Prognoses and improvement for head and neck cancers diagnosed in Europe in early 2000s: The EUROCARE-5 a population-based study.

BACKGROUND: Head and neck (H&N) cancers are a heterogeneous group of malignancies, affecting various sites, with different prognoses. The aims of this study are to analyse survival for patients with H&N cancers in relation to tumour location, to assess the change in survival between European countries, and to investigate whether survival improved over time.
METHODS: We analysed about 250,000 H&N cancer cases from 86 cancer registries (CRs). Relative survival (RS) was estimated by sex, age, country and stage. We described survival time trends over 1999-2007, using the period approach. Model based survival estimates of relative excess risks (RERs) of death were also provided by country, after adjusting for sex, age and sub-site.
RESULTS: Five-year RS was the poorest for hypopharynx (25%) and the highest for larynx (59%). Outcome was significantly better in female than in male patients. In Europe, age-standardised 5-year survival remained stable from 1999-2001 to 2005-2007 for laryngeal cancer, while it increased for all the other H&N cancers. Five-year age-standardised RS was low in Eastern countries, 47% for larynx and 28% for all the other H&N cancers combined, and high in Ireland and the United Kingdom (UK), and Northern Europe (62% and 46%). Adjustment for sub-site narrowed the difference between countries. Fifty-four percent of patients was diagnosed at advanced stage (regional or metastatic). Five-year RS for localised cases ranged between 42% (hypopharynx) and 74% (larynx).
CONCLUSIONS: This study shows survival progresses during the study period. However, slightly more than half of patients were diagnosed with regional or metastatic disease at diagnosis. Early diagnosis and timely start of treatment are crucial to reduce the European gap to further improve H&N cancers outcome.

Signal Reliability Improvement Using Selection Combining Based Macro-Diversity for Off-Body Communications At 868 MHz

This paper investigates the potential improvement in signal reliability for outdoor short-range off-body communications channels at 868 MHz using the macro-diversity offered by multiple co-located base stations. In this study, ten identical hypothetical base stations were positioned equidistantly around the perimeter of a rectangle of length 6.67 m and width 3.3 m. A body worn node was placed on the central chest region of an adult male. Five scenarios, each considering different user trajectories, were then analyzed to test the efficacy of using macro-diversity when the desired link is subject to shadowing caused by the human body. A number of selection combining based macro-diversity configurations consisting of four and then ten base stations were considered. It was found that using a macro-diversity system consisting of four base stations (or equivalently signal branches), a maximum diversity gain of 22.5 dB could be obtained while implementing a 10-base station setup this figure could be improved to 25.2 dB.

Pet population management and public health:A web service based tool for the improvement of dog traceability

The risks associated with zoonotic infections transmitted by companion animals are a serious public health concern: the control of zoonoses incidence in domestic dogs, both owned and stray, is hence important to protect human health. Integrated dog population management (DPM) programs, based on the availability of information systems providing reliable data on the structure and composition of the existing dog population in a given area, are fundamental for making realistic plans for any disease surveillance and action system. Traceability systems, based on the compulsory electronic identification of dogs and their registration in a computerised database, are one of the most effective ways to ensure the usefulness of DPM programs. Even if this approach provides many advantages, several areas of improvement have emerged in countries where it has been applied. In Italy, every region hosts its own dog register but these are not compatible with one another. This paper shows the advantages of a web-based-application to improve data management of dog regional registers. The approach used for building this system was inspired by farm animal traceability schemes and it relies on a network of services that allows multi-channel access by different devices and data exchange via the web with other existing applications, without changing the pre-existing platforms. Today the system manages a database for over 300,000 dogs registered in three different Italian regions. By integrating multiple Web Services, this approach could be the solution to gather data at national and international levels at reasonable cost and creating a traceability system on a large scale and across borders that can be used for disease surveillance and development of population management plans. © 2012 Elsevier B.V.

The association between refractive cutoffs for spectacle provision and visual improvement among school-aged children in South Africa.

OBJECTIVES: To evaluate different refractive cutoffs for spectacle provision with regards to their impact on visual improvement and spectacle compliance. DESIGN: Prospective study of visual improvement and spectacle compliance. PARTICIPANTS: South African school children aged 6-19 years receiving free spectacles in a programme supported by Helen Keller International. METHODS: Refractive error, age, gender, urban versus rural residence, presenting and best-corrected vision were recorded for participants. Spectacle wear was observed directly at an unannounced follow-up examination 4-11 months after initial provision of spectacles. The association between five proposed refractive cutoff protocols and visual improvement and spectacle compliance were examined in separate multivariate models. MAIN OUTCOMES: Refractive cutoffs for spectacle distribution which would effectively identify children with improved vision, and those more likely to comply with spectacle wear. RESULTS: Among 8520 children screened, 810 (9.5%) received spectacles, of whom 636 (79%) were aged 10-14 years, 530 (65%) were girls, 324 (40%) had vision improvement > or = 3 lines, and 483 (60%) were examined 6.4+/-1.5 (range 4.6 to 10.9) months after spectacle dispensing. Among examined children, 149 (31%) were wearing or carrying their glasses. Children meeting cutoffs < or = -0.75 D of myopia, > or = +1.00 D of hyperopia and > or = +0.75 D of astigmatism had significantly greater improvement in vision than children failing to meet these criteria, when adjusting for age, gender and urban versus rural residence. None of the proposed refractive protocols discriminated between children wearing and not wearing spectacles. Presenting vision and improvement in vision were unassociated with subsequent spectacle wear, but girls (p < or = 0.0006 for all models) were more likely to be wearing glasses than were boys. CONCLUSIONS: To the best of our knowledge, this is the first suggested refractive cutoff for glasses dispensing validated with respect to key programme outcomes. The lack of association between spectacle retention and either refractive error or vision may have been due to the relatively modest degree of refractive error in this African population.

Correction of moderate myopia is associated with improvement in self-reported visual functioning among Mexican school-aged children.

PURPOSE: To quantify the impact on self-reported visual functioning of spectacle provision for school-aged children in Oaxaca, Mexico. METHODS: The Refractive Status Vision Profile (RSVP), a previously validated tool to measure the impact of refractive correction on visual functioning, was adapted for use in rural children and administered at baseline and 4 weeks (27.3 +/- 4.4 days) after the provision of free spectacles. Visual acuity with and without correction, age, sex, and spherical equivalent refraction were recorded at the time of follow-up. RESULTS: Among 88 children (mean age, 12 years; 55.7% girls), the median presenting acuity (uncorrected or with original spectacles), tested 4 weeks after the provision of free spectacles, was 6/9 (range, 6/6-6/120). Significant improvements in the following subscales of the RSVP were seen for the group as a whole after the provision of free spectacles: function, 11.2 points (P = 0.0001); symptoms, 14.3 points (P < 0.0001); total score, 10.3 points (P = 0.0001). After stratification by presenting vision in the better-seeing eye, children with 6/6 acuity (n = 22) did not have significant improvement in any subscale; those with acuity of 6/7.5 to 6/9 (n = 34) improved only on function (P = 0.02), symptoms (P = 0.005), and total score (P = 0.003); and those with acuity of 6/12 or worse improved on total score (P < 0.0001) and all subscales. Subjects (n = 31) with uncorrected myopia of -1.25 D or more had a mean improvement in total score of 15.9 points (P < 0.0001), whereas those with uncorrected myopia between -0.50 and -1.00 D inclusive (n = 53) had a mean improvement of 8 points (P = 0.01). CONCLUSIONS: Provision of spectacles to children in this setting had a significant impact on self-reported function, even at modest levels of baseline visual disability. The correlation between presenting vision/refraction and improvement and the failure of children 6/6 at baseline to improve offer evidence for a real effect.

Selection of the most appropriate roadside vehicle restraint system – the SAVeRS project

Run Off Road (ROR) crashes are road accidents that often result in severe injuries or fatalities. To reduce the severity of ROR crashes, “forgiving roadsides” need to be designed and this includes identifying situations where there is a need for a Vehicle Restraint System (VRS) and what appropriate VRS should be selected for a specific location and traffic condition. Whilst there are standards covering testing, evaluation and classification of VRS within Europe (EN1317 parts 1 to 8), their selection, location and installation requirements are typically based upon national guidelines and standards, often produced by National Road Authorities (NRA) and/or overseeing organisations. Due to local conditions, these national guidelines vary across Europe.
The European SAVeRS project funded by CEDR has developed a practical and readily understandable VRS guidance document and a user-friendly software tool which allow designers and road administrations to select the most appropriate solution in different road and traffic conditions.
This paper describes the main outcomes of the project, the process to select the most appropriate roadside barrier, and the user friendly SAVeRS tool.

Micropropagation in elite corck oak trees: a tool for suber production improvement?

Dada a extrema importância económica e ambiental que o montado de sobro tem em Portugal, e dado o declínio deste devido a várias razões (e.g. doença, idade das plantas) é premente desenvolver estratégias de preservação de sobreiros elite e optimizar técnicas para a propagação destes genótipos. No primeiro Capítulo expõe-se uma breve introdução sobre o montado actual e as técnicas actuais de regeneração/propagação do sobreiro. Descreve-se ainda as principais técnicas de preservação e avaliação de estabilidade genética referidas na literatura para sobreiro e outras lenhosas. No Capítulo II é apresentado um estudo de melhoramento das condições actuais de maturação de embriões somáticos de sobreiro com vista a aperfeiçoar o processo de conversão em plantas. Neste capítulo é apresentado um protocolo melhorado em relação ao actual que permite um desenvolvimento dos embriões somáticos dum modo semelhante aos embriões zigóticos em termos de substâncias de reserva. O Capítulo III mostra um estudo efectuado com o objectivo principal de avaliar estabilidade genética durante todo o processo de embriogénese somática. Neste capítulo são apresentados resultados duma análise feita por RAPD em fases distintas da embriogénese somática de sobreiro. Neste estudo mostra-se que não existem diferenças significativas entre plantas de campo, embriões somáticos e plantas regeneradas. No Capítulo VI, pretende-se complementar o estudo anterior. Neste Capítulo descreve-se a dinâmica do ciclo celular durante as primeiras fases de embriogénese somática na presença de reguladores de crescimento. Este trabalho permitiu concluir a importância dos reguladores de crescimento na indução e perceber o peso do factor genótipo durante o processo. Considerando os resultados anteriores, a necessidade de um processo eficiente de preservação de genótipos elite torna-se fundamental. No Capítulo V descreve-se um protocolo de criopreservação eficiente sem recursos a substâncias tóxicas. Nesta secção é ainda feita uma análise de variabilidade genética após criopreservação através de FCM, AFLP e SSR. Todos os resultados obtidos anteriormente são postos a prova no Capítulo VI onde se faz uma monitorização extensiva de 10 genótipos elite, tendo em conta a sua capacidade de produção de cortiça, através do processo de embriogénese somática. Durante esta secção são utilizados os protocolos desenvolvidos anteriormente e avaliados na sua eficiência. Neste capítulo é descrita a integração de vários segmentos deste estudo num só protocolo eficiente de regeneração e preservação de sobreiros através de embriogénese somática. Finalmente, no Capítulo VI são apresentadas as conclusões da presente Tese de Doutoramento, com especial incidência para linhas de investigação futuras a serem tomadas. Discute-se a importância deste novo protocolo na optimização da produção da cortiça e traçam-se possíveis aplicações alternativas.

Simulation of economic benefits achieved by water quality improvement for recreational and professional users, within the SPICOSSA SSA (SPICOSSA System Approach) 11 - Guadiana estuary ecosystem sic

Dissertação de Mestrado, Gestão da Água e da Costa, Faculdade de Ciências e Tecnologia, Universidade do Algarve, 2010

The estimation and improvement of the selectivity in crustacean and fish trawls

Tese de dout., Ciências e Tecnologias das Pescas, Faculdade de Ciências do Mar e do Ambiente, Univ. do Algarve, 2003

SWOT analysis of a pediatric rehabilitation programme : a participatory evaluation fostering quality improvement

Purpose. To present the results of a strengths, weaknesses, opportunities and threats (SWOT) analysis used as part of a process aimed at reorganising services provided within a pediatric rehabilitation programme (PRP) in Quebec, Canada and to report the perceptions of the planning committee members regarding the usefulness of the SWOT in this process. Method. Thirty-six service providers working in the PRP completed a SWOT questionnaire and reported what they felt worked and what did not work in the existing model of care. Their responses were used by a planning committee over a 12- month period to assist in the development of a new service delivery model. Committee members shared their thoughts about the usefulness of the SWOT. Results. Current programme strengths included favourable organisational climate and interdisciplinary work whereas weaknesses included lack of psychosocial support to families and long waiting times for children. Opportunities included working with community partners, whereas fear of losing professional autonomy with the new service model was a threat. The SWOT results helped the planning committee redefine the programme goals and make decisions to improve service coordination. SWOT analysis was deemed as a very useful tool to help guide service reorganisation. Conclusions. SWOT analysis appears to be an interesting evaluation tool to promote awareness among service providers regarding the current functioning of a rehabilitation programme. It fosters their active participation in the reorganisation of a new service delivery model for pediatric rehabilitation.

QoS improvement in TCP/IP-based wireless sensor networks using cross-layer optimization

Dissertação de Mestrado, Engenharia Informática, Faculdade de Ciências e Tecnologia, Universidade do Algarve, 2015

Target identification of situations of improvement through Medication Review in patients type 2 diabetes

Introduction: Prevention, early detection and management of diabetes are fundamental for stopping this present epidemic. Medication review may contribute to the early detection of negative clinical outcomes risk factors associated to the use of medicines. Aims: To use the medication review to identify the situations that may lead to clinical negative outcomes, described as findings, in the process of medicines use in type 2 diabetic patients. To verify if the inclusion criteria list of the Pharmaceutical Society of Australia for medication review allows identifying patients of higher risks of obtaining clinical negative outcomes.

Improvement in the Accuracy of Back Trajectories Using WRF to Identify Pollen Sources in Southern Iberian Peninsula

Airborne pollen transport at micro-, meso-gamma and meso-beta scales must be studied by atmospheric models, having special relevance in complex terrain. In these cases, the accuracy of these models is mainly determined by the spatial resolution of the underlying meteorological dataset. This work examines how meteorological datasets determine the results obtained from atmospheric transport models used to describe pollen transport in the atmosphere. We investigate the effect of the spatial resolution when computing backward trajectories with the HYSPLIT model. We have used meteorological datasets from the WRF model with 27, 9 and 3 km resolutions and from the GDAS files with 1 ° resolution. This work allows characterizing atmospheric transport of Olea pollen in a region with complex flows. The results show that the complex terrain affects the trajectories and this effect varies with the different meteorological datasets. Overall, the change from GDAS to WRF-ARW inputs improves the analyses with the HYSPLIT model, thereby increasing the understanding the pollen episode. The results indicate that a spatial resolution of at least 9 km is needed to simulate atmospheric flows that are considerable affected by the relief of the landscape. The results suggest that the appropriate meteorological files should be considered when atmospheric models are used to characterize the atmospheric transport of pollen on micro-, meso-gamma and meso-beta scales. Furthermore, at these scales, the results are believed to be generally applicable for related areas such as the description of atmospheric transport of radionuclides or in the definition of nuclear-radioactivity emergency preparedness.