Stool DNA testing is a new approach to colorectal cancer detection. Few data are available from the screening setting.
To compare stool DNA and fecal blood testing for detection of screen-relevant ...neoplasia (curable-stage cancer, high-grade dysplasia, or adenomas >1 cm).
Blinded, multicenter, cross-sectional study.
Communities surrounding 22 participating academic and regional health care systems in the United States.
4482 average-risk adults.
Fecal blood and DNA markers. Participants collected 3 stools, smeared fecal blood test cards and used same-day shipment to a central facility. Fecal blood cards (Hemoccult and HemoccultSensa, Beckman Coulter, Fullerton, California) were tested on 3 stools and DNA assays on 1 stool per patient. Stool DNA test 1 (SDT-1) was a precommercial 23-marker assay, and a novel test (SDT-2) targeted 3 broadly informative markers. The criterion standard was colonoscopy.
Sensitivity for screen-relevant neoplasms was 20% by SDT-1, 11% by Hemoccult (P = 0.020), 21% by HemoccultSensa (P = 0.80); sensitivity for cancer plus high-grade dysplasia did not differ among tests. Specificity was 96% by SDT-1, compared with 98% by Hemoccult (P < 0.001) and 97% by HemoccultSensa (P = 0.20). Stool DNA test 2 detected 46% of screen-relevant neoplasms, compared with 16% by Hemoccult (P < 0.001) and 24% by HemoccultSensa (P < 0.001). Stool DNA test 2 detected 46% of adenomas 1 cm or larger, compared with 10% by Hemoccult (P < 0.001) and 17% by HemoccultSensa (P < 0.001). Among colonoscopically normal patients, the positivity rate was 16% with SDT-2, compared with 4% with Hemoccult (P = 0.010) and 5% with HemoccultSensa (P = 0.030).
Stool DNA test 2 was not performed on all subsets of patients without screen-relevant neoplasms. Stools were collected without preservative, which reduced detection of some DNA markers.
Stool DNA test 1 provides no improvement over HemoccultSensa for detection of screen-relevant neoplasms. Stool DNA test 2 detects significantly more neoplasms than does Hemoccult or HemoccultSensa, but with more positive results in colonoscopically normal patients. Higher sensitivity of SDT-2 was particularly apparent for adenomas.
In clinical trials, vitamin D supplementation has been reported to reduce serum levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) but not ...high-density lipoprotein cholesterol (HDL-C). In this cohort study we evaluated the association between changes in vitamin D (25-hydroxyvitamin D) and changes in lipid levels in a real-world setting. Changes in lipid levels over a 1-year period were evaluated among individuals whose vitamin D levels increased (group 1) or decreased (group 2) by ≥ 10 ng/mL in year 2018 versus 2017 (cohort 1; n = 5580), in 2019 versus 2018 (cohort 2, n = 6057), or in 2020 versus 2019 (cohort 3, n = 7249). In each cohort, levels of TC, LDL-C, and TG decreased in group 1 and increased in group 2. Between-group differences in average changes in the 3 cohorts ranged from 10.71 to 12.02 mg/dL for TC, from 7.42 to 8.95 mg/dL for LDL-C, and from 21.59 to 28.09 mg/dL for TG. These differences were significant after adjusting for age, sex, race, education, body mass index, blood pressure, smoking status, geographical location, and baseline levels of vitamin D and lipids (P < 0.001). Changes in vitamin D levels were not significantly associated with changes in HDL-C levels.
Hydrothermal liquefaction (HTL) is an attractive method for converting wet biomass into petroleum-like biocrude oil that can be refined to make petroleum products. This approach is advantageous for ...conversion of low-lipid algae, which are promising feedstocks for sustainable large-scale biofuel production. As with natural petroleum formation, the water in contact with the produced oil contains toxic compounds. The objectives of this research were to: (1) identify nitrogenous organic compounds (NOCs) in wastewater from HTL conversion of Spirulina; (2) characterize mammalian cell cytotoxicity of specific NOCs, NOC mixture, and the complete HTL wastewater (HTL-WW) matrix; and (3) investigate mitigation measures to reduce toxicity in HTL-WW. Liquid–liquid extraction and nitrogen–phosphorus detection was used in conjunction with gas chromatography–mass spectrometry (GC–MS), which detected hundreds of NOCs in HTL-WW. Reference materials for nine of the most prevalent NOCs were used to identify and quantify their concentrations in HTL-WW. Mammalian cell cytotoxicity of the nine NOCs was quantified using a Chinese hamster ovary (CHO) cell assay, and the descending rank order for cytotoxicity was 3-dimethylamino-phenol > 2,2,6,6-tetramethyl-4-piperidone > 2,6-dimethyl-3-pyridinol > 2-picoline > pyridine > 1-methyl-2-pyrrolidinone > σ-valerolactam > 2-pyrrolidinone > ε-caprolactam. The organic mixture extracted from HTL-WW expressed potent CHO cell cytotoxic activity, with a LC50 at 7.5% of HTL-WW. Although the toxicity of HTL-WW was substantial, 30% of the toxicity was removed biologically by recycling HTL-WW back into algal cultivation. The remaining toxicity of HTL-WW was mostly eliminated by subsequent treatment with granular activated carbon.
To accurately model the long‐term durability of environmental barrier coatings (EBCs), a more complete understanding of the phase composition and transformations of the thermally grown oxide SiO2 ...(TGO) is desired. For the TGO formed during thermal cycling in steam, cristobalite formation and the subsequent β‐ to α‐cristobalite transformation has been identified as a potentially life‐limiting mechanism. In this study, Raman micro‐spectroscopy was used to quantify the cristobalite transformation on a polycrystalline Si coupon that was exposed to steam at 1350°C for 100 h. The phase transformation was mapped at 200–260°C on the TGO surface at different ramp rates using a heating stage and a micro‐positioning stage. The stress in the Si substrate was also determined using Raman spectroscopy by measuring the stress induced peak shift. The α→β phase transformation produced a 300–500 MPa tensile stress in the Si substrate, which compared well to the stress predicted from the volumetric expansion of the cristobalite. Quantifying the phase transformation and residual stress are critical tools in developing the next generation of high performance EBCs.
Metallic alloy bond coats are used as an interlayer to promote adhesion of ceramic Thermal Barrier Coatings (TBCs) to the superalloy substrates. These bond coats can be applied through a variety of ...processing means such as Air Plasma Spray (APS), High-Velocity Oxy Fuel spray (HVOF), and Vacuum Plasma Spray (VPS). While widely adopted in the industry, some uncertainties remain as to the specific microstructural attributes which are influenced by the processing routes and their implications on durability. This paper seeks to elucidate these subtleties between bond coat deposition processing routes through an integrated study of processing to connect to furnace cycle durability on a single bond coat chemistry of NiCoCrAlYHfSi. A standard porous APS TBC top coating based on yttria stabilized zirconia (7YSZ) was consistently applied on these distinct bond coats and tested for durability in cyclic furnace testing at 1100 °C. The results point to substantial differences in durability which are not readily explained only by the variances in coating roughness. Detailed assessment of deposited bond coat properties (modulus, thermal expansion, chemistry) provided some explanation relative to durability. The results suggest a complex interplay among roughness, compliance, aluminum diffusion pathway, and thermal expansion mismatch. Photo-stimulated luminescence piezospectroscopy (PLPS) provided additional insights enabling a comprehensive assessment of processing-performance linkages.
•Direct study of one bond coat powder chemistry, sprayed by three main processes (APS/HVOF/VPS).•Phase analysis of the bond coats from the three processes – APS has a phase not present in the others.•Dilation experiments of bond coats – APS shows low temperature behavior deviating from others.•No clear trend between FCT Life of TBC and Ra of the bond coat.•Stress maps of the bond coat oxide scale show there is a process dependence on scale growth behavior.
We present a study of the relation between dark matter halo mass and the baryonic content of their host galaxies, quantified through galaxy luminosity and stellar mass. Our investigation uses 154 ...deg2 of Canada-France-Hawaii Telescope Lensing Survey (CFHTLenS) lensing and photometric data, obtained from the CFHT Legacy Survey. To interpret the weak lensing signal around our galaxies, we employ a galaxy-galaxy lensing halo model which allows us to constrain the halo mass and the satellite fraction. Our analysis is limited to lenses at redshifts between 0.2 and 0.4, split into a red and a blue sample. We express the relationship between dark matter halo mass and baryonic observable as a power law with pivot points of
and
for luminosity and stellar mass, respectively. For the luminosity-halo mass relation, we find a slope of 1.32 ± 0.06 and a normalization of
for red galaxies, while for blue galaxies the best-fitting slope is
and the normalization is
. Similarly, we find a best-fitting slope of
and a normalization of
for the stellar mass-halo mass relation of red galaxies, while for blue galaxies the corresponding values are
and
. All numbers convey the 68 per cent confidence limit. For red lenses, the fraction which are satellites inside a larger halo tends to decrease with luminosity and stellar mass, with the sample being nearly all satellites for a stellar mass of
. The satellite fractions are generally close to zero for blue lenses, irrespective of luminosity or stellar mass. This, together with the shallower relation between halo mass and baryonic tracer, is a direct confirmation from galaxy-galaxy lensing that blue galaxies reside in less clustered environments than red galaxies. We also find that the halo model, while matching the lensing signal around red lenses well, is prone to overpredicting the large-scale signal for faint and less massive blue lenses. This could be a further indication that these galaxies tend to be more isolated than assumed.
Extreme obesity is associated with health and cardiovascular disease risks. Although gastric bypass surgery induces rapid weight loss and ameliorates many of these risks in the short term, long-term ...outcomes are uncertain.
To examine the association of Roux-en-Y gastric bypass (RYGB) surgery with weight loss, diabetes mellitus, and other health risks 6 years after surgery.
A prospective Utah-based study conducted between July 2000 and June 2011 of 1156 severely obese (body mass index BMI ≥ 35) participants aged 18 to 72 years (82% women; mean BMI, 45.9; 95% CI, 31.2-60.6) who sought and received RYGB surgery (n = 418), sought but did not have surgery (n = 417; control group 1), or who were randomly selected from a population-based sample not seeking weight loss surgery (n = 321; control group 2).
Weight loss, diabetes, hypertension, dyslipidemia, and health-related quality of life were compared between participants having RYGB surgery and control participants using propensity score adjustment.
Six years after surgery, patients who received RYGB surgery (with 92.6% follow-up) lost 27.7% (95% CI, 26.6%-28.9%) of their initial body weight compared with 0.2% (95% CI, -1.1% to 1.4%) gain in control group 1 and 0% (95% CI, -1.2% to 1.2%) in control group 2. Weight loss maintenance was superior in patients who received RYGB surgery, with 94% (95% CI, 92%-96%) and 76% (95% CI, 72%-81%) of patients receiving RYGB surgery maintaining at least 20% weight loss 2 and 6 years after surgery, respectively. Diabetes remission rates 6 years after surgery were 62% (95% CI, 49%-75%) in the RYGB surgery group, 8% (95% CI, 0%-16%) in control group 1, and 6% (95% CI, 0%-13%) in control group 2, with remission odds ratios (ORs) of 16.5 (95% CI, 4.7-57.6; P < .001) vs control group 1 and 21.5 (95% CI, 5.4-85.6; P < .001) vs control group 2. The incidence of diabetes throughout the course of the study was reduced after RYGB surgery (2%; 95% CI, 0%-4%; vs 17%; 95% CI, 10%-24%; OR, 0.11; 95% CI, 0.04-0.34 compared with control group 1 and 15%; 95% CI, 9%-21%; OR, 0.21; 95% CI, 0.06-0.67 compared with control group 2; both P < .001). The numbers of participants with bariatric surgery-related hospitalizations were 33 (7.9%), 13 (3.9%), and 6 (2.0%) for the RYGB surgery group and 2 control groups, respectively.
Among severely obese patients, compared with nonsurgical control patients, the use of RYGB surgery was associated with higher rates of diabetes remission and lower risk of cardiovascular and other health outcomes over 6 years.
The increasing emergence of antibiotic-resistant bacterial pathogens represents a serious risk to human health and the entire health care system. Many currently circulating strains of Acinetobacter ...baumannii exhibit resistance to multiple antibiotics. A key limitation in combating A. baumannii is that our understanding of the molecular mechanisms underlying the pathogenesis of A. baumannii is lacking. To identify potential virulence determinants of a contemporary multidrug-resistant isolate of A. baumannii, we used transposon insertion sequencing (TnSeq) of strain AB5075. A collection of 250,000 A. baumannii transposon mutants was analyzed for growth within Galleria mellonella larvae, an insect-based infection model. The screen identified 300 genes that were specifically required for survival and/or growth of A. baumannii inside G. mellonella larvae. These genes encompass both known, established virulence factors and several novel genes. Among these were more than 30 transcription factors required for growth in G. mellonella. A subset of the transcription factors was also found to be required for resistance to antibiotics and environmental stress. This work thus establishes a novel connection between virulence and resistance to both antibiotics and environmental stress in A. baumannii.
Acinetobacter baumannii is rapidly emerging as a significant human pathogen, largely because of disinfectant and antibiotic resistance, causing lethal infection in fragile hosts. Despite the increasing prevalence of infections with multidrug-resistant A. baumannii strains, little is known regarding not only the molecular mechanisms that allow A. baumannii to resist environmental stresses (i.e., antibiotics and disinfectants) but also how these pathogens survive within an infected host to cause disease. We employed a large-scale genetic screen to identify genes required for A. baumannii to survive and grow in an insect disease model. While we identified many known virulence factors harbored by A. baumannii, we also discovered many novel genes that likely play key roles in A. baumannii survival of exposure to antibiotics and other stress-inducing chemicals. These results suggest that selection for increased resistance to antibiotics and environmental stress may inadvertently select for increased virulence in A. baumannii.
Global climate change during the Late Pleistocene periodically encroached and then released habitat during the glacial cycles, causing range expansions and contractions in some species. These ...dynamics have played a major role in geographic radiations, diversification and speciation. We investigate these dynamics in the most widely distributed of marine mammals, the killer whale (Orcinus orca), using a global data set of over 450 samples. This marine top predator inhabits coastal and pelagic ecosystems ranging from the ice edge to the tropics, often exhibiting ecological, behavioural and morphological variation suggestive of local adaptation accompanied by reproductive isolation. Results suggest a rapid global radiation occurred over the last 350 000 years. Based on habitat models, we estimated there was only a 15% global contraction of core suitable habitat during the last glacial maximum, and the resources appeared to sustain a constant global effective female population size throughout the Late Pleistocene. Reconstruction of the ancestral phylogeography highlighted the high mobility of this species, identifying 22 strongly supported long‐range dispersal events including interoceanic and interhemispheric movement. Despite this propensity for geographic dispersal, the increased sampling of this study uncovered very few potential examples of ancestral dispersal among ecotypes. Concordance of nuclear and mitochondrial data further confirms genetic cohesiveness, with little or no current gene flow among sympatric ecotypes. Taken as a whole, our data suggest that the glacial cycles influenced local populations in different ways, with no clear global pattern, but with secondary contact among lineages following long‐range dispersal as a potential mechanism driving ecological diversification.
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