Alcoholism: independent predictor of survival in patients with head and neck cancer

BACKGROUND: Despite recognition of the high prevalence of alcoholism among patients with head and neck cancer, the prognostic importance of alcoholism has not been evaluated adequately. Previous investigators have speculated that alcoholic patients may have a poorer prognosis than nonalcoholic patients because of more advanced stage of cancer, the immunosuppressive effects of alcohol, and an increased rate of death due to other alcohol-related diseases. PURPOSE: The goal of this population-based study was to identify the features of alcoholism that are associated with survival for patients with head and neck cancer and to develop an alcoholic severity staging system from a composite of the independent features of alcoholism. METHODS: This prospective study included 649 patients who were diagnosed with cancer of the oral cavity, oropharynx, hypopharynx, or larynx during the period from September 1, 1983, through February 28, 1987, in a three-county area of western Washington state that participates in the Surveillance, Epidemiology, and End Results Program of the U.S. National Cancer Institute. Details on lifetime alcohol consumption, treatment for alcoholism, abstinence from alcohol prior to the diagnosis of cancer, and alcohol-related health problems were ascertained through in-person interviews near the time of diagnosis. Patients were classified as either nonalcoholics or alcoholics according to their responses to questions from the Michigan Alcoholism Screening Test. The measures of alcohol consumption and abuse that were found to be independently associated with 5-year survival by logistic regression analysis were combined using conjunctive consolidation to create a final composite variable, called an alcoholic severity stage. Cox proportional hazards regression analysis was done to estimate the relative risk (R) of death within 5 years due to specific causes of death for each of the alcoholic severity stages. RESULTS: Alcoholism (RR = 2.06; 95% confidence interval [CI] = 1.43-2.98) and a history of alcohol-related systemic health problems (i.e., liver disease, pancreatitis, delirium tremens, or seizures) (RR = 2.76; 95% CI = 1.69-4.49) were associated with an increased risk of death, whereas abstinence (i.e., the consumption of fewer than one drink per week at 1 year prior to the diagnosis of cancer) (RR = 0.62; 95% CI = 0.39-0.97) was associated with a decreased risk of death. These associations were independent of age, site of cancer, anatomical stage, histopathologic grade, smoking, and type of antineoplastic treatment. Patients in the two worst alcoholic severity stages had an increased risk of dying not only of head and neck cancer but also of cardiovascular disease, pulmonary disease, and other alcohol-related causes. CONCLUSIONS: Alcohol abuse, measured by alcohol consumption, functional impairment, a history of alcohol-related health problems, or abstinence, can provide important prognostic information for patients with head and neck cancer. Our results suggest that sobriety among alcoholic patients can lead to prolonged survival.     

Gelling of alginate fibres

Equipment was developed to measure the time for complete gelling of sodium alginate fibres in calcium chloride solution, taken as the time to achieve maximum tensile strength. The effects of fibre diameter, alginate concentration, alginate composition and calcium chloride concentration on gelling time were investigated. A diffusional model, developed to predict the gelling time, agreed with experimental results except for the effect of calcium ion concentration which was modelled empirically.     

Using spreadsheets in introductory EE courses

Ways in which spreadsheet programs can be used to introduce practical considerations in introductory electrical engineering courses are discussed. Examples are presented which show that spreadsheets can be used to predict and/or minimize the errors due to loading, the availability of only standard resistor values, and resistor tolerances. The circuits considered in these examples were selected to be as simple as possible. These examples could be used in the first semester of sophomore credits. They illustrate trade-offs, performance criteria, and nonunique solutions, and are intended to illustrate the power of spreadsheet programs. In the first example, a macro is used to implement a simple iterative optimization procedure. In the second example, minimization is done by exhaustive search using the table lookup capabilities of the spreadsheet. In the final example, the spreadsheet's random number generator is used to perform a Monte Carlo analysis     

The relationship between attachment, psychopathology, and childhood disability.

Analyzes the literature on 3 aspects of attachment—neurobiological influences, interpersonal and intrapersonal factors, and societal factors—in the psychological development of chronically disabled children. Evidence suggests that neurochemical substances such as cortisol and brain biogenic amine systems reciprocally interact with psychological and psychosocial factors to influence attachment. Interpersonal and intrapersonal factors such as temperamental characteristics of children, severity and type of disability, and family influences interact in the process of attachment. Social perceptions and prejudices about the disabled individual increase parental stress, and diminish parental involvement and resources, which are necessary for attachment. These 3 processes are powerful and interrelated forces in child development, with potential to modify social competence, neurological development, and psychosocial adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Randomized trial of breast self-examination in Shanghai: methodology and preliminary results

BACKGROUND: The efficacy of breast self-examination in helping to reduce mortality from breast cancer has not been rigorously demonstrated. PURPOSE: To assess efficacy, a large, randomized trial was initiated in Shanghai, China. METHODS: From October 1989 to October 1991, 267040 current and retired female employees associated with 520 factories in the Shanghai Textile Industry Bureau were randomly assigned on the basis of factory to either a self-examination instruction group (133375 women) or a control group (133665 women). The women were born within the period from 1925 through 1958. Women in the instruction group were given intensive training in breast self-examination, including the use of silicone breast models and personalized instruction, plus two subsequent reinforcement sessions and multiple reminders to practice the technique. Women in the control group were asked to attend training sessions on the prevention of low back pain. All women have been followed for the development of breast diseases and for death from breast cancer. RESULTS: A high level of participation during the first 4-5 years of the trial was documented among women in the instruction group. Randomly sampled women in this group demonstrated greater proficiency in detecting lumps in breast models than did randomly sampled women in the control group. Approximately equal numbers of breast cancers were detected in the two groups (331 in the instruction group and 322 in the control group) through 1994, which is the last year for which case-finding efforts have been completed. The breast cancers detected in the instruction group were not diagnosed at an appreciably earlier stage or smaller size than those in the control group. More benign breast lesions were detected in the instruction group than in the control group (1457 versus 623, respectively), suggesting a higher index of suspicion for women who received training. Cumulative breast cancer mortality rates through 5 years from entry into the study were nearly equivalent for the two groups. CONCLUSIONS: Breast self-examination has not led to a reduction in mortality from breast cancer in this study cohort in the first several years since the trial began. A shift toward the diagnosis of disease at a less advanced stage in women given instruction has also not been demonstrated. Longer follow-up of participants in this trial is required before final assessment can be made of the efficacy of breast self-examination. IMPLICATIONS: At this time, there is insufficient evidence to recommend for or against the teaching of breast self-examination.     

Modified oil agglomeration process for coal beneficiation. III. Grinding and agglomeration using different szego mill designs

The simultaneous grinding/agglormeration process has been used to beneficiate Minto coal. Experiments with the Szego Mill, a planetary ring-roller mill with grooved rollers, have given good results. Different roller ridge/groove sizes have been tested and favourable oil-coal-water ratios established. Ash removal is closely related to grinding performance. Very short mill residence times, of the order of 10 seconds, are sufficient for microagglomerate formation. Considerable equipment and operating cost savings are possible with the modified process.