Pre-diagnostic concordance with the WCRF/AICR guidelines and survival in European colorectal cancer patients: a cohort study.

BACKGROUND Cancer survivors are advised to follow lifestyle recommendations on diet, physical activity, and body fatness proposed by the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) for cancer prevention. Previous studies have demonstrated that higher concordance with these recommendations measured using an index score (the WCRF/AICR score) was associated with lower cancer incidence and mortality. The aim of this study was to evaluate the association between pre-diagnostic concordance with WCRF/AICR recommendations and mortality in colorectal cancer (CRC) patients. METHODS The association between the WCRF/AICR score (score range 0-6 in men and 0-7 in women; higher scores indicate greater concordance) assessed on average 6.4 years before diagnosis and CRC-specific (n = 872) and overall mortality (n = 1,113) was prospectively examined among 3,292 participants diagnosed with CRC in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort (mean follow-up time after diagnosis 4.2 years). Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality. RESULTS The HRs (95% CIs) for CRC-specific mortality among participants in the second (score range in men/women: 2.25-2.75/3.25-3.75), third (3-3.75/4-4.75), and fourth (4-6/5-7) categories of the score were 0.87 (0.72-1.06), 0.74 (0.61-0.90), and 0.70 (0.56-0.89), respectively (P for trend <0.0001), compared to participants with the lowest concordance with the recommendations (category 1 of the score: 0-2/0-3). Similar HRs for overall mortality were observed (P for trend 0.004). Meeting the recommendations on body fatness and plant food consumption were associated with improved survival among CRC cases in mutually adjusted models. CONCLUSIONS Greater concordance with the WCRF/AICR recommendations on diet, physical activity, and body fatness prior to CRC diagnosis is associated with improved survival among CRC patients.

Rheumatoid arthritis response to treatment across IgG1 allotype - anti-TNF incompatibility: a case-only study.

INTRODUCTION We have hypothesized that incompatibility between the G1m genotype of the patient and the G1m1 and G1m17 allotypes carried by infliximab (INX) and adalimumab (ADM) could decrease the efficacy of these anti-tumor necrosis factor (anti-TNF) antibodies in the treatment of rheumatoid arthritis (RA). METHODS The G1m genotypes were analyzed in three collections of patients with RA totaling 1037 subjects. The first, used for discovery, comprised 215 Spanish patients. The second and third were successively used for replication. They included 429 British and Greek patients and 393 Spanish and British patients, respectively. Two outcomes were considered: change in the Disease Activity Score in 28 joint (ΔDAS28) and the European League Against Rheumatism (EULAR) response criteria. RESULTS An association between less response to INX and incompatibility of the G1m1,17 allotype was found in the discovery collection at 6 months of treatment (P = 0.03). This association was confirmed in the replications (P = 0.02 and 0.08, respectively) leading to a global association (P = 0.001) that involved a mean difference in ΔDAS28 of 0.4 units between compatible and incompatible patients (2.3 ± 1.5 in compatible patients vs. 1.9 ± 1.5 in incompatible patients) and an increase in responders and decrease in non-responders according to the EULAR criteria (P = 0.03). A similar association was suggested for patients treated with ADM in the discovery collection, but it was not supported by replication. CONCLUSIONS Our results suggest that G1m1,17 allotypes are associated with response to INX and could aid improved therapeutic targeting in RA.

Una aproximación al dequeísmo desde la perspectiva diacrónica

El dequeísmo es una variación marcada del sistema gramatical del español, consistente en la anteposición y adición de la preposición de ante la conjunción subordinante que, sin que su presencia sea exigida por ningún elemento oracional. Asimismo, el dequeísmo suele aflorar con mayor frecuencia en la comunicación oral y coloquial y, por ello, acostumbra a asociarse a un registro informal e, incluso, vulgar, por lo que la prescripción normativa recomienda evitar su uso en la lengua culta. No obstante, debido a su actual expansión entre la comunidad de hablantes hispanos se considera conveniente estudiar el origen y desarrollo de las construcciones dequeístas a lo largo de la historia del español, puesto que se trata de un fenómeno todavía sin un marco teórico único y específico. Mi tesina: “Una aproximación al dequeísmo desde una perspectiva diacrónica” se enfoca siguiendo la perspectiva diacrónica y concibe el dequeísmo como un cambio sintáctico inacabado e iniciado en el transcurso del español medieval al clásico a partir de la gramaticalización de la preposición de. Por otra parte, en este estudio se ofrece una explicación de carácter histórico, cuyo propósito es hacer comprender mejor la complejidad de esta construcción sintáctica. Para ello, se parte del análisis de una serie de estructuras formadas con los predicados verbales decir, pensar, creer y temer, seguidos de la secuencia de que + Oración subordinada de sustantivo, halladas en el Corpus Diacrónico del Español (CORDE). Tras una búsqueda exhaustiva de dichas construcciones puede concluirse que no se encuentran estructuras claramente dequeístas hasta el español clásico (siglo XVI). Además, esta investigación pone de manifiesto la importancia en el estudio del dequeísmo de la construcción tematizada de la pasiva refleja con el verbo decir. Por ejemplo: «Y lo que se dice de que allí son mejor criados, y doctrinados no me convence» (CORDE: 1648, Juan Solórzano y Pereira, Política indiana, España); en donde “lo que” funciona como tema de la subordinada sustantiva, la cual presenta una función discursiva remática. Estas estructuras no son dequeístas, pero podrían explicar el origen dequeísta de las pasivas reflejas con decir. En conclusión, esta investigación se ha concebido con el firme propósito de mostrar la realidad de este cambio sintáctico que está sucediendo en el español contemporáneo, pero sin olvidar que no ha surgido por azar, sino que debe ser un fenómeno analizado desde la sintaxis histórica y desde la gramaticalización de la preposición de, con el objetivo de poder describir y caracterizar el fenómeno desde sus orígenes hasta la actualidad

L'analyse des renvois régionaux et interrégionaux en pratique médicale ambulatoire. [Analysis of regional and interregional referrals in ambulatory medical practice].

This article examines, in two Swiss cantons, the interdependence from a medical care point of view of various regions (health planning zones in one canton, political districts in the other). The volume and the destination of patient referrals prescribed by physicians in ambulatory practice are analyzed. The available data (on 1609 referrals) were gathered by the practitioners themselves, during a National Ambulatory Medical Care Survey type study in February-March 1981, in which 203 physicians participated. Several indicators are proposed (including an integration coefficient and an attraction coefficient for each zone); they show marked differences among the regions. This dynamic approach, based on the effective behavior of physicians, appears to be of major interest for health planning purposes (as compared with the frequent practice to use mainly parameters in relation with the availability of care services--the "supply"--numbers of professionals and/or health facilities).

Communication skills training in oncology: a position paper based on a consensus meeting among European experts in 2009.

BACKGROUND: Communication in cancer care has become a major topic of interest. Since there is evidence that ineffective communication affects both patients and oncology clinicians (physicians and nurses), so-called communication skills trainings (CSTs) have been developed over the last decade. While these trainings have been demonstrated to be effective, there is an important heterogeneity with regard to implementation and with regard to evidence of different aspects of CST. METHODS: In order to review and discuss the scientific literature on CST in oncology and to formulate recommendations, the Swiss Cancer League has organised a consensus meeting with European opinion leaders and experts in the field of CST, as well as oncology clinicians, representatives of oncology societies and patient organisations. On the basis of a systematic review and a meta-analysis, recommendations have been developed and agreed upon. RESULTS: Recommendations address (i) the setting, objectives and participants of CST, (ii) its content and pedagogic tools, (iii) organisational aspects, (iv) outcome and (v) future directions and research. CONCLUSION: This consensus meeting, on the basis of European expert opinions and a systematic review and meta-analysis, defines key elements for the current provision and future development and evaluation of CST in oncology.

Carte de la Grèce ancienne pour servir à l'histoire des Juifs de Mr. Prideaux / G. par L. Borde

Échelle(s) : [1:2 900 000 environ], Echelle, Stades grecs a 600 au D. [600 = 3,8 cm]

Glucose sensing by the hepatoportal sensor is GLUT2-dependent: in vivo analysis in GLUT2-null mice.

In the preceding article, we demonstrated that activation of the hepatoportal glucose sensor led to a paradoxical development of hypoglycemia that was associated with increased glucose utilization by a subset of tissues. In this study, we tested whether GLUT2 plays a role in the portal glucose-sensing system that is similar to its involvement in pancreatic beta-cells. Awake RIPGLUT1 x GLUT2-/- and control mice were infused with glucose through the portal (Po-) or the femoral (Fe-) vein for 3 h at a rate equivalent to the endogenous glucose production rate. Blood glucose and plasma insulin concentrations were continuously monitored. Glucose turnover, glycolysis, and glycogen synthesis rates were determined by the 3H-glucose infusion technique. We showed that portal glucose infusion in RIPGLUT1 x GLUT24-/- mice did not induce the hypoglycemia observed in control mice but, in contrast, led to a transient hyperglycemic state followed by a return to normoglycemia; this glycemic pattern was similar to that observed in control Fe-mice and RIPGLUT1 x GLUT2-/- Fe-mice. Plasma insulin profiles during the infusion period were similar in control and RIPGLUT1 x GLUT2-/- Po- and Fe-mice. The lack of hypoglycemia development in RIPGLUT1 x GLUT2-/- mice was not due to the absence of GLUT2 in the liver. Indeed, reexpression by transgenesis of this transporter in hepatocytes did not restore the development of hypoglycemia after initiating portal vein glucose infusion. In the absence of GLUT2, glucose turnover increased in Po-mice to the same extent as that in RIPGLUT1 x GLUT2-/- or control Fe-mice. Finally, co-infusion of somatostatin with glucose prevented development of hypoglycemia in control Po-mice, but it did not affect the glycemia or insulinemia of RIPGLUT1 x GLUT2-/- Po-mice. Together, our data demonstrate that GLUT2 is required for the function of the hepatoportal glucose sensor and that somatostatin could inhibit the glucose signal by interfering with GLUT2-expressing sensing units.

The Economic Effects of Christian Moralities

This article examines the different influences that Catholicism and Protestantism exert on economically relevant values. It argues that Catholic theology and practice facilitate personal transactions while Protestantism favors values and types of moral and legal enforcement better adapted for impersonal trade. Protestantism may thus be more conducive to economic growth through anonymous exchange while Catholicism may provide better support for personal contracting. Several components of this hypothesis are confirmed using statistical models with data from the 1998 ISSP international survey on religion. These show that Protestants are more trusting of anonymous counter parties, develop more reliable institutions for legal enforcement and are more willing to spend resources on monitoring and punishing other members of the community. Catholicism is more protective of the family and small-group relationships, and provides more tolerant and less motivating beliefs. Relatively smaller and less consistent differences appear in terms of worldly personal success and incentives.

Drama i espectacle operístic : la dialèctica entre espai i temps en el Parsifal de Herheim i el ritus com a obra d’art del futur

Parsifal és, segons la manera en què es mire, l’excepció dins el llistat de drames musicals wagnerians pel tractament sense precedents que fa de motius catòlics en un lloc i un moment com la recentment unificada Alemanya, on la construcció de la identitat nacional passava per un model social i cultural concret i, per tant, també religiós. Però una òptica diferent ens pot apropar a una ingent quantitat de paral·lelismes entre el model artístic expressat per Wagner en els seus escrits teòrics de joventut i alguns dels elements estètics i ideològics de la seua darrera obra. L’espectacle operístic en l’actualitat continua sent fruit de la societat en què es gesta i per això Stefan Herheim utilitza una visió diacrònica de la recepció d’aquesta obra wagneriana com a un dels motius principals sobre els quals construirà una dramatúrgia densa i meditada en què es durà a terme fins a les seues últimes conseqüències una revisió en clau contemporània del concepte d’obra d’art del futur.