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.

E-Health individual adoption - empirical model based on UTAUT 2.

The future of health care delivery is becoming more citizen-centred, as today’s user is more active, better informed and more demanding. The European Commission is promoting online health services and, therefore, member states will need to boost deployment and use of online services. This makes e-health adoption an important field to be studied and understood. This study applied the extended unified theory of acceptance and usage technology (UTAUT2) to explain patients’ individual adoption of e-health. An online questionnaire was administrated Portugal using mostly the same instrument used in UTAUT2 adapted to e-health context. We collected 386 valid answers. Performance expectancy, effort expectancy, social influence, and habit had the most significant explanatory power over behavioural intention and habit and behavioural intention over technology use. The model explained 52% of the variance in behavioural intention and 32% of the variance in technology use. Our research helps to understand the desired technology characteristics of ehealth. By testing an information technology acceptance model, we are able to determine what is more valued by patients when it comes to deciding whether to adopt e-health systems or not.

Global surveillance of cancer survival 1995-2009 : analysis of individual data for 25200;676200;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 75200;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. FUNDING: Canadian Partnership Against Cancer (Toronto, Canada), Cancer Focus Northern Ireland (Belfast, UK), Cancer Institute New South Wales (Sydney, Australia), Cancer Research UK (London, UK), Centers for Disease Control and Prevention (Atlanta, GA, USA), Swiss Re (London, UK), Swiss Cancer Research foundation (Bern, Switzerland), Swiss Cancer League (Bern, Switzerland), and University of Kentucky (Lexington, KY, USA).

1.° Richardi, Anglici, tractatus de anatomia. — 2.° Ejusdem summa de diebus criticis. — 3.° Ejusdem practica. — 4.° Rogerii, Cancellarii Studii Montispessulani, summa, sive, Rogerina major, minor et media. — 5.° Summa secundùm Trotulam. — 6.° Cleopatrae ad Deodatam liber de morbis mulierum. — 7.° Gilberti, Cancellarii Studii Montispessulani, experimenta. — 8.° Anonymus de mulierum aegritudinibus. — 9.° Anonymi antidotarium. — 10.° Anonymus de ponderibus et mensuris. — 11.° Synonyma medica. — 12.° Galeni antibalomena. — 13.° Nicolai antidotarium.

DD. de Bethune

Salud familiar y su relación con la salud individual en diabetes tipo 2.

Tesis (Doctor en Ciencias de Enfermería) UANL, 2014.

Case study part 2: probabilistic modelling of long-term effects of pesticides on individual breeding success in birds and mammals

Abstract: Long-term exposure of skylarks to a fictitious insecticide and of wood mice to a fictitious fungicide were modelled probabilistically in a Monte Carlo simulation. Within the same simulation the consequences of exposure to pesticides on reproductive success were modelled using the toxicity-exposure-linking rules developed by R.S. Bennet et al. (2005) and the interspecies extrapolation factors suggested by R. Luttik et al.(2005). We built models to reflect a range of scenarios and as a result were able to show how exposure to pesticide might alter the number of individuals engaged in any given phase of the breeding cycle at any given time and predict the numbers of new adults at the season’s end.

Dynamic portrait of the planetary 2/1 mean-motion resonance - I. Systems with a more massive outer planet

We analyse the global structure of the phase space of the planar planetary 2/1 mean-motion resonance in cases where the outer planet is more massive than its inner companion. Inside the resonant domain, we show the existence of two families of periodic orbits, one associated to the librational motion of resonant angle (sigma-family) and the other related to the circulatory motion of the difference in longitudes of pericentre (Delta pi-family). The well-known apsidal corotation resonances (ACR) appear as intersections between both families. A complex web of secondary resonances is also detected for low eccentricities, whose strengths and positions are dependent on the individual masses and spatial scale of the system. The construction of dynamical maps for various values of the total angular momentum shows the evolution of the families of stable motion with the eccentricities, identifying possible configurations suitable for exoplanetary systems. For low-moderate eccentricities, several different stable modes exist outside the ACR. For larger eccentricities, however, all stable solutions are associated to oscillations around the stationary solutions. Finally, we present a possible link between these stable families and the process of resonance capture, identifying the most probable routes from the secular region to the resonant domain, and discussing how the final resonant configuration may be affected by the extension of the chaotic layer around the resonance region.

Estudos sobre estrutura, ciclo de vida e comportamento de Sardinella brasiliensis (Steindachner, 1879), na área entre 22ºS e 28ºS, Brasil: 2. determinação da idade individual e crescimento dos otólitos

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Dynamics of two planets in the 3/2 mean-motion resonance: Application to the planetary system of the pulsar PSR B1257+12

This paper considers the dynamics of two planets, as the planets B and C of the pulsar PSR B1257+12, near a 3/2 mean-motion resonance. A two-degrees-of-freedom model, in the framework of the general three-body planar problem, is used and the solutions are analyzed through surfaces of section and Fourier techniques in the full phase space of the system.

Collisions with the Earth: the Moon's contribution

In the present work is analyzed the contribution of the Moon on the collisional process of the Earth with asteroids (NEOs). The dynamical system adopted is the restricted four-body problem Sun-Earth-Moon-particle. Using a simple analytical approach one can verify that, the orbit of an object can be significantly affected by the Moon's gravitational field when their relative velocity is smaller than 5 km/s. Therefore, the present work is based on hypothetical asteroids whose velocities relative to Moon are of the order of 1 km/s. In fact, there are several real objects (NEOs) with such velocities at the point they cross the Earth's orbit. The net results obtained indicate that the Moon helps to avoid collisions (2.6%) more than it contributes to extra collisions (0.6%). (C) 2003 COSPAR. Published by Elsevier Ltd. All rights reserved.

Mobilidade asteroidal induzida por encontros próximos com vários asteroides massivos

Pós-graduação em Física - FEG

Isoflurane and propofol contribute to increasing the antioxidant status of patients during minor elective surgery: a randomized clinical study

Isoflurane is a volatile halogenated anesthetic used especially for anesthesia maintenance whereas propofol is a venous anesthetic utilized for anesthesia induction and maintenance, and reportedly an antioxidant. However, there are still controversies related to isoflurane-induced oxidative stress and it remains unanswered whether the antioxidant effects occur in patients under propofol anesthesia.Taking into account the importance of better understanding the role of anesthetics on oxidative stress in anesthetized patients, the present study was designed to evaluate general anesthesia maintained with isoflurane or propofol on antioxidant status in patients who underwent minimally invasive surgeries.We conducted a prospective randomized trial in 30 adult patients without comorbidities who underwent elective minor surgery (septoplasty) lasting at least 2 h admitted to a Brazilian tertiary hospital.The patients were randomly allocated into 2 groups, according to anesthesia maintenance (isoflurane, n = 15 or propofol, n = 15). Peripheral blood samples were drawn before anesthesia (baseline) and 2-h after anesthesia induction.The primary outcomes were to investigate the effect of either isoflurane or propofol anesthesia on aqueous plasma oxidizability and total antioxidant performance (TAP) by fluorometry as well as several individual antioxidants by high-performance liquid chromatography. As secondary outcome, oxidized genetic damage (7,8-dihydro-8-oxoguanine, known as 8-oxo-Gua) was investigated by the comet assay.Both anesthesia techniques (isoflurane or propofol) for a 2-h period resulted in a significant decrease of plasma α-tocopherol, but not other antioxidants including uric acid, carotenoids, and retinol (P > 0.05). Propofol, in contrast to isoflurane anesthesia, significantly increased (P < 0.001) anti-inflammatory/antioxidant plasma γ-tocopherol concentration in patients. Both anesthesia types significantly enhanced hydrophilic antioxidant capacity and TAP, with no significant difference between them, and 8-oxo-Gua remained unchanged during anesthesia in both groups. In addition, both anesthetics showed antioxidant capacity in vitro.This study shows that anesthesia maintained with either propofol or isoflurane increase both hydrophilic and total antioxidant capacity in plasma, but only propofol anesthesia increases plasma γ-tocopherol concentration. Additionally, both types of anesthetics do not lead to oxidative DNA damage in patients without comorbidities undergoing minimally invasive surgery.

The Gemini NICI planet-finding campaign: the frequency of giant planets around young B and A stars

We have carried out high contrast imaging of 70 young, nearby B and A stars to search for brown dwarf and planetary companions as part of the Gemini NICI Planet-Finding Campaign. Our survey represents the largest, deepest survey for planets around high-mass stars (≈1.5-2.5 M ☉) conducted to date and includes the planet hosts β Pic and Fomalhaut. We obtained follow-up astrometry of all candidate companions within 400 AU projected separation for stars in uncrowded fields and identified new low-mass companions to HD 1160 and HIP 79797. We have found that the previously known young brown dwarf companion to HIP 79797 is itself a tight (3 AU) binary, composed of brown dwarfs with masses 58$^{+21}_{-20}$ M Jup and 55$^{+20}_{-19}$ M Jup, making this system one of the rare substellar binaries in orbit around a star. Considering the contrast limits of our NICI data and the fact that we did not detect any planets, we use high-fidelity Monte Carlo simulations to show that fewer than 20% of 2 M ☉ stars can have giant planets greater than 4 M Jup between 59 and 460 AU at 95% confidence, and fewer than 10% of these stars can have a planet more massive than 10 M Jup between 38 and 650 AU. Overall, we find that large-separation giant planets are not common around B and A stars: fewer than 10% of B and A stars can have an analog to the HR 8799 b (7 M Jup, 68 AU) planet at 95% confidence. We also describe a new Bayesian technique for determining the ages of field B and A stars from photometry and theoretical isochrones. Our method produces more plausible ages for high-mass stars than previous age-dating techniques, which tend to underestimate stellar ages and their uncertainties.