Days spent in acute care hospitals at the end of life of cancer patients in four Swiss cantons: a retrospective database study (SAKK 89/09).

Number of days spent in acute hospitals (DAH) at the end of life is regarded as an important care quality indicator for cancer patients. We analysed DAH during 90 days prior to death in patients from four Swiss cantons. Claims data from an insurance provider with about 20% market share and patient record review identified 2086 patients as dying of cancer. We calculated total DAH per patient. Multivariable generalised linear modelling served to evaluate potential explanatory variables. Mean DAH was 26 days. In the multivariable model, using complementary and alternative medicine (DAH = 33.9; +8.8 days compared to non-users) and canton of residence (for patient receiving anti-cancer therapy, Zürich DAH = 22.8 versus Basel DAH = 31.4; for other patients, Valais DAH = 22.7 versus Ticino DAH = 33.7) had the strongest influence. Age at death and days spent in other institutions were additional significant predictors. DAH during the last 90 days of life of cancer patients from four Swiss cantons is high compared to most other countries. Several factors influence DAH. Resulting differences are likely to have financial impact, as DAH is a major cost driver for end-of-life care. Whether they are supply- or demand-driven and whether patients would prefer fewer days in hospital remains to be established.

Training primary care physicians to offer their patients faecal occult blood testing and colonoscopy for colorectal cancer screening on an equal basis: a pilot intervention with before-after and parallel group surveys.

OBJECTIVES Primary care physicians (PCPs) should prescribe faecal immunochemical testing (FIT) or colonoscopy for colorectal cancer screening based on their patient's values and preferences. However, there are wide variations between PCPs in the screening method prescribed. The objective was to assess the impact of an educational intervention on PCPs' intent to offer FIT or colonoscopy on an equal basis. DESIGN Survey before and after training seminars, with a parallel comparison through a mailed survey to PCPs not attending the training seminars. SETTING All PCPs in the canton of Vaud, Switzerland. PARTICIPANTS Of 592 eligible PCPs, 133 (22%) attended a seminar and 106 (80%) filled both surveys. 109 (24%) PCPs who did not attend the seminars returned the mailed survey. INTERVENTION A 2 h-long interactive seminar targeting PCP knowledge, skills and attitudes regarding offering a choice of colorectal cancer (CRC) screening options. OUTCOME MEASURES The primary outcome was PCP intention of having their patients screened with FIT and colonoscopy in equal proportions (between 40% and 60% each). Secondary outcomes were the perceived role of PCPs in screening decisions (from paternalistic to informed decision-making) and correct answer to a clinical vignette. RESULTS Before the seminars, 8% of PCPs reported that they had equal proportions of their patients screened for CRC by FIT and colonoscopy; after the seminar, 33% foresaw having their patients screened in equal proportions (p<0.001). Among those not attending, there was no change (13% vs 14%, p=0.8). Of those attending, there was no change in their perceived role in screening decisions, while the proportion responding correctly to a clinical vignette increased (88-99%, p<0.001). CONCLUSIONS An interactive training seminar increased the proportion of physicians with the intention to prescribe FIT and colonoscopy in equal proportions.

Abundance of nodules, chemical and mineral compositions of nodules and sediments from the Central Pacific

The monograph considers facial conditions of ore-formation in the Central Equatorial Pacific, as well as lithostratigraphy and local variability of bottom sediments. Mineral composition of nodules, forms of occurrence of chemical elements in sediments and nodules, composition of interstitial waters, age of nodules, regularities and processes of ore formation in the radiolarian belt of the Pacific Ocean zone are also under consideration.

It's confusing when the Swiss go to the polls. Here are 6 surprising things about their elections

On Sunday, Switzerland votes on its federal parliament. The members of both chambers - 200 National Councillors and 46 Councillors of States - are directly elected, with the 26 Swiss cantons (or provinces) forming the districts. Seats in the National Council are distributed to the cantons based on their population size, while in the Council of States each full canton gets two seats and the six half-cantons get one each. Here are six things to look out for.

EuroPineDB: a high-coverage web database for maritime pine transcriptome

Pinus pinaster is an economically and ecologically important species that is becoming a woody gymnosperm model. Its enormous genome size makes whole-genome sequencing approaches are hard to apply. Therefore, the expressed portion of the genome has to be characterised and the results and annotations have to be stored in dedicated databases.

Gromov hyperbolicity of periodic planar graphs

The study of hyperbolic graphs is an interesting topic since the hyperbolicity of a geodesic metric space is equivalent to the hyperbolicity of a graph related to it. The main result in this paper is a very simple characterization of the hyperbolicity of a large class of periodic planar graphs.

Asymptotic values of quasiregular maps

Suslin analytic sets characterize the sets of asymptotic values of entire holomorphic functions. By a theorem of Ahlfors, the set of asymptotic values is finite for a function with finite order of growth. Quasiregular maps are a natural generalization of holomorphic functions to dimensions n ≥ 3 and, in fact, many of the properties of holomorphic functions have counterparts for quasiregular maps. It is shown that analytic sets also characterize the sets of asymptotic values of quasiregular maps in Rn, even for those with finite order of growth. Our construction is based on Drasin's quasiregular sine function

Quasi-isometries and isoperimetric inequalities

We consider the stability of isoperimetric inequalities under quasi-isometries between Riemann surfaces. Kanai observed that quasi-isometries preserve isoperimetric inequalities on complete Riemannian manifolds with finite geometry: positive injectivity radius and Ricci curvature bounded from below (see [2]). In [1], it is shown that the linear isoperimetric inequality is a quasi-isometric invariant for planar Riemann surfaces (genus zero surfaces) with vanishing injectivity radius. Moreover, it is proved that non-linear isoperimetric inequalities can only hold for Riemann surfaces with positive injectivity radius, and hence, by Kanai's observation, preserved by quasi-isometries. In this talk we present an overview on isoperimetric inequalities and give some of the ideas of the proofs of the results cited above.

Youth participation in development planning: case study of Sayausí (Rural Parish) Cuenca-Ecuador

Young people now represent the highest percentage of the world population. Soon, they will be seniors and they will take decisions for a more orderly and equitable world. For this reason, the participation of young people in development planning is very important and many countries are trying to promote it through various measures. This article analyzes the trajectory of youth participation in the Latin American region and specifically the profile of youth participation in Ecuador, country in which the Constitution recognizes the strategic role of youth in development. The case study of Sayausí rural parish in canton Cuenca is analyzed, through surveys, interviews and an Empowerment Evaluation workshop to young people and decentralized government. The results obtained allow to propose strategies to help improve the participation of youth in the community.

Expression of Drosophila mushroom body mutations in alternative genetic backgrounds: a case study of the mushroom body miniature gene (mbm).

Mutations in 12 genes regulating Drosophila melanogaster mushroom body (MB) development were each studied in two genetic backgrounds. In all cases, brain structure was qualitatively or quantitatively different after replacement of the "original" genetic background with that of the Canton Special wild-type strain. The mushroom body miniature gene (mbm) was investigated in detail. mbm supports the maintenance of MB Kenyon cell fibers in third instar larvae and their regrowth during metamorphosis. Adult mbm1 mutant females are lacking many or most Kenyon cell fibers and are impaired in MB-mediated associative odor learning. We show here that structural defects in mbm1 are apparent only in combination with an X-linked, dosage-dependent modifier (or modifiers). In the Canton Special genetic background, the mbm1 anatomical phenotype is suppressed, and MBs develop to a normal size. However, the olfactory learning phenotype is not fully restored, suggesting that submicroscopic defects persist in the MBs. Mutant mbm1 flies with full-sized MBs have normal retention but show a specific acquisition deficit that cannot be attributed to reductions in odor avoidance, shock reactivity, or locomotor behavior. We propose that polymorphic gene interactions (in addition to ontogenetic factors) determine MB size and, concomitantly, the ability to recognize and learn odors.

Acute Synaptic Activity Causes Differential miRNA Expression in The Drosophila melanogaster Larval Central Nervous System

The primary goal of this thesis was to determine if spaced synaptic stimulation induced the differential expression of microRNAs (miRNAs) in the Drosophila melanogaster central nervous system (CNS). Prior to attaining this goal, we needed to identify and validate a spaced stimulation paradigm that could induce the formation of new synaptic growth at a model synapse, the larval neuromuscular junction (NMJ). Both Channelrhodopsin- and high potassium-based stimulation paradigms adapted from (Ataman, et al. 2008) were tested. Once validation of these paradigms was complete, we sought to characterize the miRNA expression profile of the larval CNS by miRNA array. Following attainment of these data, we used quantitative real-time PCR (RT-qPCR) to determine if acute synaptic stimulation caused the differential expression of neuronal miRNAs. We found that upon high potassium spaced training in a wild type (Canton S) genotype, 5 miRNAs showed significant differential expression when normalized to a validated reference gene, the U1 snRNA. Moreover, absolute quantification of our RT-qPCR study implicated one miRNA: miR-958 as being significantly regulated by activity. Investigation into potential targets for miR-958 revealed it to be a potential regular of Dlar, a protein tyrosine phosphatase implicated in synapse development. This investigation provides the foundation to directly test our underlying hypothesis that, following spaced training, differential expression of miRNAs alters the translation of proteins required to induce and maintain these structural changes at the synapse.