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23 results

Page 1 of 2

  • Computed tomography-based radiomic markers are independent prognosticators of survival in advanced laryngeal cancer: a pilot study

  • Amarkumar Dhirajlal Rajgor, Christopher Kui, Andrew McQueen, Josh Cowley, Colin Gillespie, Aileen Mill, Stephen Rushton, Boguslaw Obara, Theophile Bigirumurame, Khaled Kallas, James O'Hara, Eric Aboagye, David Winston Hamilton
  • Journal:
    The Journal of Laryngology & Otology / Volume 138 / Issue 6 / June 2024
    Published online by Cambridge University Press:
    14 December 2023, pp. 685-691
    Print publication:
    June 2024
    • Article
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      • Open access
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  • Objective

    Advanced laryngeal cancers are clinically complex; there is a paucity of modern decision-making models to guide tumour-specific management. This pilot study aims to identify computed tomography-based radiomic features that may predict survival and enhance prognostication.

    Methods

    Pre-biopsy, contrast-enhanced computed tomography scans were assembled from a retrospective cohort (n = 72) with advanced laryngeal cancers (T3 and T4). The LIFEx software was used for radiomic feature extraction. Two features: shape compacity (irregularity of tumour volume) and grey-level zone length matrix – grey-level non-uniformity (tumour heterogeneity) were selected via least absolute shrinkage and selection operator-based Cox regression and explored for prognostic potential.

    Results

    A greater shape compacity (hazard ratio 2.89) and grey-level zone length matrix – grey-level non-uniformity (hazard ratio 1.64) were significantly associated with worse 5-year disease-specific survival (p < 0.05). Cox regression models yielded a superior C-index when incorporating radiomic features (0.759) versus clinicopathological variables alone (0.655).

    Conclusions

    Two radiomic features were identified as independent prognostic biomarkers. A multi-centre prospective study is necessary for further exploration. Integrated radiomic models may refine the treatment of advanced laryngeal cancers.

  • Galeaclolusite, [Al6(AsO4)3(OH)9(H2O)4]⋅8H2O, a new bulachite-related mineral from Cap Garonne, France

  • Ian E. Grey, George Favreau, Stuart J. Mills, W. Gus Mumme, Catherine Bougerol, Helen E.A. Brand, Anthony R. Kampf, Colin M. MacRae, Finlay Shanks
  • Journal:
    Mineralogical Magazine / Volume 85 / Issue 2 / April 2021
    Published online by Cambridge University Press:
    04 December 2020, pp. 142-148

  • Galeaclolusite, [Al6(AsO4)3(OH)9(H2O)4]⋅8H2O, is a new secondary hydrated aluminium arsenate mineral from Cap Garonne, Var, France. It forms crusts and spheroids of white fibres up to 50 μm long by 0.4 μm wide and only 0.1 μm thick. The fibres are elongated along [001] and flattened on (100). The calculated density is 2.27 g⋅cm–3. Optically, galeaclolusite is biaxial with α = 1.550(5), β not determined, γ = 1.570(5) (white light) and partial orientation: Z = c (fibre axis). Electron microprobe analyses coupled with crystal structure refinement results gives an empirical formula based on 33 O atoms of Al5.72Si0.08As2.88O33H34.12. Galeaclolusite is orthorhombic, Pnma, with a = 19.855(4), b = 17.6933(11), c = 7.7799(5) Å, V = 2733.0(7) Å3 and Z = 4. The crystal structure of galeaclolusite was established from its close relationship to bulachite and refined using synchrotron powder X-ray diffraction data. It is based on heteropolyhedral layers, parallel to (100), of composition Al6(AsO4)3(OH)9(H2O)4 and with H-bonded H2O between the layers. The layers contain [001] spiral chains of edge-shared octahedra, decorated with corner-connected AsO4 tetrahedra, that are the same as in the mineral liskeardite.

  • The future of walnut–fruit forests in Kyrgyzstan and the status of the iconic Endangered apple Malus niedzwetzkyana

  • Brett Wilson, Morena Mills, Maksim Kulikov, Colin Clubbe
  • Journal:
    Oryx / Volume 53 / Issue 3 / July 2019
    Published online by Cambridge University Press:
    07 March 2019, pp. 415-423
    Print publication:
    July 2019
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  • Forest ecosystems are rich in biodiversity and provide valuable ecosystem services, but are declining worldwide. Malus niedzwetzkyana, an Endangered wild relative of domesticated apples, is an important component of the walnut–fruit forests of Central Asia. Its iconic pink blossom and genetic properties give it special cultural and scientific significance, but livestock grazing and firewood collection threaten its survival. The conservation of the species and its native forest ecosystem is critical and urgent. This study provides information on the ecology and population of M. niedzwetzkyana and the threats affecting its habitat, improving our understanding of its distribution and proposing measures to reduce threats. We collected ecological data and assessed population structure and threats at four forest sites in southern Kyrgyzstan. We mapped 149 individuals, creating the largest known dataset for this species. We developed species distribution models for M. niedzwetzkyana to identify climatically suitable regions and potential areas for restoration. Sary-Chelek Biosphere Reserve contained the largest expanse of pristine forest and the most stable M. niedzwetzkyana population, followed by Kara-Alma Forestry Unit. Forests in the Gava Forestry Unit and Dashman Reserve were most extensively damaged by humans and livestock. The wild apple's favoured habitat was south-west facing slopes with a gradient < 30° and a relatively open canopy. Overall, the study population was vulnerable to extinction with limited regeneration potential. We recommend short-term population enhancement through planting projects and increased protection of individuals in pristine sites. Community-based conservation initiatives should be prioritized in extensively damaged sites, and larger-scale reforestation of these forests needs to be considered.

  • Case management of individuals with long-term conditions by community matrons: report of qualitative findings of a mixed method evaluation

  • Sue Randall, Guy Daly, Colin Thunhurst, Natalie Mills, David A. Guest, Annette Barker
  • Journal:
    Primary Health Care Research & Development / Volume 15 / Issue 1 / January 2014
    Published online by Cambridge University Press:
    04 February 2013, pp. 26-37
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  • Aim

    To consider findings from a study that evaluated case management of individuals with long-term conditions (LTCs) by a community matron (CM) service. The paper highlights issues related to the implementation of a new role and the impact this had on the experience of care across hospital and community settings for patients and their carers.

    Background

    The introduction of the role of CM was intended to increase effective management of patients with complex comorbid LTCs through the introduction of case management, thereby reducing unplanned hospital admissions.

    Methods

    The overall methodological approach was one of mixed methods. This paper reports the qualitative findings from CMs (n = 15); patients (n = 13); family carers (n = 8); and secondary care staff who interface with the CM service (n = 7). Data were collected between October 2009 and May 2010.

    Findings

    A thematic analysis resulted in the identification of four themes: (1) visibility; (2) interpersonal relationships; (3) leadership; and (4) systems/professional boundaries. Patients enjoyed being seen as a whole and family carers appreciated the coordination aspect of the role. Difficulties arose from the limited understanding of the CM role and from a lack of a shared vision across healthcare professionals concerning the role and its goals.

  • Trends in Intergenerational Class Mobility in Modern Britain: Evidence From National Surveys, 1972—2005

  • John H. Goldthorpe, Colin Mills
  • Journal:
    National Institute Economic Review / Volume 205 / July 2008
    Published online by Cambridge University Press:
    26 March 2020, pp. 83-100
    Print publication:
    July 2008

  • We present analyses of intergenerational social class mobility based on data from representative samples of the British population from 1972 to 2005. We distinguish throughout between absolute and relative rates of mobility. As regards absolute rates, we find little or no change in total mobility rates over the period covered. In the case of men, there is also little change in rates of upward and downward mobility — in contrast with the middle decades of the twentieth century when upward mobility steadily increased while downward mobility fell. This latter pattern does, however, prevail in the case of women. As regards relative rates, we again find, for men and women alike, an essential constancy over time. This, then, indicates that such changes as are apparent in absolute rates derive from shifts in class distributions rather than from any significant increase or decrease in social fluidity. Our results are contrary to the prevailing view in political and media circles that in Britain today the level of social mobility is in decline, although for men the pattern of mobility has become less favourable. We end with some remarks on policy implications.

  • Clinical Anaesthesia

  • from Section 1 - Questions
  • Colin Pinnock, Robert Jones, Simon Maguire, Julian M. Barker, Simon Mills
  • Book:
    QBase Anaesthesia
    Published online:
    05 October 2015
    Print publication:
    01 January 2000, pp 35-46

  • Summary

    Q 1. Signs of increasing intracranial pressure may include

    1. A. Decreasing level of consciousness

    2. B. Hypotension

    3. C. Small pupils

    4. D. Tachycardia

    5. E. Rhinorrhoea

    Q 2. Which of the following are correct

    1. A. Vagus nerve innervates the epiglottis

    2. B. Recurrent laryngeal nerve gives the motor supply to the abductors of the vocal cords

    3. C. Median nerve supplies the outer 3½ fingers

    4. D. Subclavian vein is posterior to the artery

    5. E. Subarachnoid space ends at L2

    Q 3. In a patient with a recent head injury the following are indications for immediate surgery

    1. A. Depressed skull fracture

    2. B. Extradural haematoma

    3. C. Subdural haematoma

    4. D. CSF rhinorrhoea

    5. E. Hydrocephalus

    Q 4. DC cardioversion may be indicated in

    1. A. Ventricular tachycardia

    2. B. Premature atrial contractions

    3. C. Atrial flutter

    4. D. Digitalis toxicity

    5. E. Supraventricular tachycardia

    Q 5. Which of the following nerves supply the intrinsic muscles of the larynx

    1. A. Internal laryngeal

    2. B. Hypoglossal

    3. C. Those originating in the nucleus ambiguus

    4. D. Recurrent laryngeal

    5. E. Glossopharyngeal

    Q 6. Deep venous thrombosis (DVT) is more common in

    1. A. Elderly patients

    2. B. Patients with malignant disease

    3. C. Patients with cardiac failure

    4. D. Patients receiving dextrans

    5. E. Patients on hormone replacement therapy

    Q 7. The following ECG changes are seen with hyperkalaemia

    1. A. Loss of p wave

    2. B. Widening of QRS

    3. C. VF

    4. D. Increased size of T wave

    5. E. Increased size of U wave

    Q 8. In a pressure cycled ventilator

    1. A. The cycling pressure is determined by the patients compliance

    2. B. The inspiratory time is fixed

    3. C. It is a minute volume divider

    4. D. The expiratory period may be time cycled

    5. E. The tidal volume is fixed

    Q 9. Regarding statistics

    1. A. The middle observation in an ordered series is a median

    2. B. The mean is the most frequently occurring observation in a series

    3. C. Standard deviation gives an indication of the scatter of Observations

    4. D. 95% of all observations should lie within ±2 standard deviations

    5. E. Standard deviation is a measure of the significance of observations

    Q 10. Regarding statistics

    1. A. The standard deviation is the square root of the variance

    2. B. The standard deviation is less than the standard error

    3. C. A type I error occurs when the null hypothesis is rejected when it is true

    4. D. The power of a study is defined as 1_ type II error rate

    5. E. The student's t test can be applied to normally distributed data

  • Physiology

  • from Section 1 - Questions
  • Colin Pinnock, Robert Jones, Simon Maguire, Julian M. Barker, Simon Mills
  • Book:
    QBase Anaesthesia
    Published online:
    05 October 2015
    Print publication:
    01 January 2000, pp 47-78

  • Summary

    Q 1. The knee jerk

    1. A. Is a monosynaptic reflex

    2. B. Arises from the spinal cord at T12

    3. C. Afferents are from the quadriceps tendon

    4. D. Is not affected by higher centres

    5. E. Afferents come from the quadriceps muscle

    Q 2. Which of the following are true

    1. A. Vertebrate myelinated nerve fibres are between 1 and 20 microns in diameter

    2. B. When a nerve impulse reaches the muscle ‘end-plate’ electrical transmission occurs

    3. C. 5-hydroxytryptamine is one of the neurotransmitters at the skeletal neuromuscular junction

    4. D. The motor neurones running to intrafusal fibres are gammamotor fibres

    5. E. Fusimotor nerves are afferent only

    Q 3. The vesicles in the adrenal medulla

    1. A. Contain isoprenaline

    2. B. Store catecholamines and chromogranins

    3. C. Contain DOPA decarboxylase

    4. D. Calcium ions are involved in the release process

    5. E. Release is cholinergic

    Q 4. The conduction velocity along a nerve

    1. A. Increases with diameter

    2. B. Is increased by myelination

    3. C. Increases when the serum potassium is low

    4. D. Is greater in motor than in sensory nerves

    5. E. Is greater in delta than alpha fibres

    Q 5. The following are transmitters at autonomic ganglia

    1. A. Dopamine

    2. B. Metacholine

    3. C. GABA

    4. D. 5-HT

    5. E. Glycine

    Q 6. Nerve fibres

    1. A. Have a lower electrical resistance than surrounding body fluids and tissues

    2. B. The velocity of propagation of the impulse is faster in larger fibres

    3. C. The fastest conduction velocities are about 100 m/s

    4. D. Pain fibres are unmyelinated and are A-delta and C-fibres

    5. E. Smaller fibres are less susceptible to local anaesthetics

    Q 7. These modalities correspond to their pathways

    1. A. Proprioception via the dorsal columns

    2. B. Temperature and pain via the contralateral spinothalamic tracts

    3. C. Fibres subserving fine touch form the gracile and cuneate nuclei

    4. D. Proprioception and the pyramidal tract

    5. E. Spinocerebellar tracts cross before reaching the cerebellum

    Q 8. Muscle spindles

    1. A. Are the receptors which excite the normal reflex arc

    2. B. Carry afferent impulses in fusimotor fibres

    3. C. Respond to a rise in muscle tension either from contraction or external stretch

    4. D. Are bundles of modified intrafusal fibres equipped with sensory and motor nerves

    5. E. Are found in smooth muscle

  • Pharmacology

  • from Section 1 - Questions
  • Colin Pinnock, Robert Jones, Simon Maguire, Julian M. Barker, Simon Mills
  • Book:
    QBase Anaesthesia
    Published online:
    05 October 2015
    Print publication:
    01 January 2000, pp 79-108

  • Summary

    Q 1. Adrenaline

    1. A. Is synthesised from noradrenaline by a methyl transferase in the adrenal medulla and nerve endings

    2. B. Increases the basal metabolic rate

    3. C. Is metabolised in the liver

    4. D. Stimulates glycogenolysis

    5. E. Causes systolic and diastolic hypertension when injected Intravenously

    Q 2. Prostaglandins E2 and F2 are

    1. A. Not naturally occurring substances

    2. B. Used to induce abortion and labour

    3. C. Metabolised in the pulmonary circulation

    4. D. Modulators of histamine and bradykinin action in pain

    5. E. Stored in mast cells

    Q 3. Alpha-adrenergic stimulation produces

    1. A. Vasodilation

    2. B. Tachycardia

    3. C. Uterine relaxation

    4. D. A positive inotropic effect

    5. E. Intestinal relaxation

    Q 4. Ringer lactate contains (in mmol/l)

    1. A. Na – 131

    2. B. K – 5.0

    3. C. Ca – 4.0

    4. D. Lactate – 29

    5. E. Cl – 112

    Q 5. Digitalis toxicity

    1. A. May be indicated by bradycardia and a prolonged P-R interval

    2. B. May be indicated by a supra ventricular tachycardia or ventricular extrasystoles

    3. C. May be reduced by giving calcium salts

    4. D. Is usefully treated by the slow infusion of phenytoin

    5. E. Is an absolute contraindication to beta-blockade

    Q 6. Side effects of steroid therapy include

    1. A. Growth retardation in children

    2. B. Osteomalacia

    3. C. Precipitation of diabetes mellitus

    4. D. Glaucoma

    5. E. Depression

    Q 7. The rate at which the alveolar concentration of an anaesthetic approaches inspired concentration is a function of

    1. A. Alveolar ventilation

    2. B. Water solubility of agent

    3. C. Cardiac output

    4. D. Saturated vapour pressure

    5. E. Inspired concentration

    Q 8. Acetylcholinesterase

    1. A. Is found in plasma

    2. B. Is inhibited by pilocarpine

    3. C. Will hydrolyse dibucaine

    4. D. Hydrolyses acetylcholine faster than other choline esters

    5. E. Is present in high concentration in the placenta

    Q 9. Paracetamol

    1. A. Inhibits prostaglandin synthesis

    2. B. Is highly protein bound

    3. C. Has a low bioavailability due to first pass metabolism

    4. D. Can cause thrombocytopaenia at therapeutic levels

    5. E. Is conjugated in the liver to both glucuronide and sulphate Conjugates

    Q 10. Boiling points

    1. A. Diethyl ether = -104.6˚C

    2. B. Cyclopropane= -33˚C

    3. C. Nitrous oxide= -88˚C

    4. D. Halothane = 50.2˚C

    5. E. Trichloroethylene = 34˚C

    Q 11. Side effects of phenytoin are

    1. A. Ataxia

    2. B. Megaloblastic anaemia

    3. C. Hepatic damage

    4. D. Skin rashes

    5. E. Agranulocytosis

  • Physics and Clinical Measurement

  • from Section 1 - Questions
  • Colin Pinnock, Robert Jones, Simon Maguire, Julian M. Barker, Simon Mills
  • Book:
    QBase Anaesthesia
    Published online:
    05 October 2015
    Print publication:
    01 January 2000, pp 3-34

  • Summary

    Q 1. With respect to damping

    1. A. Damping does not apply to electrical devices

    2. B. Damping affects the step response of the system

    3. C. Underdamping results in overestimation

    4. D. Overdamping results in overestimation

    5. E. Critical damping refers to the fastest steady state reading of the system with no oscillation

    Q 2. Concerning the gas laws

    1. A. Boyle's law refers to the relationship between temperature and pressure of a gas

    2. B. Temperature is measured on the absolute temperature scale

    3. C. Temperature is a constant in Charles’ law

    4. D. Boyle's law states that at a constant volume, pressure varies with temperature

    5. E. The gas laws are only true for air

    Q 3. The critical temperature of a gas is that

    1. A. Below which it solidifies

    2. B. Above which it will not liquefy despite increased pressure

    3. C. At which it sublimes

    4. D. At which it liquefies if pressure is decreased

    5. E. At which kinetic energy is zero

    Q 4. The following are correct SI Units

    1. A. The unit of energy is newton

    2. B. The unit of power is watt

    3. C. The unit of frequency is hertz

    4. D. The unit of mass is gram

    5. E. The unit of length is metre

    Q 5. The peak expiratory flow rate (PEFR)

    1. A. In normal adults is often more than 500 l/min

    2. B. Can be measured by a pneumotachograph

    3. C. Can be measured by the Wright's peak flow meter

    4. D. Increases with age

    5. E. Can be improved by training

    Q 6. The amount of gas dissolved in a liquid

    1. A. Increases as the temperature of the liquid increases

    2. B. Is proportional to the pressure of the gas in contact with the liquid

    3. C. Is influenced by the presence of other dissolved gases

    4. D. Exerts the same ‘tension’ as the partial pressure of the gas in contact with the liquid at equilibrium

    5. E. Is proportional to the molecular weight of the gas

QBase Anaesthesia
  • Volume 6, MCQ Companion to Fundamentals of Anaesthesia
  • Colin Pinnock, Robert Jones, Simon Maguire, Julian M. Barker, Simon Mills
  • Published online:
    05 October 2015
    Print publication:
    01 January 2000
  • This volume has been written by the editors of Fundamentals of Anaesthesia: 2nd Edition and The Clinical Anaesthesia Viva Book, two best-selling GMM titles for trainee anaesthetists. As well as the usual QBase features that allow candidates to practice, mark, resit and infinitely customise MCQ examinations using the free QBase CD-ROM, this volume has the added value of being cross-referenced throughout to 'Fundamentals of Anaesthesia: 2nd Edition'.

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