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Background: Guidelines for urgent investigation of colorectal cancer (CRC) are based on age and symptom-based criteria. This study aims to compare the diagnostic value of clinical features and faecal immunochemical test (FIT) results to identify those at a higher risk of CRC, thereby facilitating effective triage of patients. Methods: We undertook a review of all patients referred for investigation of CRC at our centre between September 2016 and June 2018. Patients were identified using a prospectively recorded local database. We performed a logistic regression analysis of factors associated with a diagnosis of CRC. Results: One-thousand-and-seven-hundred-eighty-four patients with FIT results were included in the study. Change in bowel habit (CIBH) was the most common referring clinical feature (38.3%). Patients diagnosed with CRC were significantly older than those without malignancy (74.0 years vs 68.9 years, p = 0.0007). Male patients were more likely to be diagnosed with CRC than females (6.5% vs 2.5%, Chi-squared 16.93, p < 0.0001). CRC was diagnosed in 3.5% (24/684) with CIBH compared to 8.1% (6/74) with both CIBH and iron deficiency anaemia. No individual or combination of referring clinical features was associated with an increased diagnosis of CRC (Chi-squared, 8.03, p = 0.155). Three patients with negative FIT results (< 4 µg Hb/g faeces) were diagnosed with CRC (3/1027, 0.3%). The highest proportion of cancers detected was in the ≥ 100 µg Hb/g faeces group (55/181, 30.4%). Conclusion: In a multivariate model, FIT outperforms age, sex and all symptoms prompting referral. FIT has greater stratification value than any referral symptoms. FIT does have value in patients with iron deficiency anaemia. [ABSTRACT FROM AUTHOR]

Purpose: Primary care studies suggest that thrombocytosis (platelet counts > 400 × 109/L) is associated with an increased risk of colorectal cancer (CRC). We aimed to establish whether this marker has significant stratification value in patients seen in secondary care. Methods: A retrospective review of 2991 patients referred to our colorectal 2-week-wait (2WW) pathway between August 2014 and August 2017. Patient demographics were recorded prospectively, and local electronic records systems were used to retrieve full blood counts (FBC) and cancer diagnoses. Patients with no recent platelet count at the time of referral or incomplete records were excluded. Results: 2236 patients were included in this evaluation. There was no significant difference in the age distribution of those with thrombocytosis and those without. There were significantly more females in the thrombocytosis group (72.1% vs 53.9%, chi-squared 24.63, p < 0.0001). 130 CRCs were detected (5.8%) and patients with thrombocytosis were more likely to have CRC (OR 2.62, 95% CI 1.60–4.30). The CRC diagnosis rate was significantly higher in females with thrombocytosis (10.3% vs 2.9%, chi-squared 19.41, p < 0.0001) and males with thrombocytosis (16.1% vs 7.9%, chi-squared 4.62, p = 0.032). Conclusion: Thrombocytosis appears to have stratification value in the 2WW population. Further evaluation of its value alone or in combination with other stratification tests is required. [ABSTRACT FROM AUTHOR]

To examine the impact of projected climate changes on secondary succession, we exposed the same fallow soil with a common seed bank to an in situ gradient of urban to rural macroenvironments that differed in temperature and CO2 concentration ([CO2]). This gradient was established at three locations: Baltimore city center (urban), a city park on the outskirts of Baltimore (suburban), and an organic farm 87 km from the Baltimore city center site (rural). Over a five-year period, the urban site averaged 2.1°C warmer and had a [CO2] that was ~20% higher than at the rural location, indicating that this gradient was a reasonable surrogate for projected changes in those variables for this century. Previous work had demonstrated that other abiotic variables measured across the transect, including tropospheric ozone and nitrogen deposition, did not differ consistently. The first year of exposure resulted in (two- to threefold) greater aboveground biomass in the urban relative to the rural site, but with uniform species composition across sites. Simple regression of abiotic variables indicated that temperature and vapor pressure deficit (VPD) were the best predictors of plant biomass among locations. Stepwise multiple regressions were also performed to analyze the effect of more than one macroenvironmental variable on total plant biomass. The combination of daily CO2 concentration and nighttime temperature explained 87% ( P < 0.01) of the variability in total biomass between sites. After five years, the species demography of the plant communities had changed significantly, with a greater ratio of perennials to annuals for the urban relative to the rural location. Greater first-year biomass and litter accumulation at the urban site may have suppressed the subsequent seed germination of annual species, accelerating changes in species composition. If urban macroenvironments reflect future global change conditions, these data suggest a faster rate of secondary succession in a warmer, higher [CO2] world. [ABSTRACT FROM AUTHOR]

To examine the impact of climate change on vegetative productivity, we exposed fallow agricultural soil to an in situ temperature and CO2 gradient between urban, suburban and rural areas in 2002. Along the gradient, average daytime CO2 concentration increased by 21% and maximum (daytime) and minimum (nighttime) daily temperatures increased by 1.6 and 3.3°C, respectively in an urban relative to a rural location. Consistent location differences in soil temperature were also ascertained. No other consistent differences in meteorological variables (e.g. wind speed, humidity, PAR, tropospheric ozone) as a function of urbanization were documented. The urban-induced environmental changes that were observed were consistent with most short-term (~50 year) global change scenarios regarding CO2 concentration and air temperature. Productivity, determined as final above-ground biomass, and maximum plant height were positively affected by daytime and soil temperatures as well as enhanced [CO2], increasing 60 and 115% for the suburban and urban sites, respectively, relative to the rural site. While long-term data are needed, these initial results suggest that urban environments may act as a reasonable surrogate for investigating future climatic change in vegetative communities. [ABSTRACT FROM AUTHOR]

Responses to humidity of net photosynthesis and leaf conductance of single attached leaves were examined in populations of herbs from wet soil sites in Beltsville, Maryland and Davis, California, USA. Plants were grown in controlled environments under three conditions which differed in the magnitude of the day-night temperature difference and in daytime air saturation deficit. No population differences in response were found in Abutilon theophrasti. In Amaranthus hybridus stomatal conductance and net photosynthesis were more reduced by increasing leaf to air water vapor pressure difference (VPD) in the population from Beltsville, but only for the growth condition with a constant 25°C temperature. In Chenopodium album, stomatal conductance was more sensitive to VPD in the population from Davis, but only for the growth condition with 28/22°C day/night temperatures. Population differences in the sensitivity to VPD of leaf conductance were associated with differences in leaf area to root weight ratio. The relative reduction of net photosynthesis as VPD increased was greater than, equal to, or less than the relative decrease in substomatal carbon dioxide partial pressure. The pattern depended on species, and on growth condition. From these results one can not conclude that environmental humidity has been a strong selective force in determining sensitivity to humidity of stomatal conductance. [ABSTRACT FROM AUTHOR]

A new variational characterization of the solution of a matrix Riccati equation is presented. The characterization is given as the maximum Hermitian matrix that makes a certain compound matrix Hermitian positive semidefinite. The shorted operator (Schur complement) applied to the compound matrix produces the Riccati equation. [ABSTRACT FROM AUTHOR]