Socioeconomic inequalities in attitudes towards cancer: an international cancer benchmarking partnership study.

Socioeconomic status (SES) differences in attitudes towards cancer have been implicated in the differential screening uptake and the timeliness of symptomatic presentation. However, the predominant emphasis of this work has been on cancer fatalism, and many studies focus on specific community subgroups. This study aimed to assess SES differences in positive and negative attitudes towards cancer in UK adults. A population-based sample of UK adults (n=6965, age≥50 years) completed the Awareness and Beliefs about Cancer scale, including six belief items: three positively framed (e.g. 'Cancer can often be cured') and three negatively framed (e.g. 'A cancer diagnosis is a death sentence'). SES was indexed by education. Analyses controlled for sex, ethnicity, marital status, age, self-rated health, and cancer experience. There were few education-level differences for the positive statements, and overall agreement was high (all>90%). In contrast, there were strong differences for negative statements (all Ps<0.001). Among respondents with lower education levels, 57% agreed that 'treatment is worse than cancer', 27% that cancer is 'a death sentence' and 16% 'would not want to know if I have cancer'. Among those with university education, the respective proportions were 34, 17 and 6%. Differences were not explained by cancer experience or health status. In conclusion, positive statements about cancer outcomes attract near-universal agreement. However, this optimistic perspective coexists alongside widespread fears about survival and treatment, especially among less-educated groups. Health education campaigns targeting socioeconomically disadvantaged groups might benefit from a focus on reducing negative attitudes, which is not necessarily achieved by promoting positive attitudes

Neutral competition of stem cells is skewed by proliferative changes downstream of Hh and Hpo.

Neutral competition, an emerging feature of stem cell homeostasis, posits that individual stem cells can be lost and replaced by their neighbors stochastically, resulting in chance dominance of a clone at the niche. A single stem cell with an oncogenic mutation could bias this process and clonally spread the mutation throughout the stem cell pool. The Drosophila testis provides an ideal system for testing this model. The niche supports two stem cell populations that compete for niche occupancy. Here, we show that cyst stem cells (CySCs) conform to the paradigm of neutral competition and that clonal deregulation of either the Hedgehog (Hh) or Hippo (Hpo) pathway allows a single CySC to colonize the niche. We find that the driving force behind such behavior is accelerated proliferation. Our results demonstrate that a single stem cell colonizes its niche through oncogenic mutation by co-opting an underlying homeostatic process.This is the final version. It was first published by Wiley at http://onlinelibrary.wiley.com/doi/10.15252/embj.201387500/abstract

The SLUGGS survey: globular clusters and the dark matter content of early-type galaxies

A strong correlation exists between the total mass of a globular cluster (GC) system and the virial halo mass of the host galaxy. However, the total halo mass in this correlation is a statistical measure conducted on spatial scales that are some 10 times that of a typical GC system. Here we investigate the connection between GC systems and galaxy's dark matter on comparable spatial scales, using dynamical masses measured on a galaxy-by-galaxy basis. Our sample consists of 17 well-studied massive (~10 x 11 M☉) early-type galaxies from the SLUGGS survey. We find the strongest correlation to be that of the blue (metal-poor) GC subpopulation and the dark matter content. This correlation implies that the dark matter mass of a galaxy can be estimated to within a factor of 2 from careful imaging of its GC system. The ratio of the GC system mass to that of the enclosed dark matter is nearly constant. We also find a strong correlation between the fraction of blue GCs and the fraction of enclosed dark matter, so that a typical galaxy with a blue GC fraction of 60 per cent has a dark matter fraction of 86 per cent over similar spatial scales. Both halo growth and removal (via tidal stripping) may play some role in shaping this trend. In the context of the two-phase model for galaxy formation, we find galaxies with the highest fractions of accreted stars to have higher dark matter fractions for a given fraction of blue GCs

The SLUGGS survey: the assembly histories of individual early-type galaxies

Early-type (E and S0) galaxies may have assembled via a variety of different evolutionary pathways. Here, we investigate these pathways by comparing the stellar kinematic properties of 24 early-type galaxies from the SAGES Legacy Unifying Globulars and GalaxieS (SLUGGS) survey with the hydrodynamical simulations of Naab et al. In particular, we use the kinematics of starlight up to 4 effective radii (Re) as diagnostics of galaxy inner and outer regions, and assign each galaxy to one of six Naab et al. assembly classes. The majority of our galaxies (14/24) have kinematic characteristics that indicate an assembly history dominated by gradual gas dissipation and accretion of many gas-rich minor mergers. Three galaxies, all S0s, indicate that they have experienced gas-rich major mergers in their more recent past. One additional elliptical galaxy is tentatively associated with a gas-rich merger which results in a remnant galaxy with low angular momentum. Pathways dominated by gas-poor (major or minor) mergers dominate the mass growth of six galaxies. Most SLUGGS galaxies appear to have grown in mass (and size) via the accretion of stars and gas from minor mergers, with late major mergers playing a much smaller role. We find that the fraction of accreted stars correlates with the stellar mean age and metallicity gradient, but not with the slope of the total mass density profile. We briefly mention future observational and modelling approaches that will enhance our ability to accurately reconstruct the assembly histories of individual present-day galaxies

The AIMSS Project – III. The Stellar Populations of Compact Stellar Systems

In recent years, a growing zoo of compact stellar systems (CSSs) have been found whose physical properties (mass, size, velocity dispersion) place them between classical globular clusters (GCs) and true galaxies, leading to debates about their nature. Here we present results using a so far underutilized discriminant, their stellar population properties. Based on new spectroscopy from 8–10m telescopes, we derive ages, metallicities, and [α/Fe] of 29 CSSs. These range from GCs with sizes of merely a few parsec to compact ellipticals (cEs) larger than M32. Together with a literature compilation, this provides a panoramic view of the stellar population characteristics of early-type systems. We find that the CSSs are predominantly more metal rich than typical galaxies at the same stellar mass. At high mass, the cEs depart from the mass–metallicity relation of massive early-type galaxies, which forms a continuous sequence with dwarf galaxies. At lower mass, the metallicity distribution of ultracompact dwarfs (UCDs) changes at a few times 107 M⊙, which roughly coincides with the mass where luminosity function arguments previously suggested the GC population ends. The highest metallicities in CSSs are paralleled only by those of dwarf galaxy nuclei and the central parts of massive early types. These findings can be interpreted as CSSs previously being more massive and undergoing tidal interactions to obtain their current mass and compact size. Such an interpretation is supported by CSSs with direct evidence for tidal stripping, and by an examination of the CSS internal escape velocities

Severe and predominantly active atopic eczema in adulthood and long term risk of cardiovascular disease: population based cohort study.

OBJECTIVE: To investigate whether adults with atopic eczema are at an increased risk of cardiovascular disease and whether the risk varies by atopic eczema severity and condition activity over time. DESIGN: Population based matched cohort study. SETTING: UK electronic health records from the Clinical Practice Research Datalink, Hospital Episode Statistics, and data from the Office for National Statistics, 1998-2015. PARTICIPANTS: Adults with a diagnosis of atopic eczema, matched (on age, sex, general practice, and calendar time) to up to five patients without atopic eczema. MAIN OUTCOME MEASURES: Cardiovascular outcomes (myocardial infarction, unstable angina, heart failure, atrial fibrillation, stroke, and cardiovascular death). RESULTS: 387 439 patients with atopic eczema were matched to 1 528 477 patients without atopic eczema. The median age was 43 at cohort entry and 66% were female. Median follow-up was 5.1 years. Evidence of a 10% to 20% increased hazard for the non-fatal primary outcomes for patients with atopic eczema was found by using Cox regression stratified by matched set. There was a strong dose-response relation with severity of atopic eczema. Patients with severe atopic eczema had a 20% increase in the risk of stroke (hazard ratio 1.22, 99% confidence interval 1.01 to 1.48), 40% to 50% increase in the risk of myocardial infarction, unstable angina, atrial fibrillation, and cardiovascular death, and 70% increase in the risk of heart failure (hazard ratio 1.69, 99% confidence interval 1.38 to 2.06). Patients with the most active atopic eczema (active >50% of follow-up) were also at a greater risk of cardiovascular outcomes. Additional adjustment for cardiovascular risk factors as potential mediators partially attenuated the point estimates, though associations persisted for severe atopic eczema. CONCLUSIONS: Severe and predominantly active atopic eczema are associated with an increased risk of cardiovascular outcomes. Targeting cardiovascular disease prevention strategies among these patients should be considered

The SLUGGS survey: the mass distribution in early-type galaxies within five effective radii and beyond

We study mass distributions within and beyond 5 effective radii (Re) in 23 early-type galaxies from the SAGES Legacy Unifying Globulars and Galaxies Survey, using their globular cluster (GC) kinematic data. The data are obtained with Keck/DEep Imaging Multi-Object Spectrograph, and consist of line-of-sight velocities for ̃3500 GCs, measured with a high precision of ̃15 km s-1 per GC and extending out to ̃13 Re. We obtain the mass distribution in each galaxy using the tracer mass estimator of Watkins et al. and account for kinematic substructures, rotation of the GC systems and galaxy flattening in our mass estimates. The observed scatter between our mass estimates and results from the literature is less than 0.2 dex. The dark matter fraction within 5 Re (fDM) increases from ̃0.6 to ̃0.8 for low- and high-mass galaxies, respectively, with some intermediate-mass galaxies (M* ̃ 1011 M☉) having low fDM ̃ 0.3, which appears at odds with predictions from simple galaxy models. We show that these results are independent of the adopted orbital anisotropy, stellar mass-to-light (M/L) ratio, and the assumed slope of the gravitational potential. However, the low fDM in the ̃1011 M☉ galaxies agrees with the cosmological simulations of Wu et al. where the pristine dark matter distribution has been modified by baryons during the galaxy assembly process. We find hints that these M* ̃ 1011 M☉ galaxies with low fDM have very diffuse dark matter haloes, implying that they assembled late. Beyond 5 Re, the M/L gradients are steeper in the more massive galaxies and shallower in both low and intermediate mass galaxies

The SLUGGS Survey: stellar kinematics, kinemetry and trends at large radii in 25 early-type galaxies

Due to longer dynamical time-scales, the outskirts of early-type galaxies retain the footprint of their formation and assembly. Under the popular two-phase galaxy formation scenario, an initial in situ phase of star formation is followed by minor merging and accretion of ex situ stars leading to the expectation of observable transitions in the kinematics and stellar populations on large scales. However, observing the faint galactic outskirts is challenging, often leaving the transition unexplored. The large-scale, spatially resolved stellar kinematic data from the SAGES Legacy Unifying Galaxies and GlobularS (SLUGGS) survey are ideal for detecting kinematic transitions. We present kinematic maps out to 2.6 effective radii on average, kinemetry profiles, measurement of kinematic twists and misalignments, and the average outer intrinsic shape of 25 SLUGGS galaxies. We find good overall agreement in the kinematic maps and kinemetry radial profiles with literature. We are able to confirm significant radial modulations in rotational versus pressure support of galaxies with radius so that the central and outer rotational properties may be quite different. We also test the suggestion that galaxies may be more triaxial in their outskirts and find that while fast rotating galaxies were already shown to be axisymmetric in their inner regions, we are unable to rule out triaxiality in their outskirts.We compare our derived outer kinematic information to model predictions from a two-phase galaxy formation scenario. We find that the theoretical range of local outer angular momentum agrees well with our observations, but that radial modulations are much smaller than predicted

Systematic review and meta-analysis of the diagnostic accuracy of ultrasonography for deep vein thrombosis

Background Ultrasound (US) has largely replaced contrast venography as the definitive diagnostic test for deep vein thrombosis (DVT). We aimed to derive a definitive estimate of the diagnostic accuracy of US for clinically suspected DVT and identify study-level factors that might predict accuracy. Methods We undertook a systematic review, meta-analysis and meta-regression of diagnostic cohort studies that compared US to contrast venography in patients with suspected DVT. We searched Medline, EMBASE, CINAHL, Web of Science, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, Database of Reviews of Effectiveness, the ACP Journal Club, and citation lists (1966 to April 2004). Random effects meta-analysis was used to derive pooled estimates of sensitivity and specificity. Random effects meta-regression was used to identify study-level covariates that predicted diagnostic performance. Results We identified 100 cohorts comparing US to venography in patients with suspected DVT. Overall sensitivity for proximal DVT (95% confidence interval) was 94.2% (93.2 to 95.0), for distal DVT was 63.5% (59.8 to 67.0), and specificity was 93.8% (93.1 to 94.4). Duplex US had pooled sensitivity of 96.5% (95.1 to 97.6) for proximal DVT, 71.2% (64.6 to 77.2) for distal DVT and specificity of 94.0% (92.8 to 95.1). Triplex US had pooled sensitivity of 96.4% (94.4 to 97.1%) for proximal DVT, 75.2% (67.7 to 81.6) for distal DVT and specificity of 94.3% (92.5 to 95.8). Compression US alone had pooled sensitivity of 93.8 % (92.0 to 95.3%) for proximal DVT, 56.8% (49.0 to 66.4) for distal DVT and specificity of 97.8% (97.0 to 98.4). Sensitivity was higher in more recently published studies and in cohorts with higher prevalence of DVT and more proximal DVT, and was lower in cohorts that reported interpretation by a radiologist. Specificity was higher in cohorts that excluded patients with previous DVT. No studies were identified that compared repeat US to venography in all patients. Repeat US appears to have a positive yield of 1.3%, with 89% of these being confirmed by venography. Conclusion Combined colour-doppler US techniques have optimal sensitivity, while compression US has optimal specificity for DVT. However, all estimates are subject to substantial unexplained heterogeneity. The role of repeat scanning is very uncertain and based upon limited data

Partner Bereavement and Risk of Herpes Zoster: Results from Two Population-Based Case-Control Studies in Denmark and the United Kingdom.

Background: Psychological stress is commonly thought to increase the risk of herpes zoster by causing immunosuppression. However, epidemiological studies on the topic are sparse and inconsistent. We conducted 2 parallel case-control studies of the association between partner bereavement and risk of zoster using electronic healthcare data covering the entire Danish population and general practices in the UK Clinical Practice Research Datalink. Methods: We included patients with a zoster diagnosis from the primary care or hospital-based setting in 1997-2013 in Denmark (n = 190671) and 2000-2013 in the United Kingdom (n = 150207). We matched up to 4 controls to each case patient by age, sex, and general practice (United Kingdom only) using risk-set sampling. The date of diagnosis was the index date for case patients and their controls. We computed adjusted odds ratios with 99% confidence intervals for previous bereavement among case patients versus controls using conditional logistic regression with results from the 2 settings pooled using random-effects meta-analysis. Results: Overall, the adjusted odds ratios for the association between partner bereavement and zoster were 1.05 (99% confidence interval, 1.03-1.07) in Denmark and 1.01 (.98-1.05) in the United Kingdom. The pooled estimates were 0.72, 0.90, 1.10, 1.08, 1.02, 1.04, and 1.03 for bereavement within 0-7, 8-14, 15-30, 31-90, 91-365, 366-1095, and >1095 days before the index date, respectively. Conclusions: We found no consistent evidence of an increased risk of zoster after partner death. Initial fluctuations in estimates may be explained by delayed healthcare contact due to the loss