Predictors of prostate cancer screening among health fair participants

OBJECTIVES

Most previous studies of predictors for participation in prostate-specific antigen (PSA) screening for prostate cancer have been conducted in purposive samples or clinical settings. This population-based study identified factors associated with documented PSA screening among health fair participants.

STUDY DESIGN

Cross-sectional survey of 2098 Nebraskan men aged 35 years and older who participated in a health fair in central and eastern Nebraska in 1993.

METHODS

All participants were offered a PSA screening and a questionnaire to collect information on demographics, family medical history, lifestyle factors and self-perceived health status. Predictors of PSA screening were estimated by odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS

Men were more likely to accept the PSA screening if they were older than 50 years of age (OR=3.1; 2.4-3.9), had a higher income (OR=1.5; 1.1-2.1), were currently employed (OR=1.4; 1.0-2.5), perceived their health status as good (OR=1.1; 0.8-1.5) or excellent (OR=1.4; 1.0-2.1), and believed that they themselves, rather than physicians, should be responsible for their health (OR=1.3; 1.0-1.7). Compared with men aged 50-59 years, the ORs of participation were 0.8 (0.6-1.1) for age 60-69 years and 0.7 (0.5-1.1) for age 70+ years. Decision making was not related to education, marital status or body mass index. Predictors of screening remained unchanged when analysis was limited to men aged 50 years and over, whereas only high income and non-smoking status predicted participation among men younger than 50 years of age.

CONCLUSIONS

Age, income, employment status, perceived control of health and perceived heath status were related to participation in PSA screening for prostate cancer, particularly in men older than 50 years of age. Willingness to receive a PSA screening among men aged 50 years and over decreased with increasing age.

Macroscopic tunnel splittings in superconducting phase qubits

Prototype Josephson-junction based qubit coherence times are too short for quantum computing. Recent experiments probing superconducting phase qubits have revealed previously unseen fine splittings in the transition energy spectra. These splittings have been attributed to new microscopic degrees of freedom (microresonators), a previously unknown source of decoherence. We show that macroscopic resonant tunneling in the extremely asymmetric double-well potential of the phase qubit can have observational consequences that are strikingly similar to the observed data.

Spectroscopy of three-particle entanglement in a macroscopic superconducting circuit

We study the quantum mechanical behavior of a macroscopic, three-body, superconducting circuit. Microwave spectroscopy on our system, a resonator coupling two large Josephson junctions, produced complex energy spectra well explained by quantum theory over a large frequency range. By tuning each junction separately into resonance with the resonator, we first observe strong coupling between each junction and the resonator. Bringing both junctions together into resonance with the resonator, we find spectroscopic evidence for entanglement between all 3 degrees of freedom and suggest a new method for controllable coupling of distant qubits, a key step toward quantum computation.

The Coronary Artery Revascularisation in Diabetes (CARDia) trial: background, aims, and design

BACKGROUND

Patients with diabetes have an increased incidence and severity of ischemic heart disease, which leads to an increased requirement for coronary revascularization. Comparative information regarding mode of revascularization--coronary artery bypass graft surgery surgery (CABG) or percutaneous coronary intervention (PCI)--is limited, mainly confined to a subanalysis of the Bypass Angioplasty Revascularization (BARI) trial, suggesting a mortality benefit of CABG over PCI. No prospective trial has specifically compared these modes of revascularization in patients with diabetes.

OBJECTIVE

The Coronary Artery Revascularisation in Diabetes (CARDia) trial is designed to address the hypothesis that optimal PCI is not inferior to modern CABG as a revascularization strategy for diabetics with multivessel or complex single-vessel coronary disease. The primary end point is a composite of death, nonfatal myocardial infarction, and cerebrovascular accident at 1 year.

METHOD

A total of 600 patients with diabetes are to be randomized to either PCI or CABG, with few protocol restrictions on operative techniques or use of new technology. This gives a power of 80% to detect non-inferiority of PCI assuming that the PCI 1-year event rate is 9%. A cardiac surgeon and a cardiologist must agree that a patient is suitable for revascularization by either technique prior to recruitment into the study. Twenty-one centers in the United Kingdom and Ireland are recruiting patients. Data on cost effectiveness, quality of life, and neurocognitive function are being collected. Long-term (3-5 year) follow-up data will also be collected.

Age is a risk factor for chemotherapy-induced hepatopathy with vincristine, dactinomycin, and cyclophosphamide

PURPOSE

To evaluate the spectrum of and determine the risk factors for the development of liver toxicity (hepatopathy) after therapy with vincristine, dactinomycin, and cyclophosphamide (VAC) for rhabdomyosarcoma in children and adolescents.

PATIENTS AND METHODS

We prospectively captured all events of hepatopathy occurring on the ongoing Children's Oncology Group intermediate risk protocol, D9803, for children with rhabdomyosarcoma. Patients enrolled onto this trial were randomly assigned to receive either VAC alone or VAC alternating with vincristine, topotecan, and cyclophosphamide. In addition, we reviewed the toxicity database and requested additional information for all patients with elevated bilirubin or transaminase levels. Risk factors were analyzed.

RESULTS

Of 339 patients enrolled through August 2002, 18 developed hepatopathy. All events were captured by mandated toxicity reporting and filing of MedWatch forms, with no additional cases found after the additional search of the database. Four children died after developing this toxicity. All cases occurred after cycles of VAC (n = 16) or vincristine and cyclophosphamide with concomitant abdominal radiotherapy (n = 2). The onset of hepatopathy was 5 to 16 days from the start of a treatment cycle. For the 89 patients under 36 months of age, the risk of hepatopathy was 15%, with two deaths. For the 239 children 3 years of age or older, the risk for hepatopathy was 4%, with two deaths.

CONCLUSION

The greatest risk factor for development of hepatopathy after VAC therapy was age. Dose modifications for younger children receiving VAC therapy are recommended.

Quantum logic gates for coupled superconducting phase qubits

Based on a quantum analysis of two capacitively coupled current-biased Josephson junctions, we propose two fundamental two-qubit quantum logic gates. Each of these gates, when supplemented by single-qubit operations, is sufficient for universal quantum computation. Numerical solutions of the time-dependent Schrödinger equation demonstrate that these operations can be performed with good fidelity.

Entangled macroscopic quantum States in two superconducting qubits

We present spectroscopic evidence for the creation of entangled macroscopic quantum states in two current-biased Josephson-junction qubits coupled by a capacitor. The individual junction bias currents are used to control the interaction between the qubits by tuning the energy level spacings of the junctions in and out of resonance with each other. Microwave spectroscopy in the 4 to 6 gigahertzrange at 20 millikelvin reveals energy levels that agree well with theoretical results for entangled states. The single qubits are spatially separate, and the entangled states extend over the 0.7-millimeter distance between the two qubits.

Social processes and innovative behaviour in changing groups of lemur fulvus

A group of brown lemurs was presented with one or two baited food-boxes requiring a specific type of motor response in order to be opened. Subsequently, four groups containing different combinations of experienced individuals from the original group and naive individuals were tested. Solutions to the problem and access to the food were recorded and considered in relation to social factors. In the original group, two adult males learned to open the boxes, with one male increasingly preventing the other from approaching. In the second group, with the subordinate male and certain females removed, the dominant male tolerated successful performances by a juvenile female. Group 3 consisted of three passive female participants from the original group and a naive female; one of the three original females now became the sole box-opener. The introduction of the subordinate male from the original group into the all-female group led to a sharing of box-opening by this subject and the skilled female. In the final group, intense aggression toward the skilled female by a new, naive adult male resulted in two previously passive females succeeding on some occasions. In lemurs, at least some 'scroungers' appear able to learn to perform a new act when the social context permits.

Malignancy in a vestibular schwannoma. Report of a case with central neurofibromatosis, treated by both stereotactic radiosurgery and surgical excision, with a review of the literature

Malignant change in schwannoma is rare. Malignant change in a vestibular schwannoma (acoustic neuroma) is even more rare. This paper presents a case of rapidly growing vestibular schwannoma first treated by radiosurgery whose histopathology after surgical excision 42 months later showed malignant changes. Up to now, eight cases of malignancy in eighth nerve tumours have been reported, four of which, including the present case, had previously been treated with radiosurgery and four cases that had not received radiation. Thus, it would seem, the overall incidence is extremely low. Nevertheless, extreme vigilance and careful reporting continues to be necessary.

Cavernous sinus syndrome as the only manifestation of sarcoidosis

We describe a 63-year-old Afro-Caribbean female who presented with complete ophthalmoplegia of the right eye. Magnetic resonance imaging revealed a mass in the cavernous sinus, which was pathologically confirmed as due to sarcoidosis. No clinical or laboratory evidence of sarcoidosis was found in any other organs. We believe this is the first reported case of an isolated cavernous sinus syndrome due to sarcoidosis and suggest that sarcoidosis should be considered in the differential diagnosis of cavernous sinus syndromes even in the absence of systemic involvement of sarcoidosis.

Diffuse large B-cell lymphoma: a clinicopathologic analysis of 444 cases classified according to the updated Kiel classification

The purpose of this study was: to compare the survival of diffuse large B-cell lymphomas (DLBCL) stratified according to the up-dated Kiel classification. A retrospective study of a cohort of 1378 cases was organized in 1996 by the Non-Hodgkin's Lymphoma Classification Project, and the DLBCL were classified according to the updated Kiel classification. The distribution of the different types and subtypes was as follows: centroblastic (CB, 85.4%), composed of the polymorphic (CB-PM, 58.6%), monomorphic (CB-MM, 17.1%) and multilobated (CB-ML, 9.7%) subtypes; immunoblastic (IB, 11.2%), with (8.3%) or without (2.9%) plasmacytoid differentiation; and anaplastic large cell lymphoma (ALCL) of B-cell type (3.4%). The rate of diagnostic agreement between pathologists was 78% for CB and 65% for IB lymphoma. The 5-year overall survival (OAS) for the entire group was 47% and the 5-year failure-free survival (FFS) was 42%. No significant differences in survival were found between the three major groups (CB, IB, ALCL). However, the 5-year OAS and FFS of patients with DLBCL not containing immunoblasts (CB-MM+CB-ML) was 51 and 52%, respectively, and was significantly better than the survival of those containing immunoblasts (CB-PM+IB+ALCL), which was 44 and 38% (p = 0.06 and p = 0.037), respectively. These results did not appear to be due to differences in the clinical features of the two groups, and was most significant for patients with low stage or low risk disease. However, histologic subtyping was not an independent risk factor for the entire group by multivariate analysis. In conclusion, patients with CB-MM and CB-ML (without immunoblasts) had a significantly better OAS and FFS than those with CB-PM, IB and ALCL (with immunoblasts). Therefore, we conclude that additional studies are still needed to further evaluate the importance of immunoblastic differentiation in DLBCL.

Peripheral T-cell lymphoma (excluding anaplastic large-cell lymphoma): results from the Non-Hodgkin's Lymphoma Classification Project

BACKGROUND

Peripheral T-cell lymphoma (PTCL) is rare in most parts of the world. Therefore, we have evaluated the 96 cases of PTCL diagnosed within the Non-Hodgkin's Lymphoma Classification Project (NHLCP) (1378 cases) for their geographical distribution, pathologic features and diagnostic reliability, as well as clinical presentation and outcome.

MATERIALS AND METHODS

Diagnoses of all cases were rendered independently by five experienced hematopathologists based on morphology only, and after introduction of the immunophenotype and clinical data. Divergent diagnoses were jointly discussed and a final consensus diagnosis was established in each case. Reliability of the diagnoses was evaluated statistically, and the clinical features and outcome were analyzed according to the consensus diagnoses.

RESULTS

Seven per cent of all non-Hodgkin's lymphoma (NHL) cases reviewed were classified as PTCL and the frequency varied from 1.5% to 18.3% in different countries. The interobserver agreement with the consensus diagnosis of PTCL was 86% in the Revised European-American Lymphoma (REAL) classification, but the designation of subtypes was less reliable. Diagnostic reliability improved from 41% to 86% after immunophenotyping, but did not improve further with the addition of detailed clinical data. Clinically, angiocentric nasal lymphoma presented in young females (median age 49 years) at extranodal sites, but with few adverse risk factors, whereas angioimmunoblastic lymphoma presented most often in older males (median age 65 years) at nodal and extranodal sites with numerous risk factors. The 5-year overall and failure-free survivals for patients with PTCL treated with doxorubicin (Adriamycin)-containing regimens were only 26% and 20%, respectively. Both failure-free and overall survival were strongly correlated with the performance status and International Prognostic Index scores at presentation, but differences in survival were not observed between the major histological types. However, within the PTCL 'not otherwise specified' category, but not angioimmunoblastic lymphoma, the number of transformed blasts was prognostically relevant.

CONCLUSIONS

PTCLs can be diagnosed reliably by experienced hematopathologists, but immunophenotyping is absolutely necessary. Currently, all types of PTCL should be considered high-grade lymphomas. An increased ability to distinguish T-lymphocyte subsets is needed in order to better subclassify the PTCLs for therapeutic and prognostic purposes.

Rhabdomyosarcoma of the parotid region occurring in childhood and adolescence. A report from the Intergroup Rhabdomyosarcoma Study Group

BACKGROUND

Rhabdomyosarcoma (RMS) of the parotid region is rare and to the authors' knowledge little information is available regarding the site of tumor origin, clinical presentation, and outcome in these patients. Therefore, the authors reviewed the files of all patients with RMS of the parotid region who were registered on the Intergroup Rhabdomyosarcoma Studies (IRS) I-IV.

METHODS

Patient charts and the Intergroup Rhabdomyosarcoma Study Group (IRSG) database were reviewed.

RESULTS

Sixty-two patients presenting with a mass in the parotid region were identified. None of the tumors was localized exclusively to the parotid gland, so the primary site was referred to as the "parotid region." The tumor invaded a parameningeal site in 30 patients. These cases have been designated as parameningeal-parotid tumors to distinguish them from 32 cases that did not invade a parameningeal site and were designated as nonparameningeal-parotid tumors. The majority of patients had Group III tumors in both the nonparameningeal-parotid and parameningeal-parotid subgroups. However, although there were 16 patients with Group I or II tumors in the nonparameningeal-parotid subgroup, no patients with Group I or II tumors were found in the parameningeal-parotid subgroup (P = 0.001). Fifty-six of 62 patients (90%) received radiotherapy. The parameningeal primary site designation resulted in intensification of both chemotherapy and radiotherapy for patients with parameningeal-parotid RMS. The 5-year failure-free survival rate was 81% and the 5-year survival rate was 84%. There were no deaths reported among patients with Group I or II tumors. The 5-year failure-free survival did not appear to differ when comparing patients with parameningeal-parotid tumors with patients with nonparameningeal-parotid tumors (P = 0.21).

CONCLUSIONS

Treatment as defined by the IRS protocols has been reported to be highly effective for patients with RMS of the parotid region. Outcome for the more aggressively treated patients with parameningeal-parotid RMS appears similar to that for patients with nonparameningeal-parotid RMS.

Task preparation and task repetition: two-component model of task switching

The switch cost (the disadvantage of performing a new task vs. a repeated task) has been attributed to lack of preparation for the switched task or priming of the repeated task. These sources were examined by manipulating foreknowledge of task transition (repeat or switch), response-to-stimulus interval (RSI), and practice level. Regardless of foreknowledge, the cost decreased with RSI and practice. The reduction was greater with foreknowledge than with no foreknowledge, and the amount of switch cost did not depend on foreknowledge. These results suggest that the switch cost with foreknowledge may consist of both inadequate preparation and repetition benefit but the switch cost with no foreknowledge may reflect repetition benefit only. An ACT-R (adaptive control of thought-rational) model was proposed, accommodating both preparation and priming effect with 2 independent processes: conflict resolution among productions and decay of chunk activation.

Larviposition by nasopharyngeal bot fly parasites of Columbian black-tailed deer: a correction

Previous reports of Cephenemyia jellisoni Townsend (Diptera: Oestridae) larvipositing onto the lips/lower muzzle of deer, with larvae invading via the mouth, are shown to be erroneous. Additional studies with deer models baited with CO2, 1-octen-3-ol and Deer Trail Scent, and muzzle and nostrils treated with insect adhesive, revealed that only C. apicata Bennett & Sabrosky larviposited onto the lips/lower muzzle; C. jellisoni, by contrast, larviposited into the nostrils. Larval depositions were associated with females of both species observed attacking models. Females of both species also were found stuck on adhesive-treated, baited models not attended by observers. During several seasons of exposure, such models received 89 C. jellisoni larvipositions into the nostrils and 87 C. apicata larvipositions onto the lips/lower muzzle. In laboratory experiments nearly all larvae of both species remained stuck in adhesive within 1 mm or less of where they were deposited.

A hybrid model of categorization

Category learning is often modeled as either an exemplar-based or a rule-based process. This paper shows that both strategies can be combined in a cognitive architecture that was developed to model other task domains. Variations on the exemplar-based random walk (EBRW) model of Nosofsky and Palmeri (1997b) and the rule-plus-exception (RULEX) rule-based model of Nosofsky, Palmeri, and McKinley (1994) were implemented in the ACT-R cognitive architecture. The architecture allows the two strategies to be mixed to produce classification behavior. The combined system reproduces latency, learning, and generalization data from three category-learning experiments--Nosofsky and Palmeri (1997b), Nosofsky et al., and Erickson and Kruschke (1998). It is concluded that EBRW and ACT-R have different but equivalent means of incorporating similarity and practice. In addition, ACT-R brings a theory of strategy selection that enables the exemplar and the rule-based strategies to be mixed.

Decreased expression of cellular prostatic acid phosphatase increases tumorigenicity of human prostate cancer cells

PURPOSE

Understanding cell proliferation regulation in hormone refractory prostate cancer may provide answers for novel solutions. Protein tyrosine phosphatases have been thought to have key roles in regulating cell proliferation and be involved in oncogenesis, although to our knowledge their functional roles in human prostate cancer remain unknown. Human prostatic acid phosphatase (PAcP), a major phosphatase in prostate epithelium, has been shown to function as a neutral protein tyrosine phosphatase in these cells. We evaluated the biological significance of cellular prostatic acid phosphatase expression in human prostate cancer cells.

MATERIALS AND METHODS

Immunohistochemical testing of human prostate cancer archival specimens was done to evaluate the expression of cellular PAcP. Immunoprecipitation and immunoblotting were performed to determine cellular PAcP and SH2 domain-bearing tyrosine phosphatase-1 levels as well as tyrosine phosphorylation of c-ErbB-2/neu in different human prostate cancer cells. The biological behavior of LNCaP derivative sublines was characterized in vitro and in vivo by soft agar analysis and xenograft animal inoculation.

RESULTS

Immunohistochemical staining of human prostate clearly showed that cellular levels of PAcP significantly decreases in prostate cancer cells (p <0.001). The results of biochemical characterization revealed that the cellular level of PAcP but not SHP-1, another differentiation associated protein tyrosine phosphatase, consistently correlated negatively with the growth of several human prostate cancer cell lines. Reintroducing cellular PAcP activity in prostate cancer cells by PAcP complementary DNA transfection resulted in decreased tyrosine phosphorylation of c-ErbB-2/neu, decreased proliferation rates in culture as well as decreased anchorage independent growth in soft agar. The xenograft animal model demonstrated that a higher tumor growth rate as well as larger size is associated with a lower level of cellular PAcP.

CONCLUSIONS

Cellular PAcP can down-regulate prostate cancer cell growth, at least partially by dephosphorylating c-ErbB-2/neu. Therefore, decreased cellular PAcP expression in cancer cells may be involved in prostate cancer progression.

Tower of Hanoi: evidence for the cost of goal retrieval

Past research on the Tower of Hanoi problem has provided clear evidence for the importance of goal-subgoal structures in problem solving. However, the nature of the traditional Tower of Hanoi problem makes it impossible to determine whether there is any special cost associated with storing or retrieving goals. A variation of the Tower of Hanoi problem is described that allows one to determine separately if there is an effect of how long a goal has to be retained on storage time or how long ago it was formed on retrieval time. This paradigm provides evidence for an effect of retention interval on retrieval time and not on storage time. An ACT-R (Adaptive Control of Thought-Rational) simulation of these data is described, which treats goal memory as no different from other memories.