Decision analysis of the effectiveness of lung cancer screening using autofluorescence bronchoscopy and computed tomography

Background: Lung cancer (LC) is the leading cause of cancer death in the developed world. Most cancers are associated with tobacco smoking. A primary hope for reducing lung cancer has been prevention of smoking and successful smoking cessation programs. To date, these programs have not been as successful as anticipated. Objective: The aim of the current study was to evaluate whether lung cancer screening combining low dose computed tomography with autofluorescence bronchoscopy (combined CT & AFB) is superior to CT or AFB screening alone in improving lung cancer specific survival. In addition, the extent of improvement and ideal conditions for combined CT & AFB screening were evaluated. Methods: We applied decision analysis and Monte Carlo simulation modeling using TreeAge Software to evaluate our study aims. Histology- and stage specific probabilities of lung cancer 5-year survival proportions were taken from Surveillance and Epidemiologic End Results (SEER) Registry data. Screeningassociated data was taken from the US NCI Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO), National Lung Screening Trial (NLST), and US NCI Lung Screening Study (LSS), other relevant published data and expert opinion. Results: Decision Analysis - Combined CT and AFB was the best approach at Improving 5-year survival (Overall Expected Survival (OES) in the entire screened population was 0.9863) and in lung cancer patients only (Lung Cancer Specific Expected Survival (LOSES) was 0.3256). Combined screening was slightly better than CT screening alone (OES = 0.9859; LCSES = 0.2966), and substantially better than AFB screening alone (OES = 0.9842; LCSES = 0.2124), which was considerably better than no screening (OES = 0.9829; LCSES = 0.1445). Monte Carlo simulation modeling revealed that expected survival in the screened population and lung cancer patients is highest when screened using CT and combined CT and AFB. CT alone and combined screening was substantially better than AFB screening alone or no screening. For LCSES, combined CT and AFB screening is significantly better than CT alone (0.3126 vs. 0.2938, p< 0.0001). Conclusions: Overall, these analyses suggest that combined CT and AFB is slightly better than CT alone at improving lung cancer survival, and both approaches are substantially better than AFB screening alone or no screening.

Other-race faces : limitations of expert face recognition /

Adults' expert face recognition is limited to the kinds of faces they encounter on a daily basis (typically upright human faces of the same race). Adults process own-race faces holistically (Le., as a gestalt) and are exquisitely sensitive to small differences among faces in the spacing of features, the shape of individual features and the outline or contour of the face (Maurer, Le Grand, & Mondloch, 2002), however this expertise does not seem to extend to faces from other races. The goal of the current study was to investigate the extent to which the mechanisms that underlie expert face processing of own-race faces extend to other-race faces. Participants from rural Pennsylvania that had minimal exposure to other-race faces were tested on a battery of tasks. They were tested on a memory task, two measures of holistic processing (the composite task and the part/whole task), two measures of spatial and featural processing (the JanelLing task and the scrambledlblurred faces task) and a test of contour processing (JanelLing task) for both own-and other-race faces. No study to date has tested the same participants on all of these tasks. Participants had minimal experience with other-race faces; they had no Chinese family members, friends or had ever traveled to an Asian country. Results from the memory task did not reveal an other-race effect. In the present study, participants also demonstrated holistic processing of both own- and other-race faces on both the composite task and the part/whole task. These findings contradict previous findings that Caucasian adults process own-race faces more holistically than other-race faces. However participants did demonstrate an own-race advantage for processing the spacing among features, consistent with two recent studies that used different manipulations of spacing cues (Hayward et al. 2007; Rhodes et al. 2006). They also demonstrated an other-race effect for the processing of individual features for the Jane/Ling task (a direct measure of featural processing) consistent with previous findings (Rhodes, Hayward, & Winkler, 2006), but not for the scrambled faces task (an indirect measure offeatural processing). There was no own-race advantage for contour processing. Thus, these results lead to the conclusion that individuals may show less sensitivity to the appearance of individual features and the spacing among them in other-race faces, despite processing other-race faces holistically.

Message from the President of the United States, transmitting a report of the Secretary of State, in obedience to a resolution of the thirteenth inst. "requesting the President to lay before this House such documents relative to the Russian mediation as in his opinion it may not be improper to communicate." --

United States,13th Congress, 2d session, 1813-1814. House. Doc. no. 35.

Opinion Regarding the Estate of S.D. Woodruff

An opinion regarding the estate of S.D. Woodruff. This is in regard to the liability of the estate to pay succession duties in Ontario upon certain American bonds and securities in the City of New York. This is a 6 page printed document prepared by Dewart, Young and Maw - February 7, 1905.