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Search Results: 1 - 10 of 266560 matches for " David C Greenberg "
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Trends and variation in the management of oesophagogastric cancer patients: a population-based survey
Georgios Lyratzopoulos, Josephine M Barbiere, Chetna Gajperia, Michael Rhodes, David C Greenberg, Karen A Wright
BMC Health Services Research , 2009, DOI: 10.1186/1472-6963-9-231
Abstract: We analysed population-based cancer registry data about the treatment patterning of oesophagogastric cancer (other than oesophageal squamous cell carcinoma) during 1995-2006.There were 14,077 patients aged ≥40 years (69% men). There was only limited information on stage, and no information on co-morbidity status. During successive triennia, curative surgery use decreased from 28% to 20% (p < 0.001) whilst chemotherapy use increased from 9% to 30% (p < 0.001). Use of palliative surgery and of radiotherapy increased significantly but modestly (7% to 10%, and 9% to 11%, respectively). In multivariable logistic regression adjusting for age group, gender, diagnosis period and tumour type, curative surgery and chemotherapy were used less frequently in more deprived patients [per increasing deprivation group Odds Ratio (OR) = 0.96, 95% Confidence Interval (CI) 0.93-0.99, and OR = 0.90, 95%CI 0.87-0.93, respectively, p < 0.001 for both)]. Chemotherapy was also used less frequently in women (OR = 0.76, p < 0.001).During the study period, curative surgery decreased by a third and chemotherapy use increased by more than three-fold, reflecting improvements in the appropriateness and quality of management, but chemotherapy use, in particular, was unequal, both by socioeconomic status and gender.Oesophageal and stomach cancers [including Oesophageal Squamous Cell Carcinoma (OSCC), Oesophageal Adeno-Carcinoma (OAC), Junctional/Cardia Adenocarcinoma (JCA) and Non-Cardia Gastric Adenocarcinoma (NCGA)] are common. In the UK, they account for over 15,000 new cases per year, and over 13,000 deaths, with stomach and oesophageal cancers being the 6th and 8th most common malignancies in men[1]. Although radical surgery could offer cure, fewer than a quarter of all patients present at a stage that can be treated surgically[2]. For suitable patients, peri-operative chemotherapy has been shown to improve survival[3,4]. This is thought to have led to a substantial increase in chemotherapy use
Correction: PREDICT: a new UK prognostic model that predicts survival following surgery for invasive breast cancer
Gordon C Wishart, Elizabeth M Azzato, David C Greenberg, Jem Rashbass, Olive Kearins, Gill Lawrence, Carlos Caldas, Paul DP Pharoah
Breast Cancer Research , 2010, DOI: 10.1186/bcr2480
PREDICT: a new UK prognostic model that predicts survival following surgery for invasive breast cancer
Gordon C Wishart, Elizabeth M Azzato, David C Greenberg, Jem Rashbass, Olive Kearins, Gill Lawrence, Carlos Caldas, Paul DP Pharoah
Breast Cancer Research , 2010, DOI: 10.1186/bcr2464
Abstract: Using the Eastern Cancer Registration and Information Centre (ECRIC) dataset, information was collated for 5,694 women who had surgery for invasive breast cancer in East Anglia from 1999 to 2003. Breast cancer mortality models for oestrogen receptor (ER) positive and ER negative tumours were derived from these data using Cox proportional hazards, adjusting for prognostic factors and mode of cancer detection (symptomatic versus screen-detected). An external dataset of 5,468 patients from the West Midlands Cancer Intelligence Unit (WMCIU) was used for validation.Differences in overall actual and predicted mortality were <1% at eight years for ECRIC (18.9% vs. 19.0%) and WMCIU (17.5% vs. 18.3%) with area under receiver-operator-characteristic curves (AUC) of 0.81 and 0.79 respectively. Differences in breast cancer specific actual and predicted mortality were <1% at eight years for ECRIC (12.9% vs. 13.5%) and <1.5% at eight years for WMCIU (12.2% vs. 13.6%) with AUC of 0.84 and 0.82 respectively. Model calibration was good for both ER positive and negative models although the ER positive model provided better discrimination (AUC 0.82) than ER negative (AUC 0.75).We have developed a prognostication model for early breast cancer based on UK cancer registry data that predicts breast cancer survival following surgery for invasive breast cancer and includes mode of detection for the first time. The model is well calibrated, provides a high degree of discrimination and has been validated in a second UK patient cohort.Accurate prediction of survival is an essential part of the decision making process following surgery for early breast cancer and allows clinicians to determine which patients will benefit from adjuvant therapy. At present these decisions are largely based on known pathological prognostic factors that retain independent significance on multivariate analysis including tumour size, tumour grade and lymph node status in addition to the efficacy of any adjuvant thera
Anticholinergic delirium following Datura stramonium ingestion: Implications for the Internet age
Vearrier David,Greenberg Michael
Journal of Emergencies, Trauma and Shock , 2010,
Abstract: Recreational use of Datura to deliberately induce an anticholinergic delirium is not uncommon. We present a case of Datura intoxication in a young adult who learned about the recreational use of Datura on the Internet and subsequently purchased Datura stramonium seeds from an online vendor. Using the Google search engine, we conducted searches for "Datura," "jimson weed" and "Datura seeds" and reviewed the first 200 search results for each search term. We found 16 websites recommending the recreational use of Datura, 12 vendors selling seeds of genus Datura and one website that both promoted the recreational use of Datura and also sold Datura stramonium leaves. The promotion of recreational use of Datura on the Internet represents a danger to public health and the ability to purchase Datura seeds from Internet vendors may increase the prevalence of Datura abuse.
Acute Otitis Media in Children: Current Epidemiology, Microbiology, Clinical Manifestations, and Treatment.
Eugene Leibovitz,David Greenberg
Chang Gung Medical Journal , 2004,
Abstract: An accurate differential diagnosis of AOM is essential for ensuring appropriate treatment,since overdiagnosis of disease is common and antibiotics are not indicated for otitismedia with effusion. Although antibiotic therapy is required in only 20-30% of all AOMcases (high rate of spontaneous recovery), most of the patients are treated since this smallproportion cannot be quickly and easily identified. The main determinant of the efficacy ofantibiotics in AOM is the time that drug concentration at the site of infection exceeds theminimal inhibitory concentration for the pathogen. The major problems encountered in theantibiotic therapy of AOM are the tremendous increase in the resistance to antibiotics of itsmain pathogens and the lack of tight criteria in the selection of the appropriate antibioticdrugs for the treatment of this disease. The recently published Center for Disease Controland Prevention (CDC) guidelines for the treatment of AOM represent a major step forwardin the rational approach to the management of this disease by establishing a clear hierarchyamong the various therapeutic agents used in the treatment of simple and complicated AOM.A seven-valent pneumococcal conjugate vaccine recently licensed in the United States foruniversal immunization of infants < 2 years has demonstrated efficacy for prevention ofserotype-specific pneumococcal AOM.
Community-Acquired Pneumonia in Children: From Diagnosis to Treatment
David Greenberg,Eugene Leibovitz
Chang Gung Medical Journal , 2005,
Abstract: Community-acquired pneumonia (CAP) in children is a leading cause of childhoodmorbidity and mortality mainly in the developing world. Its etiology can be viral, bacterial,or mixed infection. The etiological agents are different in different age groups and duringthe various seasons of the year. Chest X-rays and inflammatory laboratory tests have lowdiagnostic sensitivity and specificity. CAP in children has an important impact on societyand is a frequent cause of physician visits, work loss, and reduction of quality of life of thechildren and his/her family. The use of treatment algorithms in the developing countries hasled to lower mortality rates, but the future of this approach, given the rate of development ofantimicrobial resistance, is uncertain. The wider use of pneumococcal vaccines may representan important advance in the prevention of pneumonia caused by Streptococcus pneumoniae.
Using Linkage Analysis to Detect Gene-Gene Interaction by Stratifying Family Data on Known Disease, or Disease-Associated, Alleles
Barbara Corso, David A. Greenberg
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0093398
Abstract: Detecting gene-gene interaction in complex diseases is a major challenge for common disease genetics. Most interaction detection approaches use disease-marker associations and such methods have low power and unknown reliability in real data. We developed and tested a powerful linkage-analysis-based gene-gene interaction detection strategy based on conditioning the family data on a known disease-causing allele or disease-associated marker allele. We computer-generated multipoint linkage data for a disease caused by two epistatically interacting loci (A and B). We examined several two-locus epistatic inheritance models: dominant-dominant, dominant-recessive, recessive-dominant, recessive-recessive. At one of the loci (A), there was a known disease-related allele. We stratified the family data on the presence of this allele, eliminating family members who were without it. This elimination step has the effect of raising the “penetrance” at the second locus (B). We then calculated the lod score at the second locus (B) and compared the pre- and post-stratification lod scores at B. A positive difference indicated interaction. We also examined if it was possible to detect interaction with locus B based on a disease-marker association (instead of an identified disease allele) at locus A. We also tested whether the presence of genetic heterogeneity would generate false positive evidence of interaction. The power to detect interaction for a known disease allele was 60–90%. The probability of false positives, based on heterogeneity, was low. Decreasing linkage disequilibrium between the disease and marker at locus A decreased the likelihood of detecting interaction. The allele frequency of the associated marker made little difference to the power.
AAV-Mediated, Optogenetic Ablation of Müller Glia Leads to Structural and Functional Changes in the Mouse Retina
Leah C. Byrne, Fakhra Khalid, Trevor Lee, Emilia A. Zin, Kenneth P. Greenberg, Meike Visel, David V. Schaffer, John G. Flannery
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0076075
Abstract: Müller glia, the primary glial cell in the retina, provide structural and metabolic support for neurons and are essential for retinal integrity. Müller cells are closely involved in many retinal degenerative diseases, including macular telangiectasia type 2, in which impairment of central vision may be linked to a primary defect in Müller glia. Here, we used an engineered, Müller-specific variant of AAV, called ShH10, to deliver a photo-inducibly toxic protein, KillerRed, to Müller cells in the mouse retina. We characterized the results of specific ablation of these cells on visual function and retinal structure. ShH10-KillerRed expression was obtained following intravitreal injection and eyes were then irradiated with green light to induce toxicity. Induction of KillerRed led to loss of Müller cells and a concomitant decrease of Müller cell markers glutamine synthetase and cellular retinaldehyde-binding protein, reduction of rhodopsin and cone opsin, and upregulation of glial fibrillary acidic protein. Loss of Müller cells also resulted in retinal disorganization, including thinning of the outer nuclear layer and the photoreceptor inner and outer segments. High resolution imaging of thin sections revealed displacement of photoreceptors from the ONL, formation of rosette-like structures and the presence of phagocytic cells. Furthermore, Müller cell ablation resulted in increased area and volume of retinal blood vessels, as well as the formation of tortuous blood vessels and vascular leakage. Electrophysiologic measures demonstrated reduced retinal function, evident in decreased photopic and scotopic electroretinogram amplitudes. These results show that loss of Müller cells can cause progressive retinal degenerative disease, and suggest that AAV delivery of an inducibly toxic protein in Müller cells may be useful to create large animal models of retinal dystrophies.
Steady-State Size Distributions for Collisional Populations: Analytical Solution with Size-Dependent Strength
David P. O'Brien,Richard Greenberg
Physics , 2014, DOI: 10.1016/S0019-1035(03)00145-3
Abstract: The steady-state population of bodies resulting from a collisional cascade depends on how material strength varies with size. We find a simple expression for the power-law index of the population, given a power law that describes how material strength varies with size. This result is extended to the case relevant for the asteroid belt and Kuiper belt, in which the material strength is described by 2 separate power laws--one for small bodies and one for larger bodies. We find that the power-law index of the small body population is unaffected by the strength law for the large bodies, and vice versa. Simple analytical expressions describe a wave that is superimposed on the large body population because of the transition between the two power laws describing the strength. These analytical results yield excellent agreement with a numerical simulation of collisional evolution. These results will help to interpret observations of the asteroids and KBOs, and constrain the strength properties of those objects.
Inherent enumerability of strong jump-traceability
David Diamondstone,Noam Greenberg,Daniel Turetsky
Mathematics , 2011,
Abstract: We show that every strongly jump-traceable set obeys every benign cost function. Moreover, we show that every strongly jump-traceable set is computable from a computably enumerable strongly jump-traceable set. This allows us to generalise properties of c.e.\ strongly jump-traceable sets to all such sets. For example, the strongly jump-traceable sets induce an ideal in the Turing degrees; the strongly jump-traceable sets are precisely those that are computable from all superlow Martin-L\"{o}f random sets; the strongly jump-traceable sets are precisely those that are a base for $\text{Demuth}_{\text{BLR}}$-randomness; and strong jump-traceability is equivalent to strong superlowness.
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