EURECCA colorectal: multidisciplinary mission statement on better care for patients with colon and rectal cancer in Europe

Background: Care for patients with colon and rectal cancer has improved in the last twenty years however still considerable variation exists in cancer management and outcome between European countries. Therefore, EURECCA, which is the acronym of European Registration of cancer care, is aiming at defining core treatment strategies and developing a European audit structure in order to improve the quality of care for all patients with colon and rectal cancer. In December 2012 the first multidisciplinary consensus conference about colon and rectum was held looking for multidisciplinary consensus. The expert panel consisted of representatives of European scientific organisations involved in cancer care of patients with colon and rectal cancer and representatives of national colorectal registries. Methods: The expert panel had delegates of the European Society of Surgical Oncology (ESSO), European Society for Radiotherapy & Oncology (ESTRO), European Society of Pathology (ESP), European Society for Medical Oncology (ESMO), European Society of Radiology (ESR), European Society of Coloproctology (ESCP), European CanCer Organisation (ECCO), European Oncology Nursing Society (EONS) and the European Colorectal Cancer Patient Organisation (EuropaColon), as well as delegates from national registries or audits. Experts commented and voted on the two web-based online voting rounds before the meeting (between 4th and 25th October and between the 20th November and 3rd December 2012) as well as one online round after the meeting (4th-20th March 2013) and were invited to lecture on the subjects during the meeting (13th-15th December 2012). The sentences in the consensus document were available during the meeting and a televoting round during the conference by all participants was performed. All sentences that were voted on are available on the EURECCA website www.canceraudit.eu. The consensus document was divided in sections describing evidence based algorithms of diagnostics, pathology, surgery, medical oncology, radiotherapy, and follow-up where applicable for treatment of colon cancer, rectal cancer and stage IV separately. Consensus was achieved using the Delphi method. Results: The total number of the voted sentences was 465. All chapters were voted on by at least 75% of the experts. Of the 465 sentences, 84% achieved large consensus, 6% achieved moderate consensus, and 7% resulted in minimum consensus. Only 3% was disagreed by more than 50% of the members. Conclusions: It is feasible to achieve European Consensus on key diagnostic and treatment issues using the Delphi method. This consensus embodies the expertise of professionals from all disciplines involved in the care for patients with colon and rectal cancer. Diagnostic and treatment algorithms were developed to implement the current evidence and to define core treatment guidance for multidisciplinary team management of colon and rectal cancer throughout Europe.

Directional dominance on stature and cognition in diverse human populations.

Homozygosity has long been associated with rare, often devastating, Mendelian disorders, and Darwin was one of the first to recognize that inbreeding reduces evolutionary fitness. However, the effect of the more distant parental relatedness that is common in modern human populations is less well understood. Genomic data now allow us to investigate the effects of homozygosity on traits of public health importance by observing contiguous homozygous segments (runs of homozygosity), which are inferred to be homozygous along their complete length. Given the low levels of genome-wide homozygosity prevalent in most human populations, information is required on very large numbers of people to provide sufficient power. Here we use runs of homozygosity to study 16 health-related quantitative traits in 354,224 individuals from 102 cohorts, and find statistically significant associations between summed runs of homozygosity and four complex traits: height, forced expiratory lung volume in one second, general cognitive ability and educational attainment (P < 1 × 10(-300), 2.1 × 10(-6), 2.5 × 10(-10) and 1.8 × 10(-10), respectively). In each case, increased homozygosity was associated with decreased trait value, equivalent to the offspring of first cousins being 1.2 cm shorter and having 10 months' less education. Similar effect sizes were found across four continental groups and populations with different degrees of genome-wide homozygosity, providing evidence that homozygosity, rather than confounding, directly contributes to phenotypic variance. Contrary to earlier reports in substantially smaller samples, no evidence was seen of an influence of genome-wide homozygosity on blood pressure and low density lipoprotein cholesterol, or ten other cardio-metabolic traits. Since directional dominance is predicted for traits under directional evolutionary selection, this study provides evidence that increased stature and cognitive function have been positively selected in human evolution, whereas many important risk factors for late-onset complex diseases may not have been.

Genetic associations at 53 loci highlight cell types and biological pathways relevant for kidney function.

Reduced glomerular filtration rate defines chronic kidney disease and is associated with cardiovascular and all-cause mortality. We conducted a meta-analysis of genome-wide association studies for estimated glomerular filtration rate (eGFR), combining data across 133,413 individuals with replication in up to 42,166 individuals. We identify 24 new and confirm 29 previously identified loci. Of these 53 loci, 19 associate with eGFR among individuals with diabetes. Using bioinformatics, we show that identified genes at eGFR loci are enriched for expression in kidney tissues and in pathways relevant for kidney development and transmembrane transporter activity, kidney structure, and regulation of glucose metabolism. Chromatin state mapping and DNase I hypersensitivity analyses across adult tissues demonstrate preferential mapping of associated variants to regulatory regions in kidney but not extra-renal tissues. These findings suggest that genetic determinants of eGFR are mediated largely through direct effects within the kidney and highlight important cell types and biological pathways.

MultiCampus Open Educational Resources : the case of OER-HE

In this paper we address the implementation strategies regarding Open Educational Resources within a multicampus setting. A comparison is made between 3 institutions that are taking a very different approach: K.U.Leuven, which is a traditional university, the Open Universiteit (Netherlands) which is in the process of starting up the Network Open Polytechnics, and the Universitat Oberta de Catalunya. We are looking deeper into the pedagogical and organizational issues involved in implementing an OER strategy and show how OER holds the promise of flexible solutions for reaching at first sight very divergent goals.

Nova totius Europae tabula ex magnis : generoso atque magnifico Dno. D. Theodorico Echter a Mespelbrunn ... dedicata

Julkaisussa: Speculum orbis terrae. Vol. I

Totius orbis cogniti universalis descriptio

Julkaisussa: Speculum orbis terrae. Vol I

Livoniae pronvinciae ac eius confinium verus et elegans typus

Julkaisussa: Speculum orbis terrae. Vol. II

Hemispherium ab aeqvinoctiali linea, ad circulum poli arctici : hemispherium ab aeqvinoctiali linea, ad circulum poli antarctici

Julkaisussa: Speculum orbis terrae. Vol I

Brasilia et Peruvia : ad strenuum et magnificum Theodoricum Echter a Mespelbrunn

Julkaisussa: Speculum orbis terrae. Vol I

Americae pars borealis, Florida, Baccalaos, Canada, Corterealis

Julkaisussa: Speculum orbis terrae. Vol I

China regnum : in China auem habent mira dexteritate hero suopices venatem ...

Julkaisussa: Speculum orbis terrae. Vol I

Septentrionalium regionum Suetiae, Gothiae, Norvegiae, Daniae et terrarum adiacentium recens exactaque descriptio : per Livinum algoet auctorem

Julkaisussa: Speculum orbis terrae. Vol. II

Carte générale de toutes les costes du monde et les pays nouvellement découvert

Kartta kuuluu A. E. Nordenskiöldin kokoelmaan

L' hémisphère méridional pour voir plus distinctement les terres australes où se voyent les nouvelles découvertes faites en 1739 au sud du Cap de Bonne Esperance = waar in aangetoont werd de nieuwe ontdekkingen gedaam in t'jaar 1739 bezuiden de Caap de Goede Hoop

Lisäkartta: Plan et vue des terres du Cap de la Circoncision situé à 54 degrées de lat. méridiole et environ à 28 deg. 30 min. de longitude = Plan et gezigt van de landen van de Caap der Besnydenis gelegen op 54 gr. zuider br. en omtrent op 28 gr. 30 min. - Eteläisen pallonpuoliskon halkaisija 44,6 cm

Carte des courones du nord qui comprend les royaumes de Danemark, Suède et Norvège etc.

Kartalla: Téatre de la guerre des courones du nord qui comprend les royaumes de Danemark, Suède & Norvège