriate selection of regions of interest. With advances in tissue pattern recognition techniques, a more precise region of the tissue can be evaluated, no longer bound by the pathologist's patience in manually outlining target tissue areas. Pathologists use entire tissues from which to determine a score in a region of interest when making manual immunohistochemistry assessments. Tissue pattern recognition theoretically offers this same advantage; however, error rates exist in any tissue pattern recognition program, and these error rates contribute to errors in the overall score. To provide a real-world example of tissue pattern recognition, 11 HER2-stained upper gastrointestinal malignancies with high heterogeneity were evaluated. HER2 scoring of gastric cancer was chosen due to its increasing importance in gastrointestinal disease. A method is introduced for quantifying the error rates of tissue pattern recognition. The trade-off between fully sampling tumor with a given tissue pattern recognition error rate versus randomly sampling a limited number of fields of view with higher target accuracy was modeled with a Monte-Carlo simulation. Under most scenarios, stereological methods of sampling-limited fields of view outperformed whole-slide tissue pattern recognition approaches for accurate immunohistochemistry analysis. The importance of educating pathologists in the use of statistical sampling is discussed, along with the emerging role of hybrid whole-tissue imaging and stereological approaches.

  6. Rates of Cancers and Opportunistic Infections in Patients With Psoriatic Arthritis Compared With Patients Without Psoriatic Arthritis

    PubMed Central

    Hagberg, Katrina Wilcox; Li, Lin; Peng, Michael; Paris, Maria; Shah, Kamal; Jick, Susan S.

    2016-01-01

    Objectives This study aimed to estimate rates of cancer or opportunistic infection in patients with psoriatic arthritis (PsA) compared with patients without PsA. Methods Using the Clinical Practice Research Datalink, we conducted a cohort study of patients with a PsA diagnosis and patients without such diagnosis, matched on age, sex, general practice, and calendar time, to assess the incidence of cancers (solid, hematologic, and nonmelanoma skin cancer) and opportunistic infections. We estimated incidence rates (IRs) and IR ratios (IRRs) with 95% confidence intervals (CIs) for each outcome and stratified results in the PsA cohort by receipt of systemic PsA drugs. Results The rate of hematologic cancer was slightly higher in the PsA cohort compared with the non-PsA cohort (IRR, 1.52; 95% CI, 1.10–2.10), whereas the rates of solid cancer and of nonmelanoma skin cancer were similar between the PsA and non-PsA cohorts (IRR, 1.01; 95% CI, 0.90–1.13; and IRR, 0.97; 95% CI, 0.82–1.14, respectively). Incidence rates were higher for PsA patients who received prescriptions for PsA drugs compared with those who did not. The IRs for infection were higher in the PsA compared with the non-PsA cohort (IRR, 1.39; 95% CI, 1.31–1.47) and were significantly higher in patients who received prescriptions (IRR, 1.71; 95% CI, 1.52–1.91). Conclusions The rates of solid and nonmelanoma skin cancers were similar in patients with PsA compared with patients without PsA, but the rates of hematologic cancer and opportunistic infections were higher in patients with PsA. In patients with PsA, rates of all outcomes were higher among those who received prescriptions for systemic PsA therapy. PMID:26886439

  7. 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

  8. 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

  9. Time-adjusted variable resistor

    NASA Technical Reports Server (NTRS)

    Heyser, R. C.

    1972-01-01

    Timing mechanism was developed effecting extremely precisioned highly resistant fixed resistor. Switches shunt all or portion of resistor; effective resistance is varied over time interval by adjusting switch closure rate.

  10. Heart Rate Variability in Breast Cancer Survivors After the First Year of Treatments: A Case-Controlled Study.

    PubMed

    Caro-Morán, Elena; Fernández-Lao, Carolina; Galiano-Castillo, Noelia; Cantarero-Villanueva, Irene; Arroyo-Morales, Manuel; Díaz-Rodríguez, Lourdes

    2016-01-01

    The same aggressive treatments that have led to a reduction in the breast cancer may also have adverse effects on cardiac autonomic balance. The objective of this study was to compare heart rate variability (HRV) between breast cancer survivors in the first year posttreatment and healthy women, controlling for known confounders. This descriptive case-controlled study included 22 breast cancer survivors and 22 healthy age- and sex-matched controls. Short-term HRV was measured using an accepted methodology to assess the cardiac autonomic balance. One-way analysis of covariance results revealed that heart rate was significantly higher (F = 15.86, p < .001) and the standard deviation of normal-to-normal (NN) interval (F = 19.93, p = .001), square root of mean squared differences of successive NN intervals (F = 18.72, p = .001), HRV index (F = 5.44, p = .025), and high-frequency (F = 5.77, p = .03) values were significantly lower in the breast cancer survivors than in the matched controls. The principal finding of the presence of a cardiovascular imbalance in breast cancer survivors in comparison to healthy age-matched controls suggests that HRV study could be a clinically useful tool to detect cardiovascular disease in early-stage breast cancer survivors.

  11. 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

  12. Single fraction multimodal image guided focal salvage high-dose-rate brachytherapy for recurrent prostate cancer

    PubMed Central

    Rischke, Hans-Christian; Meyer, Philipp Tobias; Knobe, Sven; Volgeova-Neher, Natalja; Kollefrath, Michael; Jilg, Cordula Annette; Grosu, Anca Ligia; Baltas, Dimos; Kroenig, Malte

    2016-01-01

    Purpose We present a novel method for treatment of locally recurrent prostate cancer (PCa) following radiation therapy: focal, multimodal image guided high-dose-rate (HDR) brachytherapy. Material and methods We treated two patients with recurrent PCa after primary (#1) or adjuvant (#2) external beam radiation therapy. Multiparametric magnetic resonance imaging (mpMRI), choline, positron emission tomography combined with computed tomography (PET/CT), or prostate-specific membrane antigen (PSMA)-PET combined with CT identified a single intraprostatic lesion. Positron emission tomography or magnetic resonance imaging – transrectal ultrasound (MRI-TRUS) fusion guided transperineal biopsy confirmed PCa within each target lesion. We defined a PET and mpMRI based gross tumor volume (GTV). A 5 mm isotropic margin was applied additionally to each lesion to generate a planning target volume (PTV), which accounts for technical fusion inaccuracies. A D90 of 18 Gy was intended in one fraction to each PTV using ultrasound guided HDR brachytherapy. Results Six month follow-up showed adequate prostate specific antygen (PSA) decline in both patients (ΔPSA 83% in patient 1 and ΔPSA 59.3% in patient 2). Follow-up 3-tesla MRI revealed regressive disease in both patients and PSMA-PET/CT showed no evidence of active disease in patient #1. No acute or late toxicities occurred. Conclusions Single fraction, focal, multimodal image guided salvage HDR brachytherapy for recurrent prostate cancer is a feasible therapy for selected patients with single lesions. This approach has to be evaluated in larger clinical trials. PMID:27504134

  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. 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

  15. 42 CFR 419.43 - Adjustments to national program payment and beneficiary copayment amounts.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...) Payment adjustment for certain cancer hospitals.—(1) General rule. CMS provides for a payment adjustment... (PCR) before the cancer hospital payment adjustment (as determined by the Secretary at cost report...-cost ratio (PCR) before the cancer hospital payment adjustment (as determined by the Secretary at...

  16. Colorectal cancer risk information presented by a nonphysician assistant does not increase screening rates

    PubMed Central

    Wilkins, Thad; Gillies, Ralph A.; Panchal, Pina; Patel, Mittal; Warren, Peter; Schade, Robert R.

    2014-01-01

    Abstract Objective To determine the effectiveness of presenting individualized colorectal cancer (CRC) risk information for increasing CRC screening rates in primary care patients at above-average risk of CRC. Design Randomized controlled trial. Setting Georgia Regents University in Augusta—an academic family medicine clinic in the southeastern United States. Participants Outpatients (50 to 70 years of age) scheduled for routine visits in the family medicine clinic who were determined to be at above-average risk of CRC. Interventions Individualized CRC risk information calculated from the Your Disease Risk tool compared with a standard CRC screening handout. Main outcome measures Intention to complete CRC screening. Secondary measures included the proportions of subjects completing fecal occult blood tests, flexible sigmoidoscopy, and colonoscopy. Results A total of 1147 consecutive records were reviewed to determine eligibility. Overall, 210 (37.7%) of 557 eligible participants were randomized to receive either individualized CRC risk information (prepared by a research assistant) or a standard CRC screening handout. The intervention group had a mean (SD) age of 55.7 (4.8) years and the control group had a mean (SD) age of 55.6 (4.6) years. Two-thirds of the participants in each group were female. The intervention group and the control group were matched by race (P = .40). There was no significant difference between groups for intention to complete CRC screening (P = .58). Overall, 26.7% of the intervention participants and 27.7% of the control participants completed 1 or more CRC screening tests (P = .66). Conclusion Presentation of individualized CRC risk information by a nonphysician assistant as a decision aid did not result in higher CRC screening rates in primary care patients compared with presentation of general CRC screening information. Future research is needed to determine if physician presentation of CRC risk information would result in increased

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

    ClinicalTrials.gov

    2016-01-10

    Metastatic Malignant Neoplasm in the Brain; Recurrent Non-Small Cell Lung Carcinoma; Stage IIA Non-Small Cell Lung Carcinoma; Stage IIB Non-Small Cell Lung Carcinoma; Stage IIIA Non-Small Cell Lung Cancer; Stage IIIB Non-Small Cell Lung Cancer; Stage IV Non-Small Cell Lung Cancer

  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. Depression Screening Using Daily Mental-Health Ratings from a Smartphone Application for Breast Cancer Patients

    PubMed Central

    Kim, Junetae; Lim, Sanghee; Min, Yul Ha; Shin, Yong-Wook; Lee, Byungtae; Sohn, Guiyun; Jung, Kyung Hae; Lee, Jae-Ho; Son, Byung Ho; Ahn, Sei Hyun; Shin, Soo-Yong

    2016-01-01

    Background Mobile mental-health trackers are mobile phone apps that gather self-reported mental-health ratings from users. They have received great attention from clinicians as tools to screen for depression in individual patients. While several apps that ask simple questions using face emoticons have been developed, there has been no study examining the validity of their screening performance. Objective In this study, we (1) evaluate the potential of a mobile mental-health tracker that uses three daily mental-health ratings (sleep satisfaction, mood, and anxiety) as indicators for depression, (2) discuss three approaches to data processing (ratio, average, and frequency) for generating indicator variables, and (3) examine the impact of adherence on reporting using a mobile mental-health tracker and accuracy in depression screening. Methods We analyzed 5792 sets of daily mental-health ratings collected from 78 breast cancer patients over a 48-week period. Using the Patient Health Questionnaire-9 (PHQ-9) as the measure of true depression status, we conducted a random-effect logistic panel regression and receiver operating characteristic (ROC) analysis to evaluate the screening performance of the mobile mental-health tracker. In addition, we classified patients into two subgroups based on their adherence level (higher adherence and lower adherence) using a k-means clustering algorithm and compared the screening accuracy between the two groups. Results With the ratio approach, the area under the ROC curve (AUC) is 0.8012, indicating that the performance of depression screening using daily mental-health ratings gathered via mobile mental-health trackers is comparable to the results of PHQ-9 tests. Also, the AUC is significantly higher (P=.002) for the higher adherence group (AUC=0.8524) than for the lower adherence group (AUC=0.7234). This result shows that adherence to self-reporting is associated with a higher accuracy of depression screening. Conclusions Our results

  20. Rates and predictors of colorectal cancer screening by race among motivated men participating in a prostate cancer risk assessment program

    PubMed Central

    Hall, Michael J.; Ruth, Karen; Giri, Veda N.

    2011-01-01

    Background Screening by fecal occult blood test and lower endoscopy have lowered colorectal cancer (CRC) mortality, but compliance gaps persist. Of concern are possible disparities in uptake of CRC screening between White and African American (AA) men. Our goal was to assess for disparities in uptake of CRC screening among men participating in a high-risk prostate cancer clinic. If present, such disparities could support hypotheses for further research examining racial differences in awareness and patient preferences in undergoing CRC screening. Methods Baseline data on a racially diverse cohort of men age 50–69 at increased risk of prostate cancer collected via the prostate cancer risk assessment program (PRAP) at Fox Chase Cancer Center were analyzed. Predictors of uptake of CRC screening were assessed using multivariable logistic regression. Results Compared to Whites, AA men had statistically significantly lower uptake of fecal occult blood testing (AA 49.0% vs White 60.7%, p=0.035), lower endoscopy (AA 44.1% vs White 58.5%, p=0.011), and any CRC screening (AA 66.2% vs White 76.3%, p=0.053). Predictors of uptake of lower endoscopy among AA men included older age (OR 3.61, 95% CI 1.87–6.97), family history of CRC (OR 3.47, 95% CI 1.30–9.25), and insurance status (OR 1.90, 95% CI 1.04–3.46). Conclusion Despite awareness of cancer risk and motivation to seek prostate cancer screening through a specialized prostate cancer risk assessment program, evidence supporting compliance gaps with CRC screening among men was found. Tailored messages to younger AA men with and without a family history of CRC are needed. PMID:21751189

  1. 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

  2. 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

  3. 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

  4. 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.

  5. Adjustment versus no adjustment when using adjustable sutures in strabismus surgery

    PubMed Central

    Liebermann, Laura; Hatt, Sarah R.; Leske, David A.; Holmes, Jonathan M.

    2013-01-01

    Purpose To compare long-term postoperative outcomes when performing an adjustment to achieve a desired immediate postoperative alignment versus simply tying off at the desired immediate postoperative alignment when using adjustable sutures for strabismus surgery. Methods We retrospectively identified 89 consecutive patients who underwent a reoperation for horizontal strabismus using adjustable sutures and also had a 6-week and 1-year outcome examination. In each case, the intent of the surgeon was to tie off and only to adjust if the patient was not within the intended immediate postoperative range. Postoperative success was predefined based on angle of misalignment and diplopia at distance and near. Results Of the 89 patients, 53 (60%) were adjusted and 36 (40%) were tied off. Success rates were similar between patients who were simply tied off immediately after surgery and those who were adjusted. At 6 weeks, the success rate was 64% for the nonadjusted group versus 81% for the adjusted group (P = 0.09; difference of 17%; 95% CI, −2% to 36%). At 1 year, the success rate was 67% for the nonadjusted group versus 77% for the adjusted group (P = 0.3; difference of 11%; 95% CI, −8% to 30%). Conclusions Performing an adjustment to obtain a desired immediate postoperative alignment did not yield inferior long-term outcomes to those obtained by tying off to obtain that initial alignment. If patients were who were outside the desired immediate postoperative range had not been not adjusted, it is possible that their long-term outcomes would have been worse, therefore, overall, an adjustable approach may be superior to a nonadjustable approach. PMID:23415035

  6. Environmental radioactivity and high incidence rates of stomach and esophagus cancer in the Van Lake region: a causal relationship?

    PubMed

    Akan, Zafer; Baskurt, Busranur; Asliyuksek, Hizir; Kam, Erol; Yilmaz, Ahmet; Yuksel, Mehmet Bilgehan; Biyik, Recep; Esen, Ramazan; Koca, Dogan

    2014-01-01

    This study examined the incidence rates of cancer cases (averages for 2006-2010) and relationships with environmental radioactivity levels. Soil and water samples were collected from provincial and district centers of Van city and the outdoor gamma doses were determined using a portable gamma scintillation detector. Gross alpha and beta, (226)Ra, (232)Th, and (40)K activities were measured in both tap water and soil samples. Although high rates of stomach and esophagus cancers have been reported previously in Van the underlying reasons have not hitherto been defined. Incidences of cancers were highest in the Gurpinar (326.0) and Ozalp (377.1) counties (p<0.001). As to the results of the gross alpha and gross beta radioactivity measurements in the drinking water, these two counties also had high beta radionuclide levels: Gurpinar (140 mBq/dm3) and Ozalp (206 mBq/dm3). Even if within the normal range, a relation between the higher rate of the incidence of stomach and esophagus cancers with that of the higher rate of beta radionuclide activity was clear. On Spearman correlation analysis, the relation between higher beta radionuclide levels and cancer incidence was found to be statistically significant (p<0.01). According to the results of the analysis, Van residents receive an average 1.86 mSv/y annual dose from outdoor gamma radiation, ingestion of radionuclides in the drinking water, and indoor 222Rn activity. Moreover, gross alpha and beta activities were found to be extremely high in all of the lakes around the city of Van, Turkey. Further investigations with long-term detailed environmental radiation measurements are needed regarding the relationship between cancer cases and environmental radioactivity in the city of Van.

  7. [Recurrence and survival rate of advanced gastric cancer after preoperative EAP-II intra-arterial infusion therapy].

    PubMed

    Masuyama, M; Taniguchi, H; Takeuchi, K; Miyata, K; Koyama, H; Tanaka, H; Higashida, T; Koishi, Y; Mugitani, T; Yamaguchi, T

    1994-09-01

    Ninety-eight patients with advanced gastric cancers underwent gastrectomy from Jan. 1989 to Dec. 1991. For these patients, preoperative intra-arterial injection therapy using EAP-II (etoposide 100 mg, epirubicin 20 mg, carboplatin 100 mg) was given to 24 patients. In this report, the recurrence and survival rate of these patients were investigated. After curative resection, the survival rate of patients with EAP-II 36 months after operation was 76.9%, while that of patients without EAP-II was 78.6%. There were no significant differences between these two groups. Two peritoneal carcinomatoses and two liver metastases were seen in patients with EAP-II (recurrence rate, 30.7%). Eight recurrences were observed in patients without preoperative injection therapy (peritoneal dissemination, 4; local recurrence, 3; lymph node recurrence, 1). Previously, we reported that drugs were remarkably accumulated in gastric cancer tissue and regional lymph nodes after EAP-II intra-arterial injection therapy. This high accumulation might cause no local or lymph node recurrence was seen in patient with EAP-II. Thus, it was concluded that preoperative EAP-II intra-arterial injection may prevent local and lymph node recurrences, and that further study of the combination and dose of anti-cancer drug needed to improve the postoperative survival rate in advanced gastric cancer patients.

  8. A single measure of cancer burden combining incidence with mortality rates for worldwide application.

    PubMed

    Kim, Jeong Lim; Cho, Kyoung-Hee; Park, Eun-Cheol; Cho, Woo Hyun

    2014-01-01

    We attempted to develop an indicator combining incidence and mortality (summary indicator of cancer burden, SMCB) and to compare the magnitudes of cancer burden by world region. The SMCB was used to measure the size of cancer burden summarizing the incidence and mortality. The incidence and mortality were divided in equivalent forms and were split. The criteria dividing the size of cancer burden were used as the maximum incidence and mortality by men and women according to the world database, and the value corresponding to 10% of each maximum was set as the cut-off value. In SMCB, the size of cancer burden was highest for men with lung cancer (SMCB=18) and for women with breast cancer (SMCB=14) in MDR (more developed regions) compared to the size of burden in LDR (lower developed regions) (lung, SMCB=11, breast, SMCB=8). For men, the size of cancer burden by region was highest in EURO (SMCB=18, lung), followed by WPRO (SMCB=16, lung), PAHO (SMCB=14, prostate), AFRO (SMCB=8, prostate) and SEARO (SMCB=7, lung). Moreover, for women, the size of cancer burden was greatest in EURO (SMCB=14, breast), followed by PAHO (SMCB=13, breast), AFRO (SMCB=11, cervix uteri), EMRO (SMCB=9, breast) or SEARO (SMCB=8, cervix uteri) and WPRO (SMCB=7, lung). The summary indicator will help to provide a priority setting for reducing cancer burden in health policy.

  9. 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

  10. 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.

  11. High-dose-rate interstitial brachytherapy for female peri-urethral cancer

    PubMed Central

    Gandhi, Ajeet Kumar; Bhatla, Neerja; Kumar, Sunesh; Rath, Goura Kisor

    2016-01-01

    Purpose Peri-urethral cancer (PUC) in females is a rare malignancy. Surgery is not usually contemplated due to associated morbidity. Radiation therapy (RT) can be employed in the form of interstitial brachytherapy (IBT) alone for early lesions, and external beam radiation therapy (EBRT) with or without IBT for advanced lesions. We report our first experience in the literature to evaluate the role of high-dose-rate (HDR) IBT in female PUC. Material and methods Between 2008 and 2013, 10 female patients with PUC (5 primary and 5 recurrent) were treated with HDR-IBT with or without EBRT at our center. Size of the lesion ranged from 1.5 cm to 5.0 cm. A 2-3 plane free-hand implant was performed using plastic catheters. The prescribed dose of HDR-IBT was 42 Gy in 14 fractions for brachytherapy alone (5 patients), and 18-21 Gy for the boost along with EBRT (5 patients). Patients were followed up regularly for assessment of disease control and toxicity. Results At a median follow up of 25 months, six patients were disease free at their last follow up. Four patients developed recurrence: 2 at inguinal nodes, 1 at local site, and 1 at both local as well as inguinal nodes. Moist desquamation was the commonest acute toxicity observed in all 5 patients treated with IBT alone, which healed within 4 weeks’ time. Overall, grade II delayed complication rate was 30%. Conclusions Though small sample size, the results of our study have shown that HDR-IBT provides good loco-regional control with acceptable toxicity for female PUC. PMID:26985196

  12. Venous Invasion in Colorectal Cancer: Impact of Morphologic Findings on Detection Rate

    PubMed Central

    Hwang, Chungsu; Lee, Sojeong; Kim, Ahrong; Kim, Young-Geum; Ahn, Sang-Jeong; Park, Do Youn

    2016-01-01

    Purpose Venous invasion (VI) is widely accepted as a poor prognostic factor in colorectal cancer (CRC), and is indicated as a high-risk factor determining the use of adjuvant chemotherapy in CRC. However, there is marked interobserver and intraobserver variability in VI identification and marked variability in the real prevalence of VI in CRC. Materials and Methods We investigated the detection rate of VI in 93 consecutive cases of T3 or T4 CRC based on the following: original pathology report, review of hematoxylin and eosin (H&E) slides with attention to the “protruding tongue” and “orphan arteriole” signs, and elastic stain as the gold standard. Results Overall, the detection rate of VI was significantly increased as follows: 14/93 (15.1%) in the original pathology report, 38/93 (40.9%) in review of H&E slides with attention to the “protruding tongue” and “orphan arteriole” signs, and 45/93 (48.4%) using elastic stain. VI detection based on morphologic features showed 77.8% sensitivity and 91.1% specificity and showed a linear correlation (Spearman correlation coefficient, 0.727; p < 0.001) with VI detected by elastic stain. In addition, improved agreement between detection methods (detection on the basis of morphologic features, κ=0.719 vs. original pathology report, κ=0.318) was observed using kappa statistics. Conclusion Slide review with special attention to the “protruding tongue” and “orphan arteriole” signs could be used for better identification of VI in CRC in routine surgical practice. PMID:26875194

  13. 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

  14. 5 CFR 9701.336 - Treatment of employees whose pay does not fall below the minimum adjusted rate of their band.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM (DEPARTMENT OF HOMELAND SECURITY-OFFICE OF PERSONNEL MANAGEMENT) DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Locality and Special Rate Supplements § 9701.336 Treatment of employees whose pay does not...

  15. [Hemodynamic benefits of AV interval adjustment and heart rate increase during exercise in dual-chamber pacing as determined by Doppler].

    PubMed

    Sancho-Tello, M J; Salvador, A; Olagüe, J

    1990-01-01

    In order to determine the relative significance of ventricular rate increase and AV delay on exercise cardiac output, we have studied 10 patients (8 male and 2 female, 16-59 years) with complete chronic heart block treated with AV sequential pacing. Cardiac output variations (delta CO) were estimated by pulsed Doppler comparisons of the aortic flow velocity in the supine position, at rest and during bicycle exercise. The following pacing programs were tested: DDD with AV intervals of 50, 100 and 150 ms (DDD50 o DDDD100, DDD150), VVI at 70 ppm (VVI70), and VVI at the maximal available rate in this pacing mode-113 or 130 ppm depending on the PM type (VVIM). Exercise measurements in DDD mode were taken when that rate was reached. The delta CO was calculated as a percent change of the product flow velocity integral x heart rate, from that obtained with VVI70 mode at rest. At rest, the delta CO obtained with DDD pacing was 20.4 +/- 14.7% and the optimal AV delay was 50 ms in 1 patient, 100 ms in 3 patients and 150 ms in six. During exercise, the delta CO was higher in DDD and VVIM modes (82.0 +/- 30.8% and 56.2 +/- 37.6%, respectively; p less than 0.01) than in VVI70 mode (20.4 +/- 10.4%; p less than 0.005), the greatest delta CO was reached at DDD mode in 8 out of 10 patients (p less than 0.03). The optimal AV delays were 50 ms in 5 patients, 100 ms in 4 patients and 150 ms in one. Thus, DDD pacing with the optimal AV delay seems to obtain greater haemodynamic benefits during exercise than does rate-responsive pacing; the optimal exercise AV delay varies from patient to patient and is usually less than 150 ms. PMID:2236802

  16. Ethnic Disparities in Cancer Incidence among Residents of Guam

    PubMed Central

    Haddock, Robert L; Whippy, Helen JD; Talon, Rebecca J; Montano, Melani V

    2015-01-01

    Cancer incidence data collected by the Guam Cancer Registry for the period 1998 through 2002 were analyzed by cancer site, age, and ethnicity. Ethnicity and site specific age-adjusted cancer incidence rates for Guam residents were calculated utilizing Guam 2000 census data and the U.S. 2000 standard population and were compared to U.S. 2000 data. Age-adjusted total cancer incidence rates per 100,000 population for the major ethnic groups represented on Guam were generally lower than U.S. averages (the exception was the Caucasian group which was higher). Some highlights include: 1). Chamorros (the indigenous people of the Mariana Islands) living on Guam had a slightly lower total cancer incidence rate than the total U.S. population (406.8/100,000 vs. 478.6 U.S.). Chamorros had high age-adjusted incidence rates for cancers of the mouth and pharynx (24.4 vs. U.S. 10.7), nasopharynx (13.9 vs. 0.6 U.S.), liver (13.2 vs. 5.2 U.S.), and cervix (16.2 vs. 9.6 U.S.). Rates for prostate cancer (103.9 vs. 167.7 U.S.), female breast (115.9 vs. 130.9 U.S.), ovary (7.0 vs. 14.2 U.S.), colon-rectum-anus (44.3 vs. 56.9 U.S.), leukemia (11.0 vs. 12.6 U.S.), and non-Hodgkin lymphoma (7.0 vs. 18.9 U.S.) were all lower than U.S. rates. 2). Filipinos living on Guam had high age-adjusted incidence rates for cancers of the nasopharynx (5.1), and liver (9.6). Filipinos had low age-adjusted incidence rates for all cancers (215.7), cancers of the mouth and pharynx when NPC was excluded (4.8), lung and bronchus (35.6 vs. U.S. 70.1), pancreas (1.7 vs. U.S. 11.1), colon-rectum-anus (37.1), female breast (60.7), prostate (46.1), leukemia (4.7), and non-Hodgkin lymphoma (8.4). 3). Micronesians other than Chamorros had the highest age-adjusted incidence rates for cancers of the lung and bronchus (111.5), liver (39.4), and cervix (27.4). Micronesians had low age-adjusted incidence rates for cancers of the colon-rectum-anus (4.1), female breast (35.0), prostate (78.4), leukemia (6.3), and non

  17. Ethnic disparities in cancer incidence among residents of Guam.

    PubMed

    Haddock, Robert L; Whippy, Helen J D; Talon, Rebecca J; Montano, Melani V

    2009-01-01

    Cancer incidence data collected by the Guam Cancer Registry for the period 1998 through 2002 were analyzed by cancer site, age, and ethnicity. Ethnicity and site specific age-adjusted cancer incidence rates for Guam residents were calculated utilizing Guam 2000 census data and the U.S. 2000 standard population and were compared to U.S. 2000 data. Age-adjusted total cancer incidence rates per 100,000 population for the major ethnic groups represented on Guam were generally lower than U.S. averages (the exception was the Caucasian group which was higher). Some highlights include: 1). Chamorros (the indigenous people of the Mariana Islands) living on Guam had a slightly lower total cancer incidence rate than the total U.S. population (406.8/100,000 vs. 478.6 U.S.). Chamorros had high age-adjusted incidence rates for cancers of the mouth and pharynx (24.4 vs. U.S. 10.7), nasopharynx (13.9 vs. 0.6 U.S.), liver (13.2 vs. 5.2 U.S.), and cervix (16.2 vs. 9.6 U.S.). Rates for prostate cancer ( 103.9 vs. 167.7 U.S.), female breast (115.9 vs. 130.9 U.S.), ovary (7.0 vs. 14.2 U.S.), colon-rectum-anus (44.3 vs. 56.9 U.S.), leukemia (11.0 vs. 12.6 U.S.), and non-Hodgkin lymphoma (7.0 vs. 18.9 U.S.) were all lower than U.S. rates. 2). Filipinos living on Guam had high age-adjusted incidence rates for cancers of the nasopharynx (5.1), and liver (9.6). Filipinos had low age-adjusted incidence rates for all cancers (215.7), cancers of the mouth and pharynx when NPC was excluded (4.8), lung and bronchus (35.6 vs. U.S. 70.1), pancreas (1.7 vs. U.S. 11.1), colon-rectum-anus (37.1), female breast (60.7), prostate (46.1), leukemia (4.7), and non-Hodgkin lymphoma (8.4). 3). Micronesians other than Chamorros had the highest age-adjusted incidence rates for cancers of the lung and bronchus (111.5), liver (39.4), and cervix (27.4). Micronesians had low age-adjusted incidence rates for cancers of the colon-rectum-anus (4.1), female breast (35.0), prostate (78.4), leukemia (6.3), and non

  18. High Hospitalization Rates in Survivors of Childhood Cancer: A Longitudinal Follow-Up Study Using Medical Record Linkage.

    PubMed

    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; Geskus, Ronald B; Kremer, Leontien C

    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

  19. 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

  20. High Hospitalization Rates in Survivors of Childhood Cancer: A Longitudinal Follow-Up Study Using Medical Record Linkage.

    PubMed

    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; Geskus, Ronald B; Kremer, Leontien C

    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.