Seasonality of cardiovascular risk factors: an analysis including over 230 000 participants in 15 countries

Objective: To assess the seasonality of cardiovascular risk factors (CVRF) in a large set of population-based studies.

Methods: Cross-sectional data from 24 population-based studies from 15 countries, with a total sample size of 237 979 subjects. CVRFs included Body Mass Index (BMI) and waist circumference; systolic (SBP) and diastolic (DBP) blood pressure; total, high (HDL) and low (LDL) density lipoprotein cholesterol; triglycerides and glucose levels. Within each study, all data were adjusted for age, gender and current smoking. For blood pressure, lipids and glucose levels, further adjustments on BMI and drug treatment were performed.

Results: In the Northern and Southern Hemispheres, CVRFs levels tended to be higher in winter and lower in summer months. These patterns were observed for most studies. In the Northern Hemisphere, the estimated seasonal variations were 0.26 kg/m2 for BMI, 0.6 cm for waist circumference, 2.9 mm Hg for SBP, 1.4 mm Hg for DBP, 0.02 mmol/L for triglycerides, 0.10 mmol/L for total cholesterol, 0.01 mmol/L for HDL cholesterol, 0.11 mmol/L for LDL cholesterol, and 0.07 mmol/L for glycaemia. Similar results were obtained when the analysis was restricted to studies collecting fasting blood samples. Similar seasonal variations were found for most CVRFs in the Southern Hemisphere, with the exception of waist circumference, HDL, and LDL cholesterol.

Conclusions: CVRFs show a seasonal pattern characterised by higher levels in winter, and lower levels in summer. This pattern could contribute to the seasonality of CV mortality.

The PREDICTS database: a global database of how local terrestrial biodiversity responds to human impacts

Biodiversity continues to decline in the face of increasing anthropogenic pressures such as habitat destruction, exploitation, pollution and introduction of alien species. Existing global databases of species' threat status or population time series are dominated by charismatic species. The collation of datasets with broad taxonomic and biogeographic extents, and that support computation of a range of biodiversity indicators, is necessary to enable better understanding of historical declines and to project - and avert - future declines. We describe and assess a new database of more than 1.6 million samples from 78 countries representing over 28,000 species, collated from existing spatial comparisons of local-scale biodiversity exposed to different intensities and types of anthropogenic pressures, from terrestrial sites around the world. The database contains measurements taken in 208 (of 814) ecoregions, 13 (of 14) biomes, 25 (of 35) biodiversity hotspots and 16 (of 17) megadiverse countries. The database contains more than 1% of the total number of all species described, and more than 1% of the described species within many taxonomic groups - including flowering plants, gymnosperms, birds, mammals, reptiles, amphibians, beetles, lepidopterans and hymenopterans. The dataset, which is still being added to, is therefore already considerably larger and more representative than those used by previous quantitative models of biodiversity trends and responses. The database is being assembled as part of the PREDICTS project (Projecting Responses of Ecological Diversity In Changing Terrestrial Systems - http://www.predicts.org.uk). We make site-level summary data available alongside this article. The full database will be publicly available in 2015.

Clinical trial designs for rare diseases: Studies developed and discussed by the International Rare Cancers Initiative

BACKGROUND: The past three decades have seen rapid improvements in the diagnosis and treatment of most cancers and the most important contributor has been research. Progress in rare cancers has been slower, not least because of the challenges of undertaking research.

SETTINGS: The International Rare Cancers Initiative (IRCI) is a partnership which aims to stimulate and facilitate the development of international clinical trials for patients with rare cancers. It is focused on interventional--usually randomized--clinical trials with the clear goal of improving outcomes for patients. The key challenges are organisational and methodological. A multi-disciplinary workshop to review the methods used in ICRI portfolio trials was held in Amsterdam in September 2013. Other as-yet unrealised methods were also discussed.

RESULTS: The IRCI trials are each presented to exemplify possible approaches to designing credible trials in rare cancers. Researchers may consider these for use in future trials and understand the choices made for each design.

INTERPRETATION: Trials can be designed using a wide array of possibilities. There is no 'one size fits all' solution. In order to make progress in the rare diseases, decisions to change practice will have to be based on less direct evidence from clinical trials than in more common diseases.

Late-Pleistocene palaeoclimate and glacial activity recorded from lake sediments in the Eastern Alps

Greenland ice core data show that the last glaciation in the Northern Hemisphere was characterized by relatively short and rapid warming-cooling cycles. While the Last Glacial Maximum (LGM) and the following Late Glacial are well documented in the Eastern Alps, continuous and well dated records of the time period preceding the LGM are only known from stalagmites. Although most of the sediment that filled the Alpine valleys prior to the LGM was eroded, thick successions have been locally preserved as terraces along the flanks of large longitudinal valleys. The Inn valley in Tyrol (Austria) offers the most striking examples of Pleistocene terraces in the Eastern Alps. A large number of drill cores provides the opportunity to study these sediments for the first time in great detail. Our study focuses on the river terrace of Unterangerberg near Wörgl, where LGM gravel and till were deposited on top of (glacio)lacustrine sediments. The cores comprise mostly silty material, ranging from organic-rich to organic-poor and dropstone-rich beds. A diamictic layer classified as basal till is present at the bottom of the lake sediments. Radiocarbon ages of plant macro remains from the lake sequences indicate deposition between ~40 and >50 cal. ka BP. Luminescence ages obtained from fine-grain polymineral (4-11 μm) samples suggest an age of the lake deposits between ~40 to 60 ka and are consistent with the radiocarbon dates. Sedimentological analyses indicate that sedimentation in these palaeolakes was driven by local processes, but also by climatically induced changes in nearby glacier activity. These observations strongly hint towards a significant ice advance in the Eastern Alps during the early last glacial and subsequent mild interstadial conditions, supporting a local coniferous forest vegetation.

Global surveillance of cancer survival 1995–2009: analysis of individual data for 25 676 887 patients from 279 population-based registries in 67 countries (CONCORD-2)

BACKGROUND: Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control.

METHODS: Individual tumour records were submitted by 279 population-based cancer registries in 67 countries for 25·7 million adults (age 15-99 years) and 75,000 children (age 0-14 years) diagnosed with cancer during 1995-2009 and followed up to Dec 31, 2009, or later. We looked at cancers of the stomach, colon, rectum, liver, lung, breast (women), cervix, ovary, and prostate in adults, and adult and childhood leukaemia. Standardised quality control procedures were applied; errors were corrected by the registry concerned. We estimated 5-year net survival, adjusted for background mortality in every country or region by age (single year), sex, and calendar year, and by race or ethnic origin in some countries. Estimates were age-standardised with the International Cancer Survival Standard weights.

FINDINGS: 5-year survival from colon, rectal, and breast cancers has increased steadily in most developed countries. For patients diagnosed during 2005-09, survival for colon and rectal cancer reached 60% or more in 22 countries around the world; for breast cancer, 5-year survival rose to 85% or higher in 17 countries worldwide. Liver and lung cancer remain lethal in all nations: for both cancers, 5-year survival is below 20% everywhere in Europe, in the range 15-19% in North America, and as low as 7-9% in Mongolia and Thailand. Striking rises in 5-year survival from prostate cancer have occurred in many countries: survival rose by 10-20% between 1995-99 and 2005-09 in 22 countries in South America, Asia, and Europe, but survival still varies widely around the world, from less than 60% in Bulgaria and Thailand to 95% or more in Brazil, Puerto Rico, and the USA. For cervical cancer, national estimates of 5-year survival range from less than 50% to more than 70%; regional variations are much wider, and improvements between 1995-99 and 2005-09 have generally been slight. For women diagnosed with ovarian cancer in 2005-09, 5-year survival was 40% or higher only in Ecuador, the USA, and 17 countries in Asia and Europe. 5-year survival for stomach cancer in 2005-09 was high (54-58%) in Japan and South Korea, compared with less than 40% in other countries. By contrast, 5-year survival from adult leukaemia in Japan and South Korea (18-23%) is lower than in most other countries. 5-year survival from childhood acute lymphoblastic leukaemia is less than 60% in several countries, but as high as 90% in Canada and four European countries, which suggests major deficiencies in the management of a largely curable disease.

INTERPRETATION: International comparison of survival trends reveals very wide differences that are likely to be attributable to differences in access to early diagnosis and optimum treatment. Continuous worldwide surveillance of cancer survival should become an indispensable source of information for cancer patients and researchers and a stimulus for politicians to improve health policy and health-care systems.

The Abbey Rebels of 1916: A Lost Revolution

The Abbey Theatre played a leading role in the politicisation of the revolutionary generation that won Irish freedom, but comparatively little is known about the men and women who formed the lifeblood of the institution: those whose radical politics drove them to fight in the 1916 Rising.

Drawing on a huge range of previously unpublished material, The Abbey Rebels of Easter 1916 explores the experiences, hopes and dreams of these remarkable but largely forgotten individuals: Máire Nic Shiubhlaigh, the Abbey’s first leading lady; Peadar Kearney, author of the national anthem; feminist Helena Molony, the first female political prisoner of her generation; Seán Connolly, the first rebel to die in the Rising; carpenter Barney Murphy; usherette Ellen Bushell; and Hollywood star Arthur Shields.

Invigorating and provocative, this is the story of how, in the years following the Easter Rising, the radical ideals that inspired their revolution were gradually supplanted by a conservative vision of the nation Ireland would become. Lavishly illustrated with 200 documents and images, it provides a fresh and compelling account of the Rising and its aftermath.

Deciphering tissue-induced Klebsiella pneumoniae lipid A structure

The host launches an antimicrobial defense program upon infection. A long-held belief is that pathogens prevent host recognition by remodeling their surface in response to different host microenvironments. Yet direct evidence that this happens in vivo is lacking. Here we report that the pathogen Klebsiella pneumoniae modifies one of its surface molecules, the lipopolysaccharide, in the lungs of mice to evade immune surveillance. These in vivo-induced changes are lost in bacteria grown after isolation from the tissues. These lipopolysaccharide modifications contribute to survival in vivo and mediate resistance to colistin, one of the last options to treat multidrug-resistant Klebsiella. This work opens the possibility of designing novel therapeutics targeting the enzymes responsible for the in vivo lipid A pattern.

Galactokinase promiscuity: a question of flexibility?

Galactokinase catalyses the first committed step of the Leloir pathway, i.e. the ATP-dependent phosphorylation of α-D-galactose at C1-OH. Reduced galactokinase activity results in the inherited metabolic disease type II galactosaemia. However, inhibition of galactokinase is considered a viable approach to treating more severe forms of galactosaemia (types I and III). Considerable progress has been made in the identification of high affinity, selective inhibitors. Although the structure of galactokinase from a variety of species is known, its catalytic mechanism remains uncertain. Although the bulk of evidence suggests that the reaction proceeds via an active site base mechanism, some experimental and theoretical studies contradict this. The enzyme has potential as a biocatalyst in the production of sugar 1-phosphates. This potential is limited by its high specificity. A variety of approaches have been taken to identify galactokinase variants which are more promiscuous. These have broadened galactokinase's specificity to include a wide range of D- and L-sugars. Initial studies suggest that some of these alterations result in increased flexibility at the active site. It is suggested that modulation of protein flexibility is at least as important as structural modifications in determining the success or failure of enzyme engineering.

An Association of Cancer Physicians' strategy for improving services and outcomes for cancer patients

The Association of Cancer Physicians in the United Kingdom has developed a strategy to improve outcomes for cancer patients and identified the goals and commitments of the Association and its members.

Adequar a ação pedagógica: explorando modos de organização diferenciada do trabalho educativo

Relatório Final apresentado para a obtenção do grau de Mestre em Educação Pré-escolar e Ensino do 1º ciclo do Ensino Básico. Orientadora:Mestre Helena Luís.Coorientadora:Professora Doutora Gracinda Hamido

POPULATION DYNAMICS OF PLANT PARASITIC NEMATODES AND THEIR RELATIONSHIPS WITH SOIL PHYSICO-CHEMICAL PARAMETERS DURING THE FALLOW PERIOD AFTER SUGARBEET AND LEADING INTO TOMATO CULTIVATION

The main objective of this research was the study of the soil nematode community, and in particular plant parasitic nematodes (PPN), from a field located in Portugal’s southern region, used for sugarbeet production. The study was performed from February to July 2003, covering part of the fallow period previous to tomato cultivation, the alternative crop in the rotation. The end of the fallow period in March and the soil preparation period in May were marked by a significant reduction in the numbers of PPN, whereas their numbers increased on the following tomato crop. The genus Helicotylenchus stood out as the most representative group, forming 90% of all PPN counted each month. The genus Heterodera was relatively abundant in the months following the previous sugarbeet crop, and numbers of the genus Meloidogyne increased during the tomato crop. The correlations between these group and environmental parameters show that, apart from the direct influence of the host, pH, organic matter, temperature and soil moisture significantly influenced nematode abundance and community composition.

Infecção de mycobacterium bovis em células fagocíticas: estratégia aplicada ao diagnóstico da tuberculose bovina

Neste trabalho foram estudadas as interacções entre Mycobacterium bovis e células hospedeiras, na perspectiva de aplicar os conhecimentos resultantes desse estudo ao melhoramento do diagnóstico da tuberculose bovina. Foi estudada a dinâmica da infecção de células fagocíticas com estirpes de M. bovis, com ênfase para a invasão e multiplicação intracelular das micobactérias. Avaliações efectuadas por citometria de fluxo, microscopia de fluorescência e contagem de colónias demonstraram que as micobactérias invadiram e replicaram em todos os modelos celulares, sendo que as células epiteliais de pulmão de bovino foram as mais permissivas ao seu crescimento. Foi nas células macrofágicas J774 e THP-1 que se verificaram as maiores concentrações micobacterianas, pelo que foram utilizadas para a detecção e identificação de M. bovis por um método molecular. A optimização da extracção de DNA, por um processo mecânico, e o desenvolvimento do método de PCR-RFLP baseado no gene gyrB, com controlo interno, permitiram a identificação de M. bovis. A sensibilidade deste método foi de 100% quando aplicado a estirpes isoladas e apenas de 40% quando utilizado directamente em amostras de macerados de tecidos de bovinos com tuberculose. Uma pré-incubação (3 dias) das amostras nas culturas celulares contribuiu para melhorar significativamente a sensibilidade (77%) do PCR-RFLP gyrB. A cultura celular, como matriz a ser utilizada para aumentar a quantidade de M. bovis presente em amostras biológicas, revela-se um método promissor para o diagnóstico laboratorial rápido, específico e sensível da tuberculose bovina. ### - Summary - Interactions between Mycobacterium bovis and host cells were studied with the purpose to apply the outcome knowledge in the improvement of bovine tuberculosis diagnosis. The dynamic of infection of four cell models with three strains of M. bovis was evaluated, with emphasis given to the invasion and intracellular multiplication of mycobacteria. Assessments by flow cytometry, fluorescence microscopy and colony counting showed that every cell models permitted the replication of mycobacteria, although bovine lung epithelial cells had been the most permissive one. The highest mycobacteria) load was found, however, in J774 and THP-1 macrophages, and hence these cells were used for the optimization of a molecular method for detection and identification of M. bovis. The optimisation of a DNA extraction step, by a mechanical process, and the development of PCR-RFLP based on gyrB gene, with an internal control, allowed the identification of M. bovis. The sensitivity of this method was 100% when applied to isolated strains and only 40% when directly used on samples of macerated of tissues from cattle with tuberculosis. Assays in which a pre-incubation step (three days) of biological samples in cell cultures was introduced significantly improved the sensitivity (77%) of the gyrB PCR-RFLP. Cell cultures as a support for growth and rapid isolation of M. bovis is a promising method for the specific, sensitive and rapid laboratorial diagnosis of bovine tuberculosis.

Exploring the links between urban stucture and air quality

A poluição atmosférica constitui actualmente um grave problema ambiental cujos efeitos se fazem sentir a diversas escalas, desde os efeitos imediatos e de longo termo na saúde humana e nos materiais, até fenómenos regionais, como a acificação, e fenómenos globais que durante este século poderão alterar as condições de vida no globo. Apesar da redução das emissões de poluentes atmosféricos, conseguida através do uso de combustíveis mais limpos e tecnologias mais eficientes, as áreas urbanas continuam a evidenciar sinais de degradação ambiental. Para ser bem sucedida a cidade deve enfrentar as três dimensões da sustentabilidade: social, económica e ambiental. O modo de utilização do solo numa zona urbana é uma característica fundamental da cidade, com influência directa no seu desempenho ambiental e na qualidade de vida que proporciona à população. O presente trabalho explora a ligação entre a estrutura urbana e a qualidade do ar, um dos muitos aspectos do desenvolvimento urbano sustentável. A perspectiva histórica sobre o desenvolvimento urbano, a poluição atmosférica e a sua interligação é abordada, bem como o trabalho de investigação que tem vindo a ser conduzido na área. A aplicação de um sistema de modelação atmosférico a um caso de estudo idealizado demonstra a importância da estrutura espacial da cidade na sustentabilidade urbana, mostrando que cidades compactas com usos do solo misturados promovem uma melhor qualidade do ar quando comparadas com cidades dispersas, com baixa densidade populacional. De modo a explorar a relação entre a estrutura urbana e a qualidade do ar numa zona urbana real, a região urbana do Porto é identificada como um caso de estudo adequado, e o processo de crescimento urbano nas últimas décadas é analisado, assim como os níveis de qualidade do ar da região. De modo a definir a configuração do sistema de modelação mais adequada para a região de estudo, são efectuados diversos testes de sensibilidade com o modelo meteorológico. Relativamente ao modelo de qualidade do ar, é descrito e implementado um conjunto de acções de modo a melhorar o desempenho do modelo para a simulação das concentrações de poluentes na atmosfera urbana, no contexto de alterações do uso do solo. Finalmente, são desenvolvidos e testados, através da aplicação do sistema de modelação, dois cenários alternativos de desenvolvimento urbano para a área de estudo. Estes cenários alternativos implicam diferentes emissões de poluentes e diferentes distribuições espaciais dessas emissões, e como consequência, diferentes níveis de qualidade do ar. O estudo permite concluir que alterações nos padrões de uso do solo em áreas urbanas conduzem a alterações na meteorologia, emissões e qualidade do ar. As áreas urbanas dispersas, quando comparadas com estruturas urbanas compactas são responsáveis por temperaturas mais elevadas, emissões de poluentes para a atmosfera mais elevadas e maiores concentrações de poluentes.