989 resultados para REVERSED HAZARD RATE


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Better treatment is required for older patients with acute myeloid leukemia (AML) not considered fit for intensive chemotherapy. We report a randomized comparison of lowdose Ara-C (LDAC) vs the novel nucleoside, clofarabine, in untreated older patients with AML and high-risk myelodysplastic syndrome (MDS). A total of 406 patients with de novo (62%), secondary disease (24%), or high-risk MDS (>10% marrow blasts) (15%), median age 74 years, were randomized to LDAC 20 mg twice daily for 10 days every 6 weeks or clofarabine 20 mg/m2 on days 1 to 5, both for up to 4 courses. These patients had more adverse demographics than contemporaneous intensively treated patients. The overall remission rate was 28%, and 2-year survival was 13%. Clofarabine significantly improved complete remission (22% vs 12%; hazard ratio [HR] 5 0.47 [0.28-0.79]; P 5 .005) and overall response (38% vs 19%; HR 5 0.41 [0.26-0.62]; P < .0001), but there was no difference in overall survival, explained by poorer survival in the clofarabine patients who did not gain complete remission and also following relapse. Clofarabine was more myelosuppressive and required more supportive care. Although clofarabine doubled remission rates, overall survival was not improved overall or in any subgroup. The treatment of patients of the type treated here remains a major unmet need. This trial was registered at www.clinicaltrials.gov as #ISRCTN 11036523.

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BACKGROUND: Smoking is the most important individual risk factor for many cancer sites but its association with breast and prostate cancer is not entirely clear. Rate advancement periods (RAPs) may enhance communication of smoking related risk to the general population. Thus, we estimated RAPs for the association of smoking exposure (smoking status, time since smoking cessation, smoking intensity, and duration) with total and site-specific (lung, breast, colorectal, prostate, gastric, head and neck, and pancreatic) cancer incidence and mortality.

METHODS: This is a meta-analysis of 19 population-based prospective cohort studies with individual participant data for 897,021 European and American adults. For each cohort we calculated hazard ratios (HRs) for the association of smoking exposure with cancer outcomes using Cox regression adjusted for a common set of the most important potential confounding variables. RAPs (in years) were calculated as the ratio of the logarithms of the HRs for a given smoking exposure variable and age. Meta-analyses were employed to summarize cohort-specific HRs and RAPs.

RESULTS: Overall, 140,205 subjects had a first incident cancer, and 53,164 died from cancer, during an average follow-up of 12 years. Current smoking advanced the overall risk of developing and dying from cancer by eight and ten years, respectively, compared with never smokers. The greatest advancements in cancer risk and mortality were seen for lung cancer and the least for breast cancer. Smoking cessation was statistically significantly associated with delays in the risk of cancer development and mortality compared with continued smoking.

CONCLUSIONS: This investigation shows that smoking, even among older adults, considerably advances, and cessation delays, the risk of developing and dying from cancer. These findings may be helpful in more effectively communicating the harmful effects of smoking and the beneficial effect of smoking cessation.

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Cytoskeleton controls the stability of transcripts, by mechanisms that involve mRNAs and eEF1A attachment to it. Besides, it plays a key role in protein synthesis and secretion, which seems to be impaired in somatotrophs of hypothyroid rats, whose cytoskeleton is disarranged. This study investigated the: eEF1A and GH mRNA binding to cytoskeleton plus GH mRNA translation rate and GH secretion, in sham-operated and thyroidectomized rats treated with T3 or saline, and killed 30 min thereafter. Thyroidectomy reduced: (a) pituitary F-actin content, and eEF1A plus GH mRNA binding to it; (b) GH mRNA recruitment to polysome; and (c) liver IGF-1 mRNA expression, indicating that GH mRNA stability and translation rate, as well as GH secretion were impaired. T3 acutely reversed all these changes, which points toward a nongenomic action of T3 on cytoskeleton rearrangement, which might contribute to the increase on GH mRNA translation rate and GH secretion. (C) 2009 Elsevier Ireland Ltd. All rights reserved.

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This paper describes the development and application of an RP HPLC method using a C(18) monolithic stationary phase for the separation and quantification of extra- and intracellular amino acids in a batch cultivation of the marine alga Tetraselmis gracilis. Fluorimetric detection was made after separation of the o-phthaldialdehyde 2-mercaptoethanol (OPA-2MCE) derivatives using a binary gradient elution. Separation of 19 amino acids was achieved with resolution >1.5 in about 39 min at a flow rate of 1.5 mL/min. RSD of analyses in seawater medium ranged from 0.36% for Orn (0.50 mu mol/L) to 12% for Ile (0.10 mu mol/L). The main constituents of the intracellular dissolved free amino acids (DFAAs) in the exponential growth phase were arginine (Arg), asparagine (Asn), alanine (Ala), aspartic acid (Asp), glutamic acid (Glu), serine (Ser), glycine (Gly), glutamine (Gln), and leucine (Leu). The major amino acids excreted to the media were valine (Val), Ala, Ser, and Gly. The monolithic phase facilitates the analysis by shortening the separation time and saving solvents and instrumentation costs (indeed conventional HPLC instrumentation can be used, running at lower pressures than those ones used with packed particle columns).

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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BACKGROUND The risk of Kaposi sarcoma (KS) among HIV-infected persons on antiretroviral therapy (ART) is not well defined in resource-limited settings. We studied KS incidence rates and associated risk factors in children and adults on ART in Southern Africa. METHODS We included patient data of 6 ART programs in Botswana, South Africa, Zambia, and Zimbabwe. We estimated KS incidence rates in patients on ART measuring time from 30 days after ART initiation to KS diagnosis, last follow-up visit, or death. We assessed risk factors (age, sex, calendar year, WHO stage, tuberculosis, and CD4 counts) using Cox models. FINDINGS We analyzed data from 173,245 patients (61% female, 8% children aged <16 years) who started ART between 2004 and 2010. Five hundred and sixty-four incident cases were diagnosed during 343,927 person-years (pys). The overall KS incidence rate was 164/100,000 pys [95% confidence interval (CI): 151 to 178]. The incidence rate was highest 30-90 days after ART initiation (413/100,000 pys; 95% CI: 342 to 497) and declined thereafter [86/100,000 pys (95% CI: 71 to 105), >2 years after ART initiation]. Male sex [adjusted hazard ratio (HR): 1.34; 95% CI: 1.12 to 1.61], low current CD4 counts (≥500 versus <50 cells/μL, adjusted HR: 0.36; 95% CI: 0.23 to 0.55), and age (5-9 years versus 30-39 years, adjusted HR: 0.20; 95% CI: 0.05 to 0.79) were relevant risk factors for developing KS. INTERPRETATION Despite ART, KS risk in HIV-infected persons in Southern Africa remains high. Early HIV testing and maintaining high CD4 counts is needed to further reduce KS-related morbidity and mortality.

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The main goals of this study were to identifythe alpine torrent catchments that are sensitive to climatic changes and to assess the robustness of the methods for the elaboration of flood and debris flow hazard zone maps to specific effects of climate changes. In this study, a procedure for the identification and localization of torrent catchments in which the climate scenarios will modify the hazard situation was developed. In two case studies, the impacts of a potential increase of precipitation intensities to the delimited hazard zones were studied. The identification and localization of the torrent and river catchments, where unfavourable changes in the hazard situation occur, could eliminate speculative and unnecessary measures against the impacts of climate changes like a general enlargement of hazard zones or a general over dimensioning of protection structures for the whole territory. The results showed a high spatial variability of the sensitivity of catchments to climate changes. In sensitive catchments, the sediment management in alpine torrents will meet future challenges due to a higher rate for sediment removal from retention basins. The case studies showed a remarkable increase of the areas affected by floods and debris flow when considering possible future precipitation intensities in hazard mapping. But, the calculated increase in extent of future hazard zones lay within the uncertainty of the methods used today for the delimitation of the hazard zones. Thus, the consideration of the uncertainties laying in the methods for the elaboration of hazard zone maps in the torrent and river catchments sensitive to climate changes would provide a useful instrument for the consideration of potential future climate conditions. The study demonstrated that weak points in protection structures in future will become more important in risk management activities.

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Carbon dioxide concentrations in the surface ocean are increasing owing to rising CO2 concentrations in the atmosphere. Higher CO2 levels are predicted to affect essential physiological processes of many aquatic organisms, leading to widespread impacts on marine diversity and ecosystem function, especially when combined with the effects of global warming. Yet the ability for marine species to adjust to increasing CO2 levels over many generations is an unresolved issue. Here we show that ocean conditions projected for the end of the century (approximately 1,000 µatm CO2 and a temperature rise of 1.5-3.0 °C) cause an increase in metabolic rate and decreases in length, weight, condition and survival of juvenile fish. However, these effects are absent or reversed when parents also experience high CO2 concentrations. Our results show that non-genetic parental effects can dramatically alter the response of marine organisms to increasing CO2 and demonstrate that some species have more capacity to acclimate to ocean acidification than previously thought.

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Ocean warming and acidification are serious threats to marine life. While each stressor alone has been studied in detail, their combined effects on the outcome of ecological interactions are poorly understood. We measured predation rates and predator selectivity of two closely related species of damselfish exposed to a predatory dottyback. We found temperature and CO2 interacted synergistically on overall predation rate, but antagonistically on predator selectivity. Notably, elevated CO2 or temperature alone reversed predator selectivity, but the interaction between the two stressors cancelled selectivity. Routine metabolic rates of the two prey showed strong species differences in tolerance to CO2 and not temperature, but these differences did not correlate with recorded mortality. This highlights the difficulty of linking species-level physiological tolerance to resulting ecological outcomes. This study is the first to document both synergistic and antagonistic effects of elevated CO2 and temperature on a crucial ecological process like predator-prey dynamics.

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The seismic hazard of the Iberian Peninsula is analysed using a nonparametric methodology based on statistical kernel functions; the activity rate is derived from the catalogue data, both its spatial dependence (without a seismogenic zonation) and its magnitude dependence (without using Gutenberg–Richter's relationship). The catalogue is that of the Instituto Geográfico Nacional, supplemented with other catalogues around the periphery; the quantification of events has been homogenised and spatially or temporally interrelated events have been suppressed to assume a Poisson process. The activity rate is determined by the kernel function, the bandwidth and the effective periods. The resulting rate is compared with that produced using Gutenberg–Richter statistics and a zoned approach. Three attenuation relationships have been employed, one for deep sources and two for shallower events, depending on whether their magnitude was above or below 5. The results are presented as seismic hazard maps for different spectral frequencies and for return periods of 475 and 2475 yr, which allows constructing uniform hazard spectra

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Natural Remanent Magnetization (NRM) was measured for regularly spaced samples from the 620-m-thick, lower middle Eocene to upper Maestrichtian section of DSDP Site 605. The total NRM of the Eocene chalks was too low (5-50 µA/m) to establish a reliable magnetic polarity stratigraphy. However, the results from the somewhat more clayrich Paleocene-upper Maestrichtian section are useful. A fourfold quality classification of the results of progressive demagnetization studies aided in determining the polarity of the original remanence. Two types (1 and 2a) showed a Characteristic Remanent Magnetization (ChRM) direction with reversed and normal polarity, respectively; the third type (2b) can be interpreted as having a reversed ChRM, which could not be cleaned, whereas the fourth type (3) is considered to be unreliable. The Site 605 magnetic polarity stratigraphy compares well with published sections, adding important detail to the correlation with planktonic microfossil zones and, hence, to the resolution of this portion of the time scale (C24-C32 on the Berggren et al., 1985, scale). The Cretaceous/Tertiary boundary occurs in a reversed polarity zone that has been correlated with Subchron C29r. We suspect the presence of an unconformity at the boundary between lithostratigraphic Units Va and IV a location which is also the level of Reflection Horizon A*.

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Borecore samples from the Trap Gully pit at Callide have been assessed using the R-70 self-heating test. The highest R-70 self-heating rate value was 16.22 degrees C/h, which is consistent with the subbituminous rank of the coal. R-70 decreases significantly with increasing mineral matter content, as defined by the ash content of the coal. This effect is due to the mineral matter in the coal acting as a heat sink. A trendline equation has been fitted to the borecore data from the Trap Gully pit: R-70 = 0.0029 x ash(2) - 0.4889 x ash + 20.644, where all parameters are on a dry-basis. This relationship can be used to model the self-heating hazard of the pit, both vertically and laterally. (c) 2005 Elsevier B.V All rights reserved.

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The northern half of the parish of St. Catherine in Jamaica was selected as a test area to study, by means of remote sensing, the problems of soil erosion in a tropical environment. An initial study was carried out to determine whether eroded land within this environment could be successfully interpreted and mapped from the available 1: 25,000 scale aerial photographs. When satisfied that a sufficiently high percentage of the eroded land could be interpreted on the aerial photographs the main study was initiated. This involved interpreting the air photo cover of the study area for identifying and classifying land use and eroded land, and plotting the results on overlays on topographic base maps. These overlays were then composited with data on the soils and slopes of the study area. The areas of different soil type/slope/land use combinations were then measured, as was the area of eroded land for each of these combinations. This data was then analysed in two ways. The first way involved determining which of the combinations of soil type, slope and land use were most and least eroded and, on the basis of this, to draw up recommendations concerning future land use. The second analysis was aimed at determining which of the three factors, soil type, slope and land use, was most responsible for determining the rate of erosion. Although it was possible to show that slope was not very significant in determining the rate of erosion, it was much more difficult to separate the effects of land use and soil type. The results do, however, suggest that land use is more significant than soil type in determining the rate of erosion within the study area.

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Government regulation of industrial hazards is examined in the context of the economic and technical processes of industrial development. Technical problems and costs of control are considered as factors in both the formation and impact of regulation. This thesis focuses on an historical case-study of the regulation of the hazard to painting workers from the use of lead pigments in paint. A regulatory strategy based on the prohibition of lead paints gained initial acceptance within the British state in 1911, but was subsequently rejected in favour of a strategy that allowed continued use of lead paint subject to hygiene precautions. The development of paint technology and its determinants, including concern about health hazards, are analysed, focusing on the innovation and diffusion into the paint industry of the major white pigments: white lead (PbC03 .PB(OH)2)and its substitutes. The process of regulatory development is examined, and the protracted and polarised regulatory d~bate contrasted to the prevailing 'consensual' methods of workplace regulation. The rejection of prohibition is analysed in terms of the different political and technical resources of those groups in conflict over this policy. This highlights the problems of consensus formation around such a strategy, and demonstrates certain constraints on state regulatory activity, particularly regarding industrial development. Member-states of the International Labour Organisation agreed to introduce partial prohibition of lead paint in 1921. Whether this was implemented is related to the economic importance of lead and non-lead metal and pigment industries to a nation. An analysis is made of the control of lead poisoning. The rate of control is related to the economic and technological trajectory of the regulated industry. Technical and organisational characteristics are considered as well as regulatory factors which range from voluntary compliance and informal pressures to direct legal requirements. The implications of this case-study for the analysis of the development and impacts of regulation are assessed.

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This dissertation examines the quality of hazard mitigation elements in a coastal, hazard prone state. I answer two questions. First, in a state with a strong mandate for hazard mitigation elements in comprehensive plans, does plan quality differ among county governments? Second, if such variation exists, what drives this variation? My research focuses primarily on Florida's 35 coastal counties, which are all at risk for hurricane and flood hazards, and all fall under Florida's mandate to have a comprehensive plan that includes a hazard mitigation element. Research methods included document review to rate the hazard mitigation elements of all 35 coastal county plans and subsequent analysis against demographic and hazard history factors. Following this, I conducted an electronic, nationwide survey of planning professionals and academics, informed by interviews of planning leaders in Florida counties. I found that hazard mitigation element quality varied widely among the 35 Florida coastal counties, but were close to a normal distribution. No plans were of exceptionally high quality. Overall, historical hazard effects did not correlate with hazard mitigation element quality, but some demographic variables that are associated with urban populations did. The variance in hazard mitigation element quality indicates that while state law may mandate, and even prescribe, hazard mitigation in local comprehensive plans, not all plans will result in equal, or even adequate, protection for people. Furthermore, the mixed correlations with demographic variables representing social and disaster vulnerability shows that, at least at the county level, vulnerability to hazards does not have a strong effect on hazard mitigation element quality. From a theory perspective, my research is significant because it compares assumptions about vulnerability based on hazard history and demographics to plan quality. The only vulnerability-related variables that appeared to correlate, and at that mildly so, with hazard mitigation element quality, were those typically representing more urban areas. In terms of the theory of Neo-Institutionalism and theories related to learning organizations, my research shows that planning departments appear to have set norms and rules of operating that preclude both significant public involvement and learning from prior hazard events.