Impact of a Cancer Survivorship Program on Well-Being and Community Involvement: Role of OT and Future Directions

Date Presented 04/03/2022

This qualitative phenomenological study explored the lived experiences of cancer survivors in a community-based, interprofessional survivorship program and explains further exploration needs for OT. Personal themes describing impact on the individuals included (1) journey of spiritual and emotional healing, (2) growing into a new sense of self, and (3) moving from survival to life. Relational themes included (1) building a community of caring and connection and (2) embracing the value of altruism.

Primary Author and Speaker: Lynne Murphy

Contributing Authors: Kendall Ellis, Nicole Fox, Sarah Lee, Rachel Lennon, Gloria Norton

972 EXPLORING THE IMPACT OF FRAILTY FOLLOWING TRAUMA: AN ANALYSIS OF EMERGENCY DEPARTMENT (ED) MANAGEMENT AND LONG TERM OUTCOMES

Introduction

Major trauma represents a large number of hospital presentations in Scotland. 1 We aimed to: -Describe the population of ‘major trauma’ patients presenting to the Emergency Department of QEUH, Glasgow -Compare assessment, management and clinical outcomes in frail versus non-frail patients with trauma.

Method

This was a retrospective, cohort study. Patients were identified using the Scottish Trauma Audit Group (STAG) database. 2 Patients aged over 18, admitted between 01/11/18 and 31/01/19 were included. STAG data was supplemented by individual case note review. Clinical Frailty Scale (CFS) and Charlson Comorbidity Index (CCI) were calculated.

Results

203 patients (173 non-frail, 30 frail) were included. Median age was 58 years (range 19–98). Isolated head injuries were the predominant injury type in frail patients (36.7%) versus polytrauma in non-frail cohort (44.5%). Injury Severity Score (ISS) was similar across both groups (median score: 10v9.5). CCI score correlated well with frailty. Frail patients were less likely to:

-Have ambulance pre-alert call (10% v 28%, p = 0.041).

-Be managed in ‘Resus’ (17% v 54%, p < 0.05).

-Have consultant-led care in ED (6.6% v 36.4%, p = 0.001).

-Undergo CT within 60 minutes (10% v 34.7%, p = 0.0095).

They were more likely to be admitted under a Medical Team (20% v 2.9%, p < 0.05). Frailty was associated with poorer outcomes:

-Mortality 30% v 9.8%: significant difference in unadjusted, 1-year survival curves (Log-rank test p = 0.0026). Frailty carried a hazard-ratio of death of 5.02 (CI:2.13–11.79, p = 0.0002) compared to non-frailty through the first year after trauma.

-Longer median Length of Stay: 22 v 8 days.

Conclusion

We identified poorer clinical outcomes in our frail patient cohort. Despite this, and with similar ISS scores across both groups, our data would suggest a tendency to under-recognise significant trauma in Frail patients. References [1] Audit of Trauma Management in Scotland. Public Health Scotland, 2021 [2] Scottish Trauma Audit Group https://www.stag.scot.nhs.uk/

Comparison of testing for failure of passive transfer in calf serum using four different testing methods

Failure of passive transfer (FPT) in calves is defined as failure to absorb colostral antibodies sufficient to achieve a serum immunoglobulin G (IgG) concentration of >10g/L within the first week of life. The aim of this study was to compare four different tests to diagnose FPT in a convenience sample of 1-7 day old dairy calves in Scotland. Published cutpoints for Brix and total protein (TP) refractometry and zinc sulphate turbidity (ZST) were compared with the reference test radial immunodiffusion (RID) for suitability to detect FPT. In addition, the current commercial RID reference test offered in Scotland was validated. FPT prevalence was estimated to be 14.17% (95% confidence intervals, 10.58 - 17.75) based on RID test results. There was moderate agreement between the reference (RID) and indirect tests (kappa=0.28 for Brix; 0.34 for TP; 0.24 for ZST). Brix and TP refractometry underestimated IgG concentration, resulting in an overestimation of FPT prevalence (40.54% and 29.46%, respectively). Similarly, ZST overestimated the prevalence of FPT (46.29%), but the variability was more consistent across all IgG concentrations. The performance of all three indirect methods was improved by lowering test cutpoints (to 5g/dL for TP; 8.2% for Brix; 15 units for ZST) which improved test specificity and accuracy of these screening tests.

Impact of a Cancer Survivorship Program on Well-Being and Community Involvement: Role of OT and Future Directions

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.

This qualitative phenomenology explored the lived experiences of cancer survivors in a community-based, interprofessional survivorship program and explains further exploration for inclusion of OT. Personal themes describing impact on the individuals included (1) journey of spiritual and emotional healing, (2) growing into a new sense of self, and (3) moving from survival to life. Relational themes included (1) building a community of caring and connection and (2) embracing the value of altruism.

Primary Author and Speaker: Lynne Murphy

Additional Authors and Speakers: Kendall Ellis, Nicole Fox, Sarah Lee, Rachel Lennon, and Gloria Norton

The impact of age and high-risk human papillomavirus (hrHPV) status on the prevalence of high-grade cervical intraepithelial neoplasia (CIN2+) in women with persistent hrHPV-positive, cytology-negative screening samples: a prospective cohort study

OBJECTIVE

To establish the prevalence of high-grade cervical intraepithelial neoplasia (CIN2+) in women referred to colposcopy with persistent high-risk human papillomavirus (hrHPV) cytology-negative screening sample according to hrHPV genotype, age at referral and colposcopic performance.

DESIGN

Prospective cohort study.

SETTING

Single colposcopy clinic linked to a population-based screening programme.

POPULATION

Women referred with persistent hrHPV cytology-negative routine screening samples.

METHODS

Prospective study with descriptive statistics from a single colposcopy unit between June 2014 and July 2019.

MAIN OUTCOME MEASURES

Prevalence of hrHPV genotypes and CIN2+, positive predictive value for colposcopic impression, and inadequate colposcopic examinations.

RESULTS

A total of 3107 women were referred. Prevalence of CIN2+ was highest for persistent HPV16 infections (10.7%) compared with HPV18 (3.6%) or HPVO (4.7%). Prevalence of CIN2+ declined with age (25-34 years 14.2% to 55-64 years 1.1%) whereas the percentage of women with an inadequate colposcopic examination increased (25-34 years 0.9% to 55-64 years 29.5%). High-grade colposcopic impression fell over time during the study from 16.1 to 5.1%. The positive predictive value for colposcopic impression of CIN2+ was affected by hrHPV genotype (57.3% for HPV16 versus 32.1% for nonHPV16). The adjunctive use of electrical impedance spectroscopy detected an extra 42 cases of CIN2+, which was irrespective of hrHPV genotype.

CONCLUSIONS

Primary hrHPV cervical screening increases detection of CIN2+; however, low specificity results in more women being referred to colposcopy with a low prevalence of CIN2+. Colposcopy performs poorly in some groups, particularly with HPVO infections and women over 50 years of age. An appropriate threshold for referral to colposcopy in primary hrHPV screening has not been established.

TWEETABLE ABSTRACT

Low prevalence of CIN2+ in HPV-positive negative cytology samples. HPV genotype, age and prevalence of CIN2+ affect colposcopic performance.

XRootD Third Party Copy for the WLCG and HLLHC

A Third Party Copy (TPC) mechanism has existed in the pure XRootD storage environment for many years. However, using the XRootD TPC in the WLCG environment presents additional challenges due to the diversity of the storage systems involved such as EOS, dCache, DPM and ECHO, requiring that we carefully navigate the unique constraints imposed by these storage systems and their site-specific environments through customized configuration and software development. To support multitenant setups seen at many WLCG sites, X509 based authentication and authorization in XRootD was significantly improved to meet both security and functionality requirements. This paper presents architecture of the pull based TPC with optional X509 credential delegation, and how it is implemented in native XRootD and dCache. The paper discusses technical requirements, challenges, design choices and implementation details in the WLCG storage systems, as well as in FTS/gfal2. It also outlines XRootD’s plan to support newer TPC and security models such as token based authorization.

Dry Rehydratable Film Method for Rapid Enumeration of Coliforms in Foods (3M™ Petrifilm™ Rapid Coliform Count Plate): Collaborative Study

A rehydratable dry-film plating method for coliforms in foods, the 3M™ Petrifilm™ Rapid Coliform Count plate method, was compared with the U.S. Food and Drug Administration's Bacteriological Analytical Manual method for nondairy foods and the American Public Health Association's Standard Methods for the Examination of Dairy Products (SMEDP) method for dairy foods. Six food types, vanilla ice cream, cheddar cheese, fresh refrigerated uncooked pasta, wheat flour, prepared frozen macaroni and cheese, and frozen hash browns, were analyzed for coliforms by 11 collaborating laboratories. For each food product tested, the collaborators received 8 blind samples consisting of a control sample and 3 levels of inoculated sample, each in duplicate. The mean log counts for the methods were comparable. The repeatability and reproducibility variances of the Petrifilm Rapid Coliform Count method at 14 and 24 h were not significantly different from those of the standard methods.

The Relative Intelligibility Threshold for One's Own Name Compared with other Names

Two recent experiments (Moray, 1959; Oswald, Taylor and Treisman, 1960) have shown that in dichotic listening, and in sleep one's own name seems to be responded to selectively. We have shown for 10 subjects, each listening binaurally to the same recording of a list of their names repeated at random 10 times, and masked by noise, that the subject's own name had a significantly lower threshold than other names. The effect we found was not significantly different from the one found by Oswald et al. during sleep and by Moray for the dichotic situation.

These three experiments taken together suggest that the same pattern-analysing mechanism is involved in normal listening, dichotic listening to the rejected message, and in discrimination during sleep.

Minimally invasive genomic and transcriptomic profiling of visceral cancers by next-generation sequencing of circulating exosomes

BACKGROUND

The ability to perform comprehensive profiling of cancers at high resolution is essential for precision medicine. Liquid biopsies using shed exosomes provide high-quality nucleic acids to obtain molecular characterization, which may be especially useful for visceral cancers that are not amenable to routine biopsies.

PATIENTS AND METHODS

We isolated shed exosomes in biofluids from three patients with pancreaticobiliary cancers (two pancreatic, one ampullary). We performed comprehensive profiling of exoDNA and exoRNA by whole genome, exome and transcriptome sequencing using the Illumina HiSeq 2500 sequencer. We assessed the feasibility of calling copy number events, detecting mutational signatures and identifying potentially actionable mutations in exoDNA sequencing data, as well as expressed point mutations and gene fusions in exoRNA sequencing data.

RESULTS

Whole-exome sequencing resulted in 95%-99% of the target regions covered at a mean depth of 133-490×. Genome-wide copy number profiles, and high estimates of tumor fractions (ranging from 56% to 82%), suggest robust representation of the tumor DNA within the shed exosomal compartment. Multiple actionable mutations, including alterations in NOTCH1 and BRCA2, were found in patient exoDNA samples. Further, RNA sequencing of shed exosomes identified the presence of expressed fusion genes, representing an avenue for elucidation of tumor neoantigens.

CONCLUSIONS

We have demonstrated high-resolution profiling of the genomic and transcriptomic landscapes of visceral cancers. A wide range of cancer-derived biomarkers could be detected within the nucleic acid cargo of shed exosomes, including copy number profiles, point mutations, insertions, deletions, gene fusions and mutational signatures. Liquid biopsies using shed exosomes has the potential to be used as a clinical tool for cancer diagnosis, therapeutic stratification and treatment monitoring, precluding the need for direct tumor sampling.

Jet energy measurement and its systematic uncertainty in proton-proton collisions at [Formula: see text] TeV with the ATLAS detector

The jet energy scale (JES) and its systematic uncertainty are determined for jets measured with the ATLAS detector using proton-proton collision data with a centre-of-mass energy of [Formula: see text] TeV corresponding to an integrated luminosity of [Formula: see text][Formula: see text]. Jets are reconstructed from energy deposits forming topological clusters of calorimeter cells using the anti-[Formula: see text] algorithm with distance parameters [Formula: see text] or [Formula: see text], and are calibrated using MC simulations. A residual JES correction is applied to account for differences between data and MC simulations. This correction and its systematic uncertainty are estimated using a combination of in situ techniques exploiting the transverse momentum balance between a jet and a reference object such as a photon or a [Formula: see text] boson, for [Formula: see text] and pseudorapidities [Formula: see text]. The effect of multiple proton-proton interactions is corrected for, and an uncertainty is evaluated using in situ techniques. The smallest JES uncertainty of less than 1 % is found in the central calorimeter region ([Formula: see text]) for jets with [Formula: see text]. For central jets at lower [Formula: see text], the uncertainty is about 3 %. A consistent JES estimate is found using measurements of the calorimeter response of single hadrons in proton-proton collisions and test-beam data, which also provide the estimate for [Formula: see text] TeV. The calibration of forward jets is derived from dijet [Formula: see text] balance measurements. The resulting uncertainty reaches its largest value of 6 % for low-[Formula: see text] jets at [Formula: see text]. Additional JES uncertainties due to specific event topologies, such as close-by jets or selections of event samples with an enhanced content of jets originating from light quarks or gluons, are also discussed. The magnitude of these uncertainties depends on the event sample used in a given physics analysis, but typically amounts to 0.5-3 %.

Muon reconstruction efficiency and momentum resolution of the ATLAS experiment in proton-proton collisions at [Formula: see text] TeV in 2010

This paper presents a study of the performance of the muon reconstruction in the analysis of proton-proton collisions at [Formula: see text] TeV at the LHC, recorded by the ATLAS detector in 2010. This performance is described in terms of reconstruction and isolation efficiencies and momentum resolutions for different classes of reconstructed muons. The results are obtained from an analysis of [Formula: see text] meson and [Formula: see text] boson decays to dimuons, reconstructed from a data sample corresponding to an integrated luminosity of 40 pb[Formula: see text]. The measured performance is compared to Monte Carlo predictions and deviations from the predicted performance are discussed.

The differential production cross section of the [Formula: see text](1020) meson in [Formula: see text] = 7 TeV [Formula: see text] collisions measured with the ATLAS detector

A measurement is presented of the [Formula: see text] production cross section at [Formula: see text] = 7 TeV using [Formula: see text] collision data corresponding to an integrated luminosity of 383 [Formula: see text], collected with the ATLAS experiment at the LHC. Selection of [Formula: see text](1020) mesons is based on the identification of charged kaons by their energy loss in the pixel detector. The differential cross section is measured as a function of the transverse momentum, [Formula: see text], and rapidity, [Formula: see text], of the [Formula: see text](1020) meson in the fiducial region 500 [Formula: see text] 1200 MeV, [Formula: see text] 0.8, kaon [Formula: see text] 230 MeV and kaon momentum [Formula: see text] 800 MeV. The integrated [Formula: see text]-meson production cross section in this fiducial range is measured to be [Formula: see text] = 570 [Formula: see text] 8 (stat) [Formula: see text] 66 (syst) [Formula: see text] 20 (lumi) [Formula: see text].

Search for quantum black hole production in high-invariant-mass lepton+jet final states using pp collisions at √s=8 TeV and the ATLAS detector

This Letter presents a search for quantum black-hole production using 20.3 fb-1 of data collected with the ATLAS detector in pp collisions at the LHC at √s = 8 TeV. The quantum black holes are assumed to decay into a final state characterized by a lepton (electron or muon) and a jet. In either channel, no event with a lepton-jet invariant mass of 3.5 TeV or more is observed, consistent with the expected background. Limits are set on the product of cross sections and branching fractions for the lepton+jet final states of quantum black holes produced in a search region for invariant masses above 1 TeV. The combined 95% confidence level upper limit on this product for quantum black holes with threshold mass above 3.5 TeV is 0.18 fb. This limit constrains the threshold quantum black-hole mass to be above 5.3 TeV in the model considered.

Search for dark matter in events with a hadronically decaying W or Z boson and missing transverse momentum in pp collisions at √s=8 TeV with the ATLAS detector

A search is presented for dark matter pair production in association with a W or Z boson in pp collisions representing 20.3  fb(-1) of integrated luminosity at √s=8  TeV using data recorded with the ATLAS detector at the Large Hadron Collider. Events with a hadronic jet with the jet mass consistent with a W or Z boson, and with large missing transverse momentum are analyzed. The data are consistent with the standard model expectations. Limits are set on the mass scale in effective field theories that describe the interaction of dark matter and standard model particles, and on the cross section of Higgs production and decay to invisible particles. In addition, cross section limits on the anomalous production of W or Z bosons with large missing transverse momentum are set in two fiducial regions.

Measurement of jet shapes in top-quark pair events at [Formula: see text] using the ATLAS detector

A measurement of jet shapes in top-quark pair events using 1.8 fb-1 of [Formula: see text]pp collision data recorded by the ATLAS detector at the LHC is presented. Samples of top-quark pair events are selected in both the single-lepton and dilepton final states. The differential and integrated shapes of the jets initiated by bottom-quarks from the top-quark decays are compared with those of the jets originated by light-quarks from the hadronic W-boson decays [Formula: see text] in the single-lepton channel. The light-quark jets are found to have a narrower distribution of the momentum flow inside the jet area than b-quark jets.

Measurement of top quark polarization in top-antitop events from proton-proton collisions at √s=7 TeV using the ATLAS detector

This Letter presents measurements of the polarization of the top quark in top-antitop quark pair events, using 4.7  fb(-1) of proton-proton collision data recorded with the ATLAS detector at the Large Hadron Collider at √s=7  TeV. Final states containing one or two isolated leptons (electrons or muons) and jets are considered. Two measurements of α(ℓ)P, the product of the leptonic spin-analyzing power and the top quark polarization, are performed assuming that the polarization is introduced by either a CP conserving or a maximally CP violating production process. The measurements obtained, α(ℓ)P(CPC)=-0.035±0.014(stat)±0.037(syst) and α(ℓ)P(CPV)=0.020±0.016(stat)(-0.017)(+0.013)(syst), are in good agreement with the standard model prediction of negligible top quark polarization.

Measurement of the azimuthal angle dependence of inclusive jet yields in Pb+Pb collisions at √(sNN)=2.76 TeV with the ATLAS detector

Measurements of the variation of inclusive jet suppression as a function of relative azimuthal angle, Δφ, with respect to the elliptic event plane provide insight into the path-length dependence of jet quenching. ATLAS has measured the Δφ dependence of jet yields in 0.14 nb(-1) of √(s(NN))=2.76 TeV Pb+Pb collisions at the LHC for jet transverse momenta p(T)>45 GeV in different collision centrality bins using an underlying event subtraction procedure that accounts for elliptic flow. The variation of the jet yield with Δφ was characterized by the parameter, v(2)(jet), and the ratio of out-of-plane (Δφ~π/2) to in-plane (Δφ~0) yields. Nonzero v(2)(jet) values were measured in all centrality bins for p(T)<160 GeV. The jet yields are observed to vary by as much as 20% between in-plane and out-of-plane directions.

Improved luminosity determination in pp collisions at [Formula: see text] using the ATLAS detector at the LHC

The luminosity calibration for the ATLAS detector at the LHC during pp collisions at [Formula: see text] in 2010 and 2011 is presented. Evaluation of the luminosity scale is performed using several luminosity-sensitive detectors, and comparisons are made of the long-term stability and accuracy of this calibration applied to the pp collisions at [Formula: see text]. A luminosity uncertainty of [Formula: see text] is obtained for the 47 pb-1 of data delivered to ATLAS in 2010, and an uncertainty of [Formula: see text] is obtained for the 5.5 fb-1 delivered in 2011.

Measurement of the inclusive jet cross-section in pp collisions at [Formula: see text] and comparison to the inclusive jet cross-section at [Formula: see text] using the ATLAS detector

The inclusive jet cross-section has been measured in proton-proton collisions at [Formula: see text] in a dataset corresponding to an integrated luminosity of [Formula: see text] collected with the ATLAS detector at the Large Hadron Collider in 2011. Jets are identified using the anti-kt algorithm with two radius parameters of 0.4 and 0.6. The inclusive jet double-differential cross-section is presented as a function of the jet transverse momentum pT and jet rapidity y, covering a range of 20≤pT<430 GeV and |y|<4.4. The ratio of the cross-section to the inclusive jet cross-section measurement at [Formula: see text], published by the ATLAS Collaboration, is calculated as a function of both transverse momentum and the dimensionless quantity [Formula: see text], in bins of jet rapidity. The systematic uncertainties on the ratios are significantly reduced due to the cancellation of correlated uncertainties in the two measurements. Results are compared to the prediction from next-to-leading order perturbative QCD calculations corrected for non-perturbative effects, and next-to-leading order Monte Carlo simulation. Furthermore, the ATLAS jet cross-section measurements at [Formula: see text] and [Formula: see text] are analysed within a framework of next-to-leading order perturbative QCD calculations to determine parton distribution functions of the proton, taking into account the correlations between the measurements.

Search for a light charged Higgs boson in the decay channel [Formula: see text] in [Formula: see text] events using pp collisions at [Formula: see text] with the ATLAS detector

A search for a charged Higgs boson (H+) in [Formula: see text] decays is presented, where one of the top quarks decays via t→H+b, followed by H+→ two jets ([Formula: see text]). The other top quark decays to Wb, where the W boson then decays into a lepton (e/μ) and a neutrino. The data were recorded in pp collisions at [Formula: see text] by the ATLAS detector at the LHC in 2011, and correspond to an integrated luminosity of 4.7 fb-1. With no observation of a signal, 95 % confidence level (CL) upper limits are set on the decay branching ratio of top quarks to charged Higgs bosons varying between 5 % and 1 % for H+ masses between 90 GeV and 150 GeV, assuming [Formula: see text].

Measurement of kT splitting scales in W→ℓν events at [Formula: see text] with the ATLAS detector

A measurement of splitting scales, as defined by the kT clustering algorithm, is presented for final states containing a W boson produced in proton-proton collisions at a centre-of-mass energy of 7 TeV. The measurement is based on the full 2010 data sample corresponding to an integrated luminosity of 36 pb-1 which was collected using the ATLAS detector at the CERN Large Hadron Collider. Cluster splitting scales are measured in events containing W bosons decaying to electrons or muons. The measurement comprises the four hardest splitting scales in a kT cluster sequence of the hadronic activity accompanying the W boson, and ratios of these splitting scales. Backgrounds such as multi-jet and top-quark-pair production are subtracted and the results are corrected for detector effects. Predictions from various Monte Carlo event generators at particle level are compared to the data. Overall, reasonable agreement is found with all generators, but larger deviations between the predictions and the data are evident in the soft regions of the splitting scales.

Observation of associated near-side and away-side long-range correlations in sqrt[s(NN)]=5.02 TeV proton-lead collisions with the ATLAS detector

Two-particle correlations in relative azimuthal angle (Δø) and pseudorapidity (Δη) are measured in sqrt[s(NN)] = 5.02 TeV p+Pb collisions using the ATLAS detector at the LHC. The measurements are performed using approximately 1 μb(-1) of data as a function of transverse momentum (p(T)) and the transverse energy (ΣE(T)(Pb)) summed over 3.1 < η < 4.9 in the direction of the Pb beam. The correlation function, constructed from charged particles, exhibits a long-range (2 < |Δ η | < 5) "near-side" (Δø ~ 0) correlation that grows rapidly with increasing ΣE(T)(Pb). A long-range "away-side" (Δø ~ π) correlation, obtained by subtracting the expected contributions from recoiling dijets and other sources estimated using events with small ΣE(T)(Pb), is found to match the near-side correlation in magnitude, shape (in Δη and Δø) and ΣE(T)(Pb) dependence. The resultant Δø correlation is approximately symmetric about π/2, and is consistent with a dominant cos2Δø modulation for all ΣE(T)(Pb) ranges and particle p(T).

Multi-channel search for squarks and gluinos in [Formula: see text]pp collisions with the ATLAS detector at the LHC

A search for supersymmetric particles in final states with zero, one, and two leptons, with and without jets identified as originating from b-quarks, in 4.7 fb-1 of [Formula: see text]pp collisions produced by the Large Hadron Collider and recorded by the ATLAS detector is presented. The search uses a set of variables carrying information on the event kinematics transverse and parallel to the beam line that are sensitive to several topologies expected in supersymmetry. Mutually exclusive final states are defined, allowing a combination of all channels to increase the search sensitivity. No deviation from the Standard Model expectation is observed. Upper limits at 95 % confidence level on visible cross-sections for the production of new particles are extracted. Results are interpreted in the context of the constrained minimal supersymmetric extension to the Standard Model and in supersymmetry-inspired models with diverse, high-multiplicity final states.