Clinical calculator predictive of chemotherapy benefit in stage 1A uterine papillary serous cancers

OBJECTIVE

Determine the utility of a clinical calculator to predict the benefit of chemotherapy in stage IA uterine papillary serous cancer (UPSC).

PATIENTS AND METHODS

Data were collected from NCDB from years 2010-2014. Based on demographic and surgical characteristics, a clinical score was developed using the random survival forest machine learning algorithm.

RESULTS

Of 1,751 patients with stage IA UPSC, 1,012 (58%) received chemotherapy and 739 (42%) did not. Older age (HR 1.06), comorbidities (HR 1.31), larger tumor size (HR 1.27), lymphovascular invasion (HR 1.86), positive peritoneal cytology (HR 2.62), no pelvic lymph node dissection (HR 1.51), and no chemotherapy (HR 2.16) were associated with poorer prognosis. Compared to no chemotherapy, patients who underwent chemotherapy had a 5-year overall survival of 80% vs. 67%. To better delineate those who may derive more benefit from chemotherapy, we designed a clinical calculator capable of dividing patients into low, moderate, and high-risk groups with associated 5-year OS of 86%, 73%, and 53%, respectively. Using the calculator to assess the relative benefit of chemotherapy in each risk group, chemotherapy improved the 5-year OS in the high (42% to 64%; p < 0.001) and moderate risk group (66% to 79%; p < 0.001) but did not benefit the low risk group (84% to 87%; p = 0.29).

CONCLUSION

Our results suggest a clinical calculator is useful for counseling and personalizing chemotherapy for stage IA UPSC.

Male fertility in cystic fibrosis

Infertility rates among males with cystic fibrosis (CF) approximate 97%. No information is currently available within Ireland determining an understanding of fertility issues and the best methods of information provision to this specialized group. This study aimed to determine understanding and preferred approaches to information provision on fertility issues to Irish CF males. A Descriptive Study utilizing prospective coded questionnaires was mailed to a male CF cohort (n=50). Sections included demographics, fertility knowledge & investigation. Response rate was 16/50 (32%). All were aware that CF affected their fertility. More than two-thirds (n=11) were able to provide explanations whilst only one-third (n=5) provided the correct explanation. Significant numbers stated thoughts of marriage and a future family. Half have discussed fertility with a healthcare professional (HCP). Mean age of discussion was 21.9 years. One third preferred an earlier discussion. The commonest first source for information was written material which was also the preferred source. Three-quarters requested further information preferring again, written material. Significant gaps in sex education of Irish CF males exist. Discussion should be initiated by HCPs and centre-directed written material devised to address deficiencies.

Size-induced changes in optical and X-ray photoelectron spectra of GaN nanoparticles deposited at lower substrate temperature

This study reports the synthesis of GaN nanoparticles having hexagonal structure by a simple technique of activated reactive evaporation with substrates kept at comparatively lower temperatures than usually reported. By varying the substrate temperature from 30 degrees C to 350 degrees C, it is possible to vary nanoparticle sizes from 5-30 nm. X-ray diffraction and X-ray photoelectron spectroscopy analysis confirm the formation of GaN on quartz and silicon substrates at room temperature. The observed size dependent shift in energy position, large increase in full width at half maximum value of Ga 3d and N 1s X-ray photoelectron spectroscopy peaks and blue shift in the optical absorption edge are related to nanoparticle character.

Statistical fluctuation versus specific mechanism and the origin of the left-handed asymmetry of proteins

We point out an intrinsic weakness in the reasoning that adduces a statistical fluctuation as the origin of a left-handed, prebiotic stereoisomeric asymmetry which might have been the initial asymmetry that led to the left-handed asymmetry of proteins observed now on Earth. The argument in favor of a statistical fluctuation as the source of the asymmetry depends implicitly on the assumption of a very small number of terrestrial sites at which polymerization leading to protein formation took place. On the other hand, the probability that a left-handed prebiotic asymmetry produced by a specific mechanism was efficacious would have increased linearly with the number of terrestrial sites. Thus, on the basis of the greater likelihood of a large number of possible polymerization sites in the prebiotic era, a random fluctuation is deemed to be a much less probable source of a stereoisomeric asymmetry than a specific mechanism, particularly the mechanism that follows from the parity violating weak interaction.

Chirality of electrons from beta-decay and the left-handed asymmetry of proteins

A simplified mathematical model of the origin of the left-handed asymmetry of proteins in living matter is presented. The model is based on the hypothesis of Vester and Ulbricht that the chirality of (left-handed) electrons from naturally beta-active elements, e.g. 14C, 40K, etc., was the specific source of the asymmetry; it requires for its application data on interaction of electrons having non-zero chirality with racemic mixtures of amino acids. This interaction is here treated theoretically in an order-of-magnitude calculation. Our analysis yields a very approximate value of the induced steady-state asymmetry in the amino acids at the beginning of protein synthesis and indicates that this asymmetry, though small, may have been sufficient to account for the dominant left-handedness of proteins now observed.