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This study investigates the impact of primary care utilisation of a symptom-based head and neck cancer risk calculator (Head and Neck Cancer Risk Calculator version 2) in the post-coronavirus disease 2019 period on the number of primary care referrals and cancer diagnoses.
Methods
The number of referrals from April 2019 to August 2019 and from April 2020 to July 2020 (pre-calculator) was compared with the number from the period January 2021 to August 2022 (post-calculator) using the chi-square test. The patients’ characteristics, referral urgency, triage outcome, Head and Neck Cancer Risk Calculator version 2 score and cancer diagnosis were recorded.
Results
In total, 1110 referrals from the pre-calculator period were compared with 1559 from the post-calculator period. Patient characteristics were comparable for both cohorts. More patients were referred on the cancer pathway in the post-calculator cohort (pre-calculator patients 51.1 per cent vs post-calculator 64.0 per cent). The cancer diagnosis rate increased from 2.7 per cent in the pre-calculator cohort to 3.3 per cent in the post-calculator cohort. A lower rate of cancer diagnosis in the non-cancer pathway occurred in the cohort managed using the Head and Neck Cancer Risk Calculator version 2 (10 per cent vs 23 per cent, p = 0.10).
Conclusion
Head and Neck Cancer Risk Calculator version 2 demonstrated high sensitivity in cancer diagnosis. Further studies are required to improve the predictive strength of the calculator.
Russell and Burch's Three Rs (replacement, reduction and refinement) remain the cornerstone for principles guiding humane experimental research. However, the concept of refinement has evolved considerably since its first inception and there have been numerous interpretations, some of which are regressive from the original definition. In this paper we examine the interpretations of refinement, and propose a harmonised progressive definition that is in line with changes in animal ethics and animal welfare science. Our definition should be applied to all aspects of refinement: those related to housing, husbandry and care, techniques used in scientific procedures, periprocedural care, health and welfare monitoring, and experimental design. We argue not only that the concept should include the avoidance or minimisation of adverse effects experienced at any time during the life of an animal destined for use in a laboratory, but also that it should be applied to the founder animals. Furthermore, we take a proactive stance and argue that refinement should include enhancing well-being through environmental enrichment. The acceptance and application of this new definition by legislative authorities and in guidelines would represent a significant step forward for animal welfare.
Caregivers for patients undergoing hematopoietic cell transplantation (HCT) are susceptible to significant psychosocial distress. This cross-sectional study aimed to describe psychosocial support services offered and used by caregivers of pediatric primary immune deficiency (PID) during HCT at 35 hospitals across North America.
Method
Caregivers of pediatric patients with PID were recruited by e-mail to participate in an anonymous 140-question survey instrument between April and May 2016 (N = 171).
Result
Of those meeting inclusion criteria (53%), family counseling services were only offered to fewer than half of caregivers (42%). Of the survey participants not offered counseling services, the majority desired family counseling (70%) and sibling counseling (73%). That said, when offered counseling, utilization rates were low, with 22% of caregivers using family counseling and none using sibling counseling.
Significance of results
These results indicate the need to offer and tailor counseling services for families throughout the HCT process. Further research should focus on reducing barriers to utilization of counseling services such as offering bedside counseling services, online modalities, and/or financial assistance.
The biographers of Alexander Hamilton have been almost unanimous in absolving him from any complicity in the enactment and enforcement of the Alien and Sedition Laws of 1798. Most of them deny that he supported those now discredited laws and portray him as a defender of civil liberties who stood against the whole Federalist party. One writer asserts that by passing the laws the Federalists “mutinied” against Hamilton's recommendation of moderation. In the only thorough study of the acts, John C. Miller concludes that they “were passed by Congress against the advice of Alexander Hamilton.” Praising him as one not easily “led into error by the anxiety or the excitement of stirring and perilous times,” an early biographer describes the Federalist leader's position as “sensible and moderate.” Two of Jefferson's most widely read biographers credit Hamilton with opposing the law, and Albert J. Beveridge pictures him as an earlier and stronger opponent of the bills than Jefferson.
An assay based on recovery rates of released laboratory-reared flies was used to compare the field performance in Australia of a series of strains bearing compound chromosomes with that of wild-type strains of Lucilia cuprina (Wiedemann). The compound chromosome strains tested all performed less well than the wild-type strains. Four of the former were recovered on average 0·37 times as readily as the average wild-type strain, and one was recovered 0·65 times as readily. The compound chromosome strains differed in the selection pressure they had been exposed to in the field, which had selected among the various compound chromosomes in an original strain and in the extent to which their non-compound chromosomes had been replaced by recently collected field material. The strain that performed best had been exposed to the most severe selection pressure, overwintering in the field, and had had much of its non-compound genome replaced. Among the group of strains with similar performance, some had had their non-compound genome replaced with field genetic material.
Experiments were undertaken to develop intracytoplasmic sperm injection (ICSI) to produce caprine embryos out of the normal breeding season. Oocytes were obtained from 2–6 mm ovarian follicles at slaughter. Selected oocytes with two to four layers of cumulus cells were incubated in 1 ml of H-TCM 199 supplemented with 10 μg each of oFSH and bLH (NHPP, NIDDK, NICHD, USDA) and 20% fetal bovine serum (FBS) in a thermos (38.5°C) for 4.5 h during transportation. Then, oocytes were transferred into 75 μl of freshly prepared maturation medium under paraffin oil and a mixture of 5% O2, 5% CO2 and 90% N2. Approximately 26 h after recovery oocytes were denuded by incubation with hyaluronidase (100 IU/ml) and pipetting and held at 38.5°C for 90 min. Spermatozoa frozen in egg yolk extender were thawed in a 37°C water bath for 15s. Motile fractions were selected by swim-up, then incubated for 90 mm in TALP with 10 μg heparin/ml. Each oocyte was positioned with its first polar body at 6 or 12 o'clock by a holding pipette. Sperm (1 μl) were added to 10 μl medium containing 10% polyvinylpyrrolidone. A sperm cell was aspirated into a pipette, and then injected head-first into the cytoplasm of an oocyte maintained in H-TCM 199 + 20% FBS at 37°C. Injected oocytes were transferred to HM and, after 90 min, cultured in 50 μl of BSA-free synthetic oviduct fluid plus polyvinyl alcohol, citrate and non-essential amino acids. Results demonstrate that caprine blastocysts can be produced outside the breeding season by the use of frozen-thawed semen and injection of sperm cells with broken tails into ova followed by culture in defined medium.
In our commission the vice-president (VP) becomes the president, and a new VP is chosen from members of the Organizing Committee. The position of secretary was discontinued and its responsibilities incorporated into the VP position. The president announced that the new officers are Steven R. Federman (president) and Glenn M. Wahlgren (vice-president).
A population-based case–control study of diet, inherited susceptibility and prostate cancer was undertaken in the lowlands and central belt of Scotland to investigate the effect of phyto-oestrogen intake and serum concentrations on prostate cancer risk. A total of 433 cases and 483 controls aged 50–74 years were asked to complete a validated FFQ and provide a non-fasting blood sample. Multivariate logistic regression analysis found significant inverse associations with increased serum concentrations of enterolactone (adjusted OR 0·40, 95 % CI 0·22, 0·71] and with the consumption of soy foods (adjusted OR 0·52, 95 % CI 0·30, 0·91). However, no significant associations were observed for isoflavone intake or serum genistein, daidzein and equol. This study supports the hypotheses that soy foods and enterolactone metabolised from dietary lignans protect against prostate cancer in older Scottish men.
Earlier models of fire plumes based on simple entrainment laws and neglecting dynamic pressure have failed to produce the relatively shallow inflow over the fire perimeter known as fire wind. This inflow is of prime importance in fire modelling as it normally provides much of the air required for combustion; for this reason we have carried out a very simple numerical experiment on two-dimensional natural convection above a strip heat source with the intention of simulating those aspects of fire behaviour involved in the generation of fire wind without attempting the formidably difficult task of detailed fire modelling. Our results show clearly that fire wind is driven by the dynamic pressure field which is generated by and intimately related to the region of strong buoyant acceleration close above the ground boundary. Throughout our parametric range there is a concentrated region of large horizontal pressure gradient in a neighbourhood above the perimeter of the fire, and elsewhere the pressure gradients play a lesser role.
We have investigated also the dependence of our solution on the boundary conditions, particularly those at the lateral boundary, where we have imposed as little constraint as possible on flow into and out of the computational region. Considerable effects even of such weak side-boundary constraints persist throughout the solution region at moderate values of the pseudo-Rayleigh number (based on eddy diffusivities), but these can be limited by an appropriate choice of the thermal conditions and kept within acceptable bounds at large pseudo-Rayleigh numbers. Similar effects of boundary conditions are likely to appear in other mesoscale convectively driven atmospheric models, including sea breezes, katabatic winds and locally concentrated convective columns.
The principal phyto-oestrogens (PO) in food are isoflavones, lignans, coumestans and prenylated flavonoids, with isoflavones and lignans being the most commonly found in UK diets. Until recently obtaining accurate data on the PO content of foods was hampered by lack of suitable analytical methods and validation techniques. Furthermore, although PO data exist for some foods, these foods may not be available in the UK. The aim of the present study was to construct a new, comprehensive isoflavone (total genistein + daidzein) database. Using data, mainly from recent GC–MS analysis, for approximately 300 foods available in the UK, and extensive recipe calculations, a new database was constructed containing approximately 6000 foods allocated an isoflavone value. By analysing 7d weighed food diaries, the database was subsequently used to estimate isoflavone intake in two groups of healthy volunteers, omnivores (n 9) and vegetarians (n 10). Mean isoflavone intake in the vegetarian and omnivorous group was 7·4 (sem 3·05) and 1·2 (sem 0·43) mg/d, respectively. Mean intake for the total group was 4·5 (sem 1·89) mg/d. Main food sources of isoflavones for the vegetarian group were soya milk (plain), meat-substitute foods containing textured vegetable protein and soya protein isolate, soya mince, wholemeal bread and rolls, white bread and rolls, croissants and pitta breads, beans, raisins and soya sauce. Main food sources of isoflavones for the omnivorous group were soya yogurts, wholemeal bread and rolls, white bread and rolls, garlic bread, nan bread and brown bread, sultanas and scones.
This triennial report from Comm. 14 covers the topics Atomic Spectra and Wave-length Standards, Atomic Transition Probabilities, Collision Processes, and Line Broadening.
During the mid to late 1990’s a cluster of Livestock Production Programme (LPP) projects, funded by the Department for International Development (DFID) was established in Zimbabwe, as a representative country of southern sub-Saharan Africa, to develop outputs to increase the livestock contribution to the alleviation of poverty. All stakeholders were involved with the projects from the planning stage and participatory on-farm research was a key feature. Several of the projects addressed one of the major constraints to livestock production in arid and semi-arid areas, dry season feeding, the animal species considered being poultry, donkeys (draught power), goats and milking cows. The benefits of these projects can only be realised through effective dissemination to relevant target groups (farmers, extension staff, which because of failing government extension services in several African countries, must include NGOs, churches and local organizations, and policy makers) and development of relevant training materials.
Two things of great historical importance certainly happened in Palestine during the first century ce. A Galilean miracle-man formed a group of followers which survived his crucifixion and became Christianity. A Jewish revolt led to the destruction of Jerusalem and the Temple, and so put an end to most powers of the priests and determined the development of Judaism as a religion without influential priesthood or public sacrifices.
While we are reasonably certain that these events occurred, their backgrounds and details are uncertain because of the inadequacy of sources and the ingenuity of scholars. For Jesus we are almost entirely dependent on the devotional utterances of Paul (c. 50) and the hagiographic accounts of the gospels (c. 75–100). Both Paul and the gospels preserve earlier material, but in such ways that the original elements and their dates, forms, and contents are uncertain. For the history of the country, the revolt and its immediate consequences we are similarly dependent on Josephus whose sources for most of this century were chiefly hearsay, his notes, and his memories – none of these reliable. Besides, he distorted them all to serve various motives (some of them discussed below) and his War was thoroughly edited (and many passages, especially the speeches, were written) by secretaries assigned to him by Titus. Josephus claims that Titus also signed the War and ordered it published (Vita 363, written after Titus was dead).
Titus', and perhaps Vespasian's, initial sponsorship of the War is commonly thought a consequence of the desire to prevent the big Jewish populations of Mesopotamia and Adiabene from trying to intervene in Palestine or using their influence to secure a Parthian invasion.
By Hasmonaean times the people of Palestine had survived and been increased by two thousand years of invasions. The Israelite invasion had been only one in a long series. The series had produced a stock of untraceable complexity, diversified by many small groups with recognizable local characteristics. Such groups were more conspicuous than the population's general uniformity, hence classical Hebrew had no word equivalent to our ‘Palestinian’; Pelishtim means ‘Philistines’, another peculiar group of invaders. ‘Canaanite’ was sometimes pressed into service for the whole non-Israelite population, but properly speaking the Canaanites were only one of the many little peoples whom the Israelites had found living in the land. According to the stories of the Israelite invasion they had shared possession with Perizzites, Hivites, Amorites, Jebusites, etc.
Such peoples the Israelites called ‘the goyyim’. Goy (the singular) refers to ‘an ethnic group considered as a political rather than a biological entity’; it was therefore rendered by the King James translators as ‘nation’. In this sense it was occasionally used for ‘Israel’ (the Israelites considered as a single group). More frequently, however, goy and goyyim were used of non-Israelite groups, often by antithesis to Israel, and pejoratively. Both singular and plural referred to ‘nations’ only; the classical Hebrew terms for a single alien, qua alien, were nokhri and zar. There was no term whatever for an individual who worshipped gods other than Yahweh, much less for all such persons. It was taken for granted that other nations worshipped their own gods (though individuals among them might also worship Yahweh), but until the end of the monarchy the Israelites thought of aliens primarily as strangers and as members of other nations, not as worshippers of other gods; there was no term for, nor concept of, ‘the heathen’ as such.
We present an analysis of wide-field, far-ultraviolet images of the LMC and SMC obtained by the Ultraviolet Imaging Telescope. The photometric catalog of over 37,000 stars allows us to make large-scale, statistical studies of massive star formation in OB associations and in the field population. Our results show that: (1) the most probable slope for the initial mass function (IMF) of field stars is Γ = −1.80, slightly steeper than the Salpeter slope; and (2) there doesn't seem to be a single, unique IMF slope for stars in OB associations, with a range of values from Γ = −1.0 to −2.0. We also analyze the stellar vs. diffuse UV flux, and the population of OB star candidates in the field.