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Background: Physician-reported clinical outcome and quality of life (QoL) measures are currently used to assess outcomes and direct treatment of plaque psoriasis. However, people with psoriasis may have different criteria for judging treatment success. Objectives: To build a unified consensus on the definition of ‘freedom from disease’ from a European stakeholder group, including people with psoriasis, dermatologists and nurses. Methods: The modified Delphi consensus methodology was used to define ‘freedom from disease’, with a consensus group consisting of people with psoriasis, nurses and dermatologists. This methodology involved people with psoriasis during the entire process and consisted of a 15-member Facilitating Consensus Panel to drive the programme content and a larger Voting Consensus Panel to vote on defining ‘freedom from disease’. The Facilitating Panel agreed on disease domains, and aspects of each domain were put forward to the Voting Consensus Panel to establish relative importance. Following two voting rounds, a meeting was held to agree on a final consensus statement. Results: The Facilitating Panel consisted of six patient advocacy group representatives, three specialist nurses and six dermatologists. Voting rounds 1 and 2 were completed by 166 and 130 respondents from the Voting Consensus Panel, respectively. The outputs from both rounds of voting were similar, focusing on normality of living, symptom control, and a relationship of mutual respect and trust between the individual with psoriasis and their healthcare professional. The consensus statement emphasizes that ‘freedom from disease’ is multifaceted and includes the following domains ‘management of clinical symptoms’, ‘psychosocial elements’, ‘QoL and well-being’, ‘treatment’ and ‘healthcare team support’. ‘Freedom from disease’ means all aspects are addressed. Conclusions: Freedom from disease in psoriasis is a multicomponent concept including five main domains. This diverse and multifaceted patient perspective will help us to improve understanding of the outcomes of treatment interventions in people with psoriasis.

Indian contract labour regulation in the manufacturing sector has been the subject of a plethora of studies over the years, and many amendments to the legislation have been proposed and enacted. However, these have failed to identify or solve a number of chronic issues plaguing the sector, as evidenced by the widespread contract labour unrest in the manufacturing sector and dissatisfaction among all stakeholders. Contract labour law is archaic and obsolete, and thus unable to meet the needs of the present-day organizational order.Here, a practical diagnostic study is undertaken to identify issues and examine potential remedies based on comparative analysis with other jurisdictions wherever possible, and to suggest innovative solutions for addressing India’s unique problems.

Background: Neonatal sepsis is commonly caused by bacteria in the first 28 days of life. If prompt management is not instituted, it could lead to death within hours of onset. Due to diagnostic limitation in developing settings, prompt laboratory identification of causative organism is usually a challenge. To prevent mortality, clear knowledge of bacteria and their antibiotics sensitivity pattern is important for prompt empirical treatment. Methods: This prospective and cross-sectional study enrolled 339 newborns and were admitted for probable sepsis to the special care unit of the university of Abuja Teaching Hospital. Socio-demographic profile and Blood culture was done from every enrolled newborn using BACTEC 9050. The pattern of the clinical features, incidence, bacteriological profile and antibiotic sensitivity pattern of newborns with confirmed neonatal sepsis were documented. Results: A total of 645 newborn were admitted for probable sepsis during the study period based on clinical features and initial laboratory work-up. Forty-six of the 645 newborns (46/645) had laboratory confirmed sepsis based on blood culture resulting in a neonatal sepsis incidence rate of 71.3 (95%CI 50.7-91.9) per 1000 admitted newborn. Seventeen of the 46 confirmed sepsis cases were among the 1322 newborns delivered within the study facility during the study period giving an in-hospital neonatal sepsis incidence rate of 12.9 (95% CI 6.7-19.0) per 1000 live birth. Amongst the 46 babies with positive blood culture, 27/46 (58.7%) had normal white cell count while the remaining 19/46 (41.3%) had abnormal results. In all, 52 counts of bacteria categorized into 11 bacteria species were isolated from the 46 positive blood cultures. Enterococcus spp and streptococcus species were the commonest gram-positive while Escherichia coli and Chryseomonas luteola were the commonest gram-negative bacteria isolates. Imipenem (all bacterial isolates except Vibrio fluvialis), Augmentin (Streptococcus spp, Staphylococcus spp, Escherichia spp, Enterococcus spp, Klebsiella spp, Moraxella catarrhalis, Acinetobacter baumannii), Vancomycin (Streptococcus spp, Staphylococcus spp, Escherichia spp, Enterococcus spp), and Ofloxacin (all except Vibrio fluvialis and Citrobacter freundii) had the widest coverage of bacteria isolated from newborn with sepsis. Conclusion: Sepsis in newborn is still prevalent in our environment and compared to previous documented isolates and sensitivity pattern, the bacteria causes, and their antibiotic sensitivity patterns appears to be changing.

A 70-year-old female reported with complaints of defective vision in both eyes. Ophthalmological examination of both eyes revealed well-centred Posterior Chamber Intraocular Lens (PCIOL), thin membranous Posterior Capsular Opacification (PCO) with no signs of inflammation, myopic fundus and normal Intraocular Pressure (IOP). She had history of uneventful cataract surgery in both eyes four years back and was on treatment for diabetes mellitus and chronic obstructive pulmonary disease. PCO was managed with Nd: YAG capsulotomy in both eyes. After ten hours, patient reported back with severe headache, right-sided periorbital pain and profound diminution of vision. Examination revealed corneal oedema, shallow Anterior Chamber (AC) and raised IOP in her right eye. Patient was admitted and treated with parenteral and local IOP lowering agents and cycloplegic agents. Once the IOP was lowered and cornea cleared, slit lamp examination revealed vitreous blocking the pupil resulting in secondary angle closure which was confirmed by Anterior Segment Optical Coherence Tomography (AS-OCT). Nd:YAG LASER peripheral iridotomy was done to relieve the pupillary block. This is presented as a rare case of pupillary block following Nd:YAG capsulotomy in the presence of well-centred PCIOL

Objective Poor food intake is known to lead to malnutrition in long-term care homes (LTCH), yet multilevel determinants of food intake are not fully understood, hampering development of interventions that can maintain the nutritional status of residents. This study measures energy and protein intake of LTCH residents, describes prevalence of diverse covariates, and the association of covariates with food intake. Design Multisite cross-sectional study. Setting Thirty-two nursing homes from 4 provinces in Canada. Participants From a sample of 639 residents (20 randomly selected per home), 628 with complete data were included in analyses. Measurements Three days of weighed food intake (main plate, estimated beverages and side dishes, snacks) were completed to measure energy and protein intake. Health records were reviewed for diagnoses, medications, and diet prescription. Mini-Nutritional Assessment-SF was used to determine nutritional risk. Oral health and dysphagia risk were assessed with standardized protocols. The Edinburgh-Feeding Questionnaire (Ed-FED) was used to identify eating challenges; mealtime interactions with staff were assessed with the Mealtime Relational Care Checklist. Mealtime observations recorded duration of meals and assistance received. Dining environments were assessed for physical features using the Dining Environment Audit Protocol, and the Mealtime Scan was used to record mealtime experience and ambiance. Staff completed the Person Directed Care questionnaire, and managers completed a survey describing features of the home and food services. Hierarchical multivariate regression determined predictors of energy and protein intake adjusted for other covariates. Results Average age of participants was 86.3 ± 7.8 years and 69% were female. Median energy intake was 1571.9 ± 411.93 kcal and protein 58.4 ± 18.02 g/d. There was a significant interaction between being prescribed a pureed/liquidized diet and eating challenges for energy intake. Age, number of eating challenges, pureed/liquidized diet, and sometimes requiring eating assistance were negatively associated with energy and protein intake. Being male, a higher Mini-Nutritional Assessment–Short Form score, often requiring eating assistance, and being on a dementia care unit were positively associated with energy and protein intake. Energy intake alone was negatively associated with homelikeness scores but positively associated with person-centered care practices, whereas protein intake was positively associated with more dietitian time. Conclusion This is the first study to consider resident, unit, staff, and home variables that are associated with food intake. Findings indicate that interventions focused on pureed food, restorative dining, eating assistance, and person-centered care practices may support improved food intake and should be the target for further research.

The incidence of thyroid cancer (TC) is increasing. Cytology by itself cannot distinguish TC from some benign nodules especially in certain subtypes of TC. Our immediate goal is to identify DNA methylation markers for early detection of TC and to molecularly differentiate TC subtypes from benign nodules. Promoter methylation status of 21 candidate genes was examined on formalin-fixed paraffin-embedded tissue (FFPE) utilizing quantitative methylation-specific polymerase chain reaction (QMSP) in a retrospective cohort of 329 patients (56% white, 29% African American, 61% female) comprising 71 normal thyroid, 83 benign nodules [follicular adenomas (FA)], 90 follicular TC (FTC) and 85 papillary TC (PTC). All genes were analyzed individually (Kruskal–Wallis and Wilcoxon rank sum tests) and in combination (logistic regression models) to identify genes whose methylation levels might best separate groups. Combination gene panels TPO and UCHL1 (ROC = 0.607, sensitivity 78%) discriminated FTC from FA, and RASSF1 and TPO (ROC = 0.881, sensitivity 78%) discriminated FTC from normal. Methylation of TSHR distinguished PTC from FTC (ROC = 0.701, sensitivity 84%) and PTC from FA (ROC = 0.685, sensitivity 70%). The six gene panel of TIMP3, RARB2, SERPINB5, RASSF1, TPO and TSHR, which differentiates PTC from normal thyroid, had the best combination sensitivity (91%) and specificity (81%) of the panels addressing discrimination of cancer tissue. Aberrant gene methylation used in combination panels may be useful clinically in differentiating FTC and PTC from benign nodules. If confirmed in additional studies, these findings could help reduce the over diagnosis of thyroid cancer and surgeries related to over diagnosis.

The shareholders of JSW Steel received a list of 24 items that would be put to vote in the AGM of the company, to be held on 31 July, 2014 along with the annual report of the company for the 2013–14 fiscal year. Item No. 23 of this list was a surprising addition, as the company stated that the brand name ‘JSW’ belongs to a private company called JSW Investments Private Limited (JSWIPL), promoted by Ms. Sangeeta Jindal, the wife of Mr. Sajjan Jindal, the Managing Director of JSW Jindal. It further stated that henceforth JSW Steel would pay 0.25% of the net consolidated turnover to JSWIPL for the use and promotion of the brand. The stock price fell in reaction to this news. JSW Steel justified its move by arguing that payment of royalties for the use of brand name is a common practice followed by Indian business groups. Many corporate governance experts, however, called this an abusive transaction and advised the shareholders to vote against the proposal. This case allows the examination of issues such as related party transactions and their corporate governance implications and the relevance of brand valuation for a steel company.

// Anju Gangadharan 1 , Sung Eun Choi 2 , Ahmed Hassan 1 , Nehad M. Ayoub 3 , Gina Durante 4 , Sakshi Balwani 1 , Young Hee Kim 4 , Andrew Pecora 5 , Andre Goy 5 and K. Stephen Suh 1 1 The Genomics and Biomarkers Program, JT Cancer Center, Hackensack University Medical Center, Hackensack Meridian Health, Hackensack, NJ, USA 2 Department of Family, Nutrition, and Exercise Sciences, Queens College, The City University of New York, Flushing, NY, USA 3 Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan 4 Department of Clinical Nutrition, Baystate Medical Center, Springfield, MA, USA 5 Clinical Divisions, JT Cancer Center, Hackensack University Medical Center, Hackensack Meridian Health, Hackensack, NJ, USA Correspondence to: K. Stephen Suh, email: // Keywords : malnutrition, cancer therapy, chemo treatment, biomarkers, nutritional intervention Received : July 25, 2016 Accepted : January 23, 2017 Published : February 04, 2017 Abstract Cancer patients often experience weight loss caused by protein calorie malnutrition (PCM) during the course of the disease or treatment. PCM is expressed as severe if the patient has two or more of the following characteristics: obvious significant muscle wasting, loss of subcutaneous fat; nutritional intake of 2% in 1 week, 5% in 1 month, or 7.5% in 3 months. Cancer anorexia-cachexia syndrome (CACS) is a multifactorial condition of advanced PCM associated with underlying illness (in this case cancer) and is characterized by loss of muscle with or without loss of fat mass. Cachexia is defined as weight loss of more than 5% of body weight in 12 months or less in the presence of chronic disease. Hence with a chronic illness on board even a small amount of weight loss can open the door to cachexia. These nutritional challenges can lead to severe morbidity and mortality in cancer patients. In the clinic, the application of personalized medicine and the ability to withstand the toxic effects of anti-cancer therapies can be optimized when the patient is in nutritional homeostasis and is free of anorexia and cachexia. Routine assessment of nutritional status and appropriate intervention are essential components of the effort to alleviate effects of malnutrition on quality of life and survival of patients.

India’s legislature, judiciary and academia have by and large cast a blind eye on workplace bullying. There is literary vacuum on legal aspects of workplace bullying in Indian context. This article tries to address this dearth of literature by analyzing potential legal remedies and roadmaps for mitigation of bullying in Indian workplaces. It tries to achieve this by evaluating existing legal provisions with potential of mitigating workplace bullying and comparatively analyzing legal strategies of other countries.

The present work reports dose dependent influence of 8 MeV electron beam irradiation on the structural and optical properties of BaWO4 nanoparticles fabricated by chemical precipitation route. The synthesized materials were calcined at 400 °C for 3 h to get well defined nanocrystalline particles. The calcined materials were irradiated by 8 MeV electron beams of different doses and studied the influence of irradiation on the structural and optical properties of BaWO4 nanoparticles using various characterization tools. The structural studies revealed modifications of lattice parameters a and c, unit cell volume, d spacing, crystallite size, micro-strain, and peak shift for major peaks of X-ray diffraction patterns of the electron irradiated samples. The electron irradiation also results some defects in the crystal lattice of BaWO4 nanocrystals upon electron beam irradiation. Scanning electron microscopic images demonstrated mesoporous behaviour of the BaWO4 materials. The optical studies established that optical bandgap and intensity of photoluminescence emission can be modified by using electron irradiation technique for potential applications in electronics. Photoluminescence emission properties of BaWO4 phosphors suggest that they are useful for the construction of near ultraviolet light excited blue light emitting diodes. Results explored from the present work constitute the first report for the dose-dependent influence of electron beam irradiation on the structure, optical absorption and photoluminescence properties of BaWO4 nanoparticles.

Background There is overwhelming evidence that increases in tobacco taxes reduce tobacco use, save lives and increase government tax revenue. High taxes, however, create an incentive to devise ways to avoid or evade tobacco taxes through contraband tobacco. The associated consequences are significant and call for an accurate measurement of contraband9s magnitude. However, its illegal nature makes the levels and trends in contraband intrinsically difficult to measure accurately. Objective To examine levels and trends in cigarette contraband in Canada. Methods We employed 2 approaches: first, we contrasted estimates of tax-paid cigarettes sales with consumption estimates based on survey data; second, we used data from several individual-level surveys that examined smokers9 purchasing and use behaviours. We placed a particular emphasis on the provinces of Quebec and Ontario because existing research suggests that cigarette contraband levels are far higher than in any other province. Results The estimates presented show a clear upward trend from the early 2000s in cigarette contraband in Quebec and Ontario followed by, on the whole, a decreasing trend from about 2007 to 2009. None of the data presented provide support to the narrative that cigarette contraband has been increasing in recent years. Of note are Quebec estimates which suggest relatively low levels of cigarette contraband since 2010, at levels no higher than in the early 2000s. Conclusions The data presented suggest that policies to tackle cigarette contraband introduced from the mid-2000s to late 2000s, at both federal and provincial levels, may have dampened the demand for contraband cigarettes.

Hodgkin lymphoma (HL) is a lymphoid malignancy that is typically derived from germinal-center B cells. EBV infection, mutations in NF-κB pathway genes, and genetic susceptibility are known risk factors for developing HL. CD30 and NF-κB have been identified as potential biomarkers in pediatric HL patients, and these molecules may represent therapeutic targets. Although current risk adapted and response based treatment approaches yield overall survival rates of >95%, treatment of relapse or refractory patients remains challenging. Targeted HL therapy with the antibody-drug conjugate Brentuximab vedotin (Bv) has proven to be superior to conventional salvage chemotherapy and clinical trials are being conducted to incorporate Bv into frontline therapy that substitutes Bv for alkylating agents to minimize secondary malignancies. The appearance of secondary malignancies has been a concern in pediatric HL, as these patients are at highest risk among all childhood cancer survivors. The risk of developing secondary leukemia following childhood HL treatment is 10.4 to 174.8 times greater than the risk in the general pediatric population and the prognosis is significantly poorer than the other hematological malignancies with a mortality rate of nearly 100%. Therefore, identifying clinically valuable biomarkers is of utmost importance to stratify and select patients who may or may not need intensive regimens to maintain optimal balance between maximal survival rates and averting late effects. Here we discuss epidemiology, risk factors, staging, molecular and genetic prognostic biomarkers, treatment for low and high-risk patients, and the late occurrence of secondary malignancies in pediatric HL.

Introduction: Common short screening measures of dependence that use number of cigarettes per day may not be appropriate for use in populations of occasional smokers.Aims: In this study, we investigate whether perceived addiction (PA) predicts quit attempts and successful cessation among occasional smokers.Methods: Current occasional smokers (18+) in the Ontario Tobacco Survey (OTS) longitudinal cohort study followed up every six months for up to three years. Respondents rated their self-perceived level of addiction (very vs. somewhat or not very addicted). Generalised Estimating Equation models and proportional hazard models were used to test the predictive ability of PA.Results/Findings: Occasional smokers with very high PA had a higher likelihood of reporting a quit attempt (RR: 2.49; 95% CI: 1.88, 3.30) after adjusting for demographics. Given an incident quit attempt, occasional smokers who reported being very addicted were 2.93 times more likely to relapse (95%: 2.01, 4.28). The effect of PA was independent of other predictors of smoking behaviour.Conclusions: For some, occasional smokers, smoking cessation is a difficult process that may require significant support. Asking occasional smokers about PA is an effective way to predict likely success in quitting smokers that may be easily assessed in population based, as well as in community and clinical, settings.

Infection is a serious complication of hematopoietic stem cell transplantation (SCT). However, the optimum oral agent for antibacterial prophylaxis in SCT recipients remains uncertain. Different antibiotics might affect incidence of blood stream infections, resistance, Clostridium difficile, gut microbiome, GVHD and relapse. To explore this we started this first clinical trial of levofloxacin (Levo) versus ciprofloxacin (Cipro) at our center. Methods: This is a single center prospective randomized study. Patients who meet the SCT program criteria to undergo autologous or allogeneic hematopoietic stem cell transplantation are eligible. Results: We present interim results. 111 consecutive patients were randomized since June 2018. At the time of the present report 102 of these patients have follow up for 60 days or more. There were 62 males and 40 females. Median age at time of SCT was 61. Fifty received Cipro and 52 received Levo. Fifty-six patients had autologous (27 Cipro and 29 Levo) while 46 patients had allogeneic SCT (23 Cipro and 23 Levo). For allogeneic SCT, 12 patients in each group had ATG. Time to engraftment and length of stay were similar in both groups. In the Cipro group 6 patients (12%) had bacteremia while in the Levo group 7 (13%) had bacteremia. Of patients with bacteremia, in the Cipro group none had Gram negative bacteremia while in the Levo group 4 had gram negative bacteremia (OR 9.37, p = 0.137). In the Cipro group 6 patients had gram positive bacteremia while in the Levo group 3 patients had gram positive bacteremia (OR 2.22, p = 0.277). In the Cipro group, 6 (12%) had clostridium difficile while in the Levo group only 1 (1.9%) had Clostridium difficile (OR 6.95, p = 0.078). Acute GVHD of all grades accrued in 17 patients (34%) in Cipro group and in 16 patients (30.7%) in the Levo group. Grade III-IV aGVHD occurred in 6 patients (12%) in Cipro group and in 3 patients (5.8%) in the Levo group (OR 2.23, p = 0.277). The hazard ratio for progression free survival was 0.67 (95% CI: 0.27, 1.67), p=0.395 for Levo vs. Cipro. The hazard ratio for overall survival, adjusted for auto/allo and age at transplant was 0.29 (95% CI: 0.09, 0.95), p = 0.041, for Levo vs. Cipro. However, 3 of deaths in the Cipro group were not related to type of antibacterial prophylaxis (listeriosis from contaminated food, fungal pneumonia in a wooden-house builder and stroke from intraventricular thrombus). So, unadjusted hazard ratio for overall survival (Levo vs. Cipro): 0.41 (95% CI: 0.13, 1.34), p = 0.142. Hazard ratio for overall survival (Levo vs. Cipro), adjusting for allo/auto and age at transplant: 0.39 (95% CI: 0.11, 1.33), p = 0.132. Conclusion: At this point, in this interim analysis, there seems to be a trend for Cipro to protect patients from gram negative bacteremia compared to levo. As a trade-off, there is higher trend for Clostridium difficile in the Cipro group compared to Levo group, but none is statistically significant so far.

BackgroundDigital mobile technology presents a promising medium for reaching young adults with smoking cessation interventions because they are the heaviest users of this technology. ObjectiveThe aim of this study was to determine the efficacy of an evidence-informed smartphone app for smoking cessation, Crush the Crave (CTC), on reducing smoking prevalence among young adult smokers in comparison with an evidence-informed self-help guide, On the Road to Quitting (OnRQ). MethodsA parallel, double-blind, randomized controlled trial with 2 arms was conducted in Canada to evaluate CTC. In total, 1599 young adult smokers (aged 19 to 29 years) intending to quit smoking in the next 30 days were recruited online and randomized to receive CTC or the control condition OnRQ for a period of 6 months. The primary outcome measure was self-reported continuous abstinence at the 6-month follow-up. ResultsOverall follow-up rates were 57.41% (918/1599) and 60.48% (967/1599) at 3 and 6 months, respectively. Moreover, 45.34% (725/1599) of participants completed baseline, 3-, and 6-month follow-up. Intention-to-treat analysis (last observation carried forward) showed that continuous abstinence (N=1599) at 6 months was not significantly different at 7.8% (64/820) for CTC versus 9.2% (72/779) for OnRQ (odds ratio; OR 0.83, 95% CI 0.59-1.18). Similarly, 30-day point prevalence abstinence at 6 months was not significantly different at 14.4% (118/820) and 16.9% (132/779) for CTC and OnRQ, respectively (OR 0.82, 95% CI 0.63-1.08). However, these rates of abstinence were favorable compared with unassisted 30-day quit rates of 11.5% among young adults. Secondary measures of quit attempts and the number of cigarettes smoked per day at 6-month follow-up did not reveal any significant differences between groups. For those who completed the 6-month follow-up, 85.1% (359/422) of young adult smokers downloaded CTC as compared with 81.8% (346/423) of OnRQ, χ21(N=845)=1.6, P=.23. Furthermore, OnRQ participants reported significantly higher levels of overall satisfaction (mean 3.3 [SD 1.1] vs mean 2.6 [SD 1.3]; t644=6.87, P

This study determines the prevalence of inadequate micronutrient intakes consumed by long-term care (LTC) residents. This cross-sectional study was completed in thirty-two LTC homes in four Canadian provinces. Weighed and estimated food and beverage intake were collected over 3 non-consecutive days from 632 randomly selected residents. Nutrient intakes were adjusted for intra-individual variation and compared with the Dietary Reference Intakes. Proportion of participants, stratified by sex and use of modified (MTF) or regular texture foods, with intakes below the Estimated Average Requirement (EAR) or Adequate Intake (AI), were identified. Numbers of participants that met these adequacy values with use of micronutrient supplements was determined. Mean age of males (n 197) was 85·2 (sd 7·6) years and females (n 435) was 87·4 (sd 7·8) years. In all, 33 % consumed MTF; 78·2 % (males) and 76·1 % (females) took at least one micronutrient pill. Participants on a MTF had lower intake for some nutrients (males=4; females=8), but also consumed a few nutrients in larger amounts than regular texture consumers (males=4; females =1). More than 50 % of participants in both sexes and texture groups consumed inadequate amounts of folate, vitamins B6, Ca, Mg and Zn (males only), with >90 % consuming amounts below the EAR/AI for vitamin D, E, K, Mg (males only) and K. Vitamin D supplements resolved inadequate intakes for 50–70 % of participants. High proportions of LTC residents have intakes for nine of twenty nutrients examined below the EAR or AI. Strategies to improve intake specific to these nutrients are needed.

INTRODUCTION Social media (SM) may extend the reach and impact for smoking cessation among young adult smokers. To-date, little research targeting young adults has been done on the use of SM to promote quitting smoking. We assessed the effect of an innovative multicomponent web-based and SM approach known as Break-it-Off (BIO) on young adult smoking cessation. METHODS The study employed a quasi-experimental design with baseline and 3-month follow-up data from 19 to 29-year old smokers exposed to BIO (n = 102 at follow-up) and a comparison group of Smokers' Helpline (SHL) users (n = 136 at follow-up). Logistic regression analysis assessed differences between groups on self-reported 7-day and 30-day point prevalence cessation rates, adjusting for ethnicity, education level, and cigarette use (daily or occasional) at baseline. RESULTS The campaign reached 37 325 unique visitors with a total of 44 172 visits. BIO users had significantly higher 7-day and 30-day quit rates compared with users of SHL. At 3-month follow-up, BIO participants (32.4%) were more likely than SHL participants (14%) to have quit smoking for 30 days (odds ratio = 2.95, 95% CI = 1.56 to 5.57, P < .001) and BIO participants (91%) were more likely than SHL participants (79%) to have made a quit attempt (odds ratio = 2.69, 95% CI = 1.03 to 6.99, P = .04). CONCLUSION The reach of the campaign and findings on quitting success indicate that a digital/SM platform can complement the traditional SHL cessation service for young adult smokers seeking help to quit.

We examine the information environments of firms following large, non-recurring charges (“baths”). We test competing hypotheses about the consequences of a bath—a bath either improves the information environment (the transparency hypothesis) or degrades it (the opacity hypothesis). Difference-in-differences analysis suggests that after a bath (1) earnings become smoother, (2) firm-level information asymmetry decreases, and (3) stock returns become more responsive to unexpected earnings. We interpret these findings as supportive of the transparency hypothesis. We also document that the relative improvement in the information environment is greater for baths that are not voluntary, consistent with managerial obfuscation prior to the bath.

Firms from emerging markets, including China, increasingly seek to raise capital outside of their home markets. We examine the short-term performance of U.S.-bound Chinese initial public offerings (IPOs) and find that these IPOs have significantly lower underpricing than a matched sample of U.S. counterparts. We also find that the magnitude of IPO underpricing for U.S.-bound Chinese firms is positively related to revisions in offer price.

Breast cancer (BC) is the second leading cause of cancer-related mortality in women. Bioinformatic analysis and expression screening showed that Prolactin Induced Protein (PIP) was differentially expressed in BC. The objective of this investigation was to characterize the expression pattern of PIP, an aspartyl proteinase, in malignant and non-malignant breast tissues.Real time quantitative PCR was employed to analyze PIP and androgen receptor (AR) mRNA levels in BC cell lines and 190 normal tissues and tumor samples. The tumor specimens were categorized based on TNM classification, anatomic stage, histologic grade and molecular subtype and expression pattern evaluated. To detect protein levels, immunohistochemistry followed by semi quantitative scoring was employed in the examination of 517 normal, benign, and invasive BC tissues.We observed substantial downregulation of PIP transcription in cancer samples compared to normal breast tissue. mRNA levels were significantly downregulated (93 fold, P 0.005) in advanced grades compared to lower grades. Transcript levels were also significantly lower (22 fold, P 0.05) in triple negative tumors compared to hormone receptor positive tumors. Significant downregulation was observed in early stage samples of triple negative and hormone receptor positive tumors. Though PIP protein showed a wide range of expression levels in BC, early stage samples showed significant downregulation.PIP mRNA is significantly downregulated in early stage BC compared to normal breast tissue. Consequently, low PIP mRNA expression in BC tissues could potentially be used as a tissue based biomarker to assist pathologists in confirmation of early stage BC diagnosis.

Background Older adults living in long term care (LTC) homes are nutritionally vulnerable, often consuming insufficient energy, macro- and micronutrients to sustain their health and function. Multiple factors are proposed to influence food intake, yet our understanding of these diverse factors and their interactions are limited. The purpose of this paper is to fully describe the protocol used to examine determinants of food and fluid intake among older adults participating in the Making the Most of Mealtimes (M3) study. Methods A conceptual framework that considers multi-level influences on mealtime experience, meal quality and meal access was used to design this multi-site cross-sectional study. Data were collected from 639 participants residing in 32 LTC homes in four Canadian provinces by trained researchers. Food intake was assessed with three-days of weighed food intake (main plate items), as well as estimations of side dishes, beverages and snacks and compared to the Dietary Reference Intake. Resident-level measures included: nutritional status, nutritional risk; disease conditions, medication, and diet prescriptions; oral health exam, signs of swallowing difficulty and olfactory ability; observed eating behaviours, type and number of staff assisting with eating; and food and foodservice satisfaction. Function, cognition, depression and pain were assessed using interRAI LTCF with selected items completed by researchers with care staff. Care staff completed a standardized person-directed care questionnaire. Researchers assessed dining rooms for physical and psychosocial aspects that could influence food intake. Management from each site completed a questionnaire that described the home, menu development, food production, out-sourcing of food, staffing levels, and staff training. Hierarchical regression models, accounting for clustering within province, home and dining room will be used to determine factors independently associated with energy and protein intake, as proxies for intake. Proportions of residents at risk of inadequate diets will also be determined. Discussion This rigorous and comprehensive data collection in a large and diverse sample will provide, for the first time, the opportunity to consider important modifiable factors associated with poor food intake of residents in LTC. Identification of factors that are independently associated with food intake will help to develop effective interventions that support food intake. Trial Registration ClinicalTrials.gov ID: NCT02800291 , retrospectively registered June 7, 2016.

Background & Aim Aim The non-viral piggyBac transposon system reduces the complexity and expense of CAR T cell manufacture. piggyBac CAR19 T cells showed potent pre-clinical activity, so we now assess safety and clinical activity in a first-in-human study. Methods, Results & Conclusion Methods Eight patients (age 18-66 years, median 30; male n=7, female n=1) with relapsed/refractory CD19+ malignancies post HLA-matched sibling HSCT were treated with donor-derived T cells genetically modified using piggyBac to express a second-generation 4-1BB-based CAR19. The trial was conducted as an investigator-initiated study at a university hospital with local CAR19 T cell manufacture. CAR19 T cells were expanded ex vivo from 50 × 106 peripheral blood mononuclear cells, with CD19 stimulation and IL-15 support. Final products contained median 1.9 × 109 (range 0.8-2.5 × 109) total cells with 80.6% (39-93%) CAR T cells, and were generated in 15 (n=7) or 23 (n=1) days. Patients received up to 3 escalating doses of CAR19 T cells (10, 50 and 100 × 106/m2) following lymphodepleting cyclophosphamide and fludarabine (3 doses, n=5; 1 dose, n=3). Results Diagnoses were B-ALL (n=6), DLBCL (n=1), and Burkitt Lymphoma (n=1). Four patients each had a high or low burden of disease prior to treatment. The patient with Burkitt Lymphoma died of complications unrelated to CAR T cells 307 days with 3 doses. Toxicity included: cytokine release syndrome (n=3), B-cell aplasia with hypogammaglobulinaemia (n=7), prolonged cytopenias (n=6), bacterial infection (n=3) and exacerbation of chronic GVHD (n=1). No CAR T cell-related encephalopathy syndrome occurred. Conclusions Manufacture of piggyBac CAR19 T cells for clinical use is rapid, robust and uncomplicated, permitting application of this technology to multiple healthcare institutions. Early results suggest similar safety and activity to that of CAR19 T cells generated with viral vectors. The optimal CAR19 T cell dosing strategy remains to be determined.

Objectives. We identified the most effective mix of school-based policies, programs, and regional environments associated with low school smoking rates in a cohort of Canadian high schools over time. Methods. We collected a comprehensive set of student, school, and community data from a national cohort of 51 high schools in 2004 and 2007. Hierarchical linear modeling was used to predict school and community characteristics associated with school smoking prevalence. Results. Between 2004 and 2007, smoking prevalence decreased from 13.3% to 10.7% in cohort schools. Predictors of lower school smoking prevalence included both school characteristics related to prevention programming and community characteristics, including higher cigarette prices, a greater proportion of immigrants, higher education levels, and lower median household income. Conclusions. Effective approaches to reduce adolescent smoking will require interventions that focus on multiple factors. In particular, prevention programming and high pricing for cigarettes sold near schools may contribute to lower school smoking rates, and these factors are amenable to change. A sustained focus on smoking prevention is needed to maintain low levels of adolescent smoking.

The purpose of this study was to determine whether there is a growing inequity in tobacco use, susceptibility to future smoking, and quit attempts among Off-Reserve Aboriginal (ORA) youth in Canada relative to Non-Aboriginal youth. Current smoking, susceptibility to future smoking and quit attempts were examined among a nationally representative sample of ORA and Non-Aboriginal Canadian youth. Data are from cross-sectional surveys of 88,661 respondents in Grades 6 to 9 across the 2004, 2006 and 2008 survey waves of the Youth Smoking Survey (YSS). At each wave, ORA youth were more likely to be current smokers (overall OR = 3.91, 95% CI 3.47 to 4.41), to be susceptible to future smoking (overall OR = 1.37, 95% CI 1.27 to 1.48), and less likely to have ever made a quit attempt compared to Non-Aboriginal youth (overall OR = 0.74, 95% CI 0.57 to 0.96). Although susceptibility to future smoking declined for Non-Aboriginal youth, the prevalence of susceptibility remained stable among ORA youth. The percentage of ORA youth reporting making a quit attempt increased, however, current smoking rates among ORA youth did not decline. These findings suggest that the disparity in susceptibility to future tobacco use among ORA and Non-Aboriginal youth has increased over time. Despite increased rates of quit attempts, current smoking rates remain significantly higher among ORA youth. Tobacco control programs for Aboriginal youth should be a public health priority.

ObjectiveThe goal was to determine the prevalence of high-risk HPV16 using saliva in a screening population in Detroit, Michigan.Materials and MethodsReal-time quantitative polymerase chain reactio...

BACKGROUND A policy for new pictorial health warning labels on tobacco packaging was introduced by Health Canada in 2012. The labels included, for the first time, a prominently displayed toll-free number for a quit-smoking line. We used data from the Ontario provincial quitline to investigate the call volume and number of new callers receiving treatment in the months before and after the new policy was introduced. METHODS We used an interrupted time-series analysis to examine trends in the overall call volume and number of new callers receiving treatment (≥ 1 telephone counselling session) through Ontario's quitline (Smokers' Helpline) between January 2010 and December 2013. We analyzed data using Box-Jenkins autoregressive integrated moving-average models; we adjusted the models for a major campaign promoting the quitline, a seasonality (January) effect and tobacco pricing. RESULTS We found a relative increase of 160% in the average monthly call volume during the 7 months after the introduction of the new labels (870 calls per month at baseline and 1391 additional calls per month on average after the policy change; standard error [SE] 108.94, p < 0.001), and a sustained increase of 43% in subsequent months. We observed a relative increase of 174% in the number of new callers receiving treatment (153 new callers per month at baseline and 267 additional new callers per month after the policy change; SE 40.03, p < 0.001) and a sustained increase of 80% in subsequent months. The effect was significant even after controlling for a major promotion campaign and the January effect. INTERPRETATION We found a significant increase in the monthly overall call volume and number of new callers receiving treatment per month after the introduction of the new tobacco health warning labels, with a sustained increase in overall calls and new callers beyond the first 7 months. Our findings add to the body of evidence on the benefit of including a toll-free quitline number on tobacco packaging.

// Arati A. Inamdar 1 , Andre Goy 2 , Nehad M. Ayoub 3 , Christen Attia 1 , Lucia Oton 1 , Varun Taruvai 1 , Mark Costales 1 , Yu-Ting Lin 1 , Andrew Pecora 2 and K. Stephen Suh 1 1 The Genomics and Biomarkers Program, The John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, USA 2 Clinical Divisions, John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, USA 3 Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan Correspondence to: K. Stephen Suh, email: // Keywords : biomarker, clinical trial, mantle cell lymphoma, personalized therapy, prognosis Received : December 24, 2015 Accepted : April 10, 2016 Published : April 23, 2016 Abstract Despite advances in the development of clinical agents for treating Mantle Cell Lymphoma (MCL), treatment of MCL remains a challenge due to complexity and frequent relapse associated with MCL. The incorporation of conventional and novel diagnostic approaches such as genomic sequencing have helped improve understanding of the pathogenesis of MCL, and have led to development of specific agents targeting signaling pathways that have recently been shown to be involved in MCL. In this review, we first provide a general overview of MCL and then discuss about the role of biomarkers in the pathogenesis, diagnosis, prognosis, and treatment for MCL. We attempt to discuss major biomarkers for MCL and highlight published and ongoing clinical trials in an effort to evaluate the dominant signaling pathways as drugable targets for treating MCL so as to determine the potential combination of drugs for both untreated and relapse/refractory cases. Our analysis indicates that incorporation of biomarkers is crucial for patient stratification and improve diagnosis and predictability of disease outcome thus help us in designing future precision therapies. The evidence indicates that a combination of conventional chemotherapeutic agents and novel drugs designed to target specific dysregulated signaling pathways can provide the effective therapeutic options for both untreated and relapse/refractory MCL.

PurposeThe purpose of this paper is to investigate short‐selling around private investment in public equity (PIPE) issuances, for evidence of manipulative short‐selling by hedge funds.Design/methodology/approachThe authors use the Regulation SHO short‐selling data in combination with information about hedge fund participation in traditional stock PIPE offerings from Sagient Research, and share price and trading volume data from the Center for Research in Security Prices (CRSP) to examine the relations among hedge fund participation, short‐selling levels and stock returns surrounding such offerings.FindingsIt is found that significantly less pre‐deal short‐selling occurs when hedge funds are included in the PIPE investor group, and adjusted returns for firms with hedge funds as investors are positive in the pre‐deal period and negative in the post‐deal period. Both of these findings are opposite of the patterns expected given manipulative short‐selling by hedge funds. Pre‐deal and post‐deal adjusted returns and PIPE discount are unrelated to pre‐deal short‐selling by hedge funds, findings inconsistent with manipulative short‐selling by these investors. The evidence suggests that most hedge funds that invest in traditional stock PIPEs do not engage in manipulative short‐selling around these deals.Originality/valueThis paper is the first, to the authors' knowledge, to examine hedge fund participation and daily short‐selling around traditional stock PIPE issuances. Previous studies focus on structured PIPE deals, which do not represent the majority of the PIPE market at present. The daily short selling data used in this study allow for detailed investigation of market behavior not afforded by monthly short interest data used in previous studies.

ObjectiveThere is a lack of consensus regarding the causes of the differences in the higher incidence of and the mortality from head and neck squamous cell carcinoma (HNSCC) in African Americans (AA) versus Caucasian Americans (CA). We examined a comprehensive array of risk factors influencing health and disease in an access-to-care, racially diverse, primary HNSCC cohort.Study DesignCross-sectional study.SettingPrimary care academic health care system.Subjects and MethodsThe cohort of 673 patients comprised 391 CA and 282 AA (42%). Risk variables included demographic, histopathology, and clinical/epidemiologic factors. Tumor DNA was interrogated for loss and gain of 113 genes with known involvement in HNSCC/cancer. Logistic regression for univariate analysis was followed by multivariate modeling with determination of model predictability (c-index).ResultsOf the 39 univariate differences between AA and CA, multivariate modeling (c-index = 0.81) retained 7 differences (P < .05). AA were less likely to be m...

IntroductionMicroRNAs (miRNAs) are endogenous, small, noncoding RNAs of 17 to 25 nucleotides that regulate approximately 30% of human genes. They are differentially expressed in various types of cancers compared with noncancerous tissues, suggesting that they may have crucial roles in tumorigenesis. The objective of this study was to identify laryngeal squamous cell cancer (LSCC)-specific miRNAs.Materials and methodsA retrospective cohort of 10 LSCC and five normal laryngeal squamous epithelium samples were examined using a global miRNA profiling approach (HTG, Tucson, AZ, USA, 800 human miRNAs plus 10 endogenous control miRNAs). The expression status of selected dysregulated miRNAs that were significantly different from normal were verified by real-time quantitative PCR (qPCR).ResultsTwenty-three of the 800 human miRNAs had significantly different expression levels (p < 0.05) between LSCC and normal tissues. Fifteen of the 23 have not been previously reported in HNSCC and include: miR-663b, miR-663, miR-193b, miR-1291, miR-720, miR-191, miR-1224-3p, miR-214, miR- 1285, miR-1207-5p, miR-483-5p, miR-1225-3p, miR-1228, miR-1280 and miR-638. Consistently upregulated miR-31 and miR- 193b and differentially expressed miR-663b in LSCC were verified by qPCR.ConclusionThe 15 novel miRNAs identified in this exploratory study, pending further confirmation and validation, may have clinical utility as LSCC-specific markers.How to cite this articleChen KM, Stephen JK, Havard S Shah V, Gardner G, Schweitzer VG, Worsham MJ. Novel Dysregulated MicroRNAs in Primary Laryngeal Squamous Cell Cancer. Int J Head Neck Surg 2012;3(2):76-81.

Genetic events specific to the pathogenesis of malignancy can offer clues to the tumorigenesis process. The objective of this study was to identify gene alterations that differentiate tumor and nontumor lesions in squamous head and neck cancer (HNSCC). DNA from 220 primary HNSCC with concurrently present tumor and nontumor lesions from the same patient was interrogated for genomic alterations of loss or gain of copy. Conditional logistic regression dealt with tumor and non-tumor records within a patient. Of 113 genes, 53 had univariate effects (P<0.01), of which 16 genes remained in the multivariable model withP<0.01. The model had a C-index (ROC) of 0.93. Loss ofCDKN2Band gain ofBCL6, FGF3, andPTP4A3predicted tumor. Loss ofBAK1andCCND1and gain ofSTCHpredicted nontumor. This highly powered model assigned alterations in 16 genes specific for malignant versus nonmalignant lesions, supporting their contribution to the pathogenesis of HNSCC as well as their potential utility as relevant targets for further evaluation as markers of early detection and progression.

The mediating role of cessation medications in the association between health professional advice and quitting behaviors is unclear.Data were from the Ontario Tobacco Survey longitudinal study, collected between July 2005 and June 2011 in Ontario, Canada. The analytic sample included 3437 baseline smokers who were seen by health professionals during follow-up. Logistic regression with generalized estimating equations and mediation analysis techniques were used to examine the impact of advice and medications on quitting outcomes (making a quit attempt, short-term quitting 1-6months and long-term quitting6months).Those who received advice to quit smoking were more likely to use cessation medications than those who did not receive advice (21% vs. 13%, P0.001). Receiving advice was associated with making a quit attempt (adjusted odds ratio (OR) 1.25, 95% confidence interval (CI) 1.10-1.41) and long-term quitting (adjusted OR 1.49, 95% CI 1.10-2.02), but not with short-term quitting. Use of cessation medications was associated with making a quit attempt (adjusted OR 11.83, 95% CI 9.93-14.08), short-term quitting (adjusted OR 3.69, 95% CI 2.90-4.68), and long-term quitting (adjusted OR 2.73, 95% CI 1.95-3.82). Using prescription medications was associated with a higher likelihood of quitting short-term (adjusted OR 2.43, 95% CI 2.59-3.74) and long-term (adjusted OR 2.27, 95% CI 1.23-4.17) than using NRT. Use of cessation medications was a significant mediator in the pathway from receiving advice to quitting.Health professionals should advise smokers to quit and encourage them to use cessation medications, especially prescription medications when trying to quit.

Methadone and QT Prolongation. Background: Methadone is associated with QTc prolongation and sudden death in susceptible patients. We sought to investigate whether there is a gender-based difference in susceptibility to methadone-associated QTc prolongation in heroin-dependent patients receiving a low-dose treatment regimen. Methods: A cross-sectional assessment of dose and gender effects was performed in 283 patients (229 males, 54 females) who received a 12-lead ECG for QTc measurement 59 days (interquartile range: 36–288 days) after methadone treatment. To determine the effects of methadone over time, a subset of 150 participants (126 men, 24 women) who underwent a 12-lead ECG before and 37 days (interquartile range: 32–44 days) after methadone treatment were selected. Results: In the cross-sectional study, a significant dose-dependent interaction between methadone and QTc (r = 0.201, P = 0.0007) was observed in individuals receiving a median methadone dose of 40 mg/day (interquartile range: 30–60 mg/day). The methadone-QTc correlation was significant in males (r = 0.210, P = 0.0014) but not in females (r = 0.164, P = 0.2363). The longitudinal assessment of methadone's effects over a 6-month period showed that 60.7% of individuals experienced an increase in QTc compared to baseline data. The adjusted QTc significantly increased from 418.5 to 426.9 milliseconds in males (P < 0.0001), compared to an insignificant change in females (437.7 milliseconds vs 441.1 milliseconds, P = 0.468). Conclusions: Low-dose methadone therapy shows dose-dependent QTc prolongation and is associated with significant QTc lengthening within 6 months of treatment initiation. Men are more susceptible than women to low-dose methadone-associated QTc prolongation. (J Cardiovasc Electrophysiol, Vol. 23, pp. 527-533, May 2012)

Aims To examine the use and role of planned quit attempts by smokers and their impact on abstinence.Design Ret- rospective, using longitudinal data from the Ontario Tobacco Survey. Setting Ontario, Canada. Participants A total of 551 adult smokers who reported having made a quit attempt during 2007-08.Measurements Reported planning of the most recent quit attempt (i.e. unplanned or planned some time in advance), engaging in preparatory behaviours believed to be related to planning (i.e. use of quit aids such as pharmacotherapy, formal support or health professionals) and abstinence at 1 week and 1 month following the attempt. Findings Of the smokers, 73.6% planned their quit attempt in advance. Reported planning was more likely among those who thought they were very addicted, compared with those who were less addicted (odds ratio (OR) = 2.22, 95% confidence interval (CI): 1.15-4.28). Smokers who planned a quit attempt were much more likely to use a quit aid (OR = 3.50, 95% CI: 1.80-6.79), particularly phar- macotherapy (OR = 6.13, 95% CI: 3.05-12.34). The odds of abstaining for 1 week were lower among those who planned (OR = 0.45, 95% CI: 0.22-0.89), independent of perceived addiction. No significant difference was observed for abstinence lasting 1 month. Other factors associated with abstinence were smoking fewer cigarettes per day and having personal support. Conclusions Although most quit attempts were planned and planners had higher odds of using quit aids, planning did not increase the likelihood of success.

Around the world, teams of researchers continue to develop a wide range of systems to capture, store, and analyze data including treatment, patient outcomes, tumor registries, next-generation sequencing, single-nucleotide polymorphism, copy number, gene expression, drug chemistry, drug safety, and toxicity. Scientists mine, curate, and manually annotate growing mountains of data to produce high-quality databases, while clinical information is aggregated in distant systems. Databases are currently scattered, and relationships between variables coded in disparate datasets are frequently invisible. The challenge is to evolve oncology informatics from a "systems" orientation of standalone platforms and silos into an "integrated knowledge environments" that will connect "knowable" research data with patient clinical information. The aim of this article is to review progress toward an integrated knowledge environment to support modern oncology with a focus on supporting scientific discovery and improving cancer care.

Background: Implantable cardioverter-defibrillators (ICDs) reduce the rate of sudden cardiac death (SCD) in patients with cardiomyopathy and reduced left ventricular systolic function. It is unclear if this benefit extends to the very elderly patient population. Methods: Patients who underwent initial ICD implantation at age 80 or older between January 1995 and April 2010 for primary SCD prevention were identified. Clinical data were collected from the medical record, including periprocedural complications, device type, and therapies delivered. Results: Three-hundred eighty patients were identified; 84 patients met eligibility criteria. The mean age was 82.68 years; mean follow-up was 34 months. Mean left ventricular ejection fraction was 28.1%. Mortality during follow-up was 17.9%. One- and 5-year survival estimates were 100% and 60%, respectively. Periprocedural complications occurred in 9.4% of patients; serious complications occurred in 4.8% with no periprocedural deaths. Device therapies occurred in 11.9% (n = 10) of patients (9.5% appropriate, n = 8; 2.4% inappropriate, n = 2). Cardiac resynchronization therapy-defibrillator (CRT-D) implantation was associated with prolonged median survival and decreased risk of death (hazard ratio 0.212; 95% confidence interval 0.048−.942, P = 0.042) compared to ICD alone. Conclusions: Implantation of primary prevention ICDs in patients 80 years of age or older was associated with a low risk of serious complications and a 5-year survival estimate of 60%. Inappropriate therapies after implantation were uncommon. CRT-D implantation was associated with a decreased risk of death compared to ICD alone. These data suggest that, in selected patients in this age group, ICD implantation is safe and effective. (PACE 2011; 34:900–906)

Thyroid cancer is the most common endocrine cancer with 1,690 deaths each year. There are four main types of which the papillary and follicular types together account for >90% followed by medullary cancers with 3% to 5% and anaplastic carcinomas making up < 3%. Epigenetic events of DNA hypermethylation are emerging as promising molecular targets for cancer detection. Our immediate and long term goal is to identify DNA methylation markers for early detection of thyroid cancer. This pilot study comprised of 21 patients to include 11 papillary thyroid cancers (PTC), 2 follicular thyroid cancers (FTC), 5 normal thyroid cases, and 3 hyperthyroid cases. Aberrant promoter methylation was examined in 24 tumor suppressor genes using the methylation specific multiplex ligation-dependent probe amplification (MS-MLPA) assay and in the NIS gene using methylation-specific PCR (MSP). The frequently methylated genes were CASP8 (17/21), RASSF1 (16/21) and NIS (9/21). In the normal samples, CASP8, RASSF1 and NIS were methylated in 5/5, 4/5 and 1/5 respectively. In the hyperthyroid samples, CASP8, RASSF1 and NIS were methylated in 3/3, 2/3 and 1/3 respectively. In the thyroid cancers, CASP8, RASSF1, and NIS were methylated in 9/13, 10/13, and 7/13 respectively. CASP8, RASSF1 and NIS were also methylated in concurrently present normal thyroid tissue in 3/11, 4/11 and 3/11 matched thyroid cancer cases (matched for presence of both normal thyroid tissue and thyroid cancer), respectively. Our data suggests that aberrant methylation of CASP8, RASSF1, and NIS maybe an early change in thyroid tumorigenesis regardless of cell type.

Background A substantial challenge in addressing adolescent tobacco use is that smoking behaviors occur in complex environments that involve the school setting and larger community context. Purpose This study provides an integrated description of factors from the school and community environment that affect youth smoking and explains variation in individual smoking behaviors both within and across schools/communities. Methods Data were collected from 82 randomly sampled secondary schools in five Canadian provinces (British Columbia, Manitoba, Ontario, Quebec, Newfoundland, and Labrador) during the 2003–2004 school year. Cross-sectional data were obtained from students; school administrators (school-based tobacco control policies and programs); and from observations in the community. In 2009, hierarchic logistic regression was used to model the role of individual, school, and community variables in predicting student smoking outcomes. Results Students who attended a school with a focus on tobacco prevention (OR=0.87, 95% CI=0.81, 0.94) and stronger policies prohibiting tobacco use (OR=0.92, 95% CI=0.88, 0.97) were less likely to smoke than students who attended a school without these characteristics. A student was more likely to smoke if a greater number of students smoked on the school periphery (OR=1.25, 95% CI=1.07, 1.47). Within the community, price per cigarette (OR=0.91, 95% CI=0.84, 0.99) and immigrants (OR=0.99, 95% CI=0.98, 0.99) were inversely related to students' smoking status. Conclusions The results suggest that school and community characteristics account for variation in smoking levels across schools. Based on the current findings, the ideal school setting that supports low student smoking levels is located in a neighborhood where the cost of cigarettes is high, provides tobacco prevention education, and has a policy prohibiting smoking.