Limited population‐based cancer registry data available in China until now has hampered efforts to inform cancer control policy. Following extensive efforts to improve the systematic cancer ...surveillance in this country, we report on the largest pooled analysis of cancer survival data in China to date. Of 21 population‐based cancer registries, data from 17 registries (n = 138,852 cancer records) were included in the final analysis. Cases were diagnosed in 2003–2005 and followed until the end of 2010. Age‐standardized relative survival was calculated using region‐specific life tables for all cancers combined and 26 individual cancers. Estimates were further stratified by sex and geographical area. The age‐standardized 5‐year relative survival for all cancers was 30.9% (95% confidence intervals: 30.6%‐31.2%). Female breast cancer had high survival (73.0%) followed by cancers of the colorectum (47.2%), stomach (27.4%), esophagus (20.9%), with lung and liver cancer having poor survival (16.1% and 10.1%), respectively. Survival for women was generally higher than for men. Survival for rural patients was about half that of their urban counterparts for all cancers combined (21.8% vs. 39.5%); the pattern was similar for individual major cancers except esophageal cancer. The poor population survival rates in China emphasize the urgent need for government policy changes and investment to improve health services. While the causes for the striking urban‐rural disparities observed are not fully understood, increasing access of health service in rural areas and providing basic health‐care to the disadvantaged populations will be essential for reducing this disparity in the future.
What's new?
Because it's difficult to create good public‐health policies without good population data, China has recently made efforts to improve its systematic recording of cancer data. This paper reports the largest pooled analysis of survival data in China, the first to include data from a wide range of geographical areas. They report the various survival rates for different cancers by age, gender, and locality. The most striking finding was that those living in rural residents had far lower survival rates than urban residents. This finding may prompt efforts to improve availability of cancer prevention and treatment in rural areas of China.
Metabolic syndrome is characterized by a constellation of comorbidities that predispose individuals to an increased risk of developing cardiovascular pathologies as well as type 2 diabetes mellitus
. ...The gut microbiota is a new key contributor involved in the onset of obesity-related disorders
. In humans, studies have provided evidence for a negative correlation between Akkermansia muciniphila abundance and overweight, obesity, untreated type 2 diabetes mellitus or hypertension
. Since the administration of A. muciniphila has never been investigated in humans, we conducted a randomized, double-blind, placebo-controlled pilot study in overweight/obese insulin-resistant volunteers; 40 were enrolled and 32 completed the trial. The primary end points were safety, tolerability and metabolic parameters (that is, insulin resistance, circulating lipids, visceral adiposity and body mass). Secondary outcomes were gut barrier function (that is, plasma lipopolysaccharides) and gut microbiota composition. In this single-center study, we demonstrated that daily oral supplementation of 10
A. muciniphila bacteria either live or pasteurized for three months was safe and well tolerated. Compared to placebo, pasteurized A. muciniphila improved insulin sensitivity (+28.62 ± 7.02%, P = 0.002), and reduced insulinemia (-34.08 ± 7.12%, P = 0.006) and plasma total cholesterol (-8.68 ± 2.38%, P = 0.02). Pasteurized A. muciniphila supplementation slightly decreased body weight (-2.27 ± 0.92 kg, P = 0.091) compared to the placebo group, and fat mass (-1.37 ± 0.82 kg, P = 0.092) and hip circumference (-2.63 ± 1.14 cm, P = 0.091) compared to baseline. After three months of supplementation, A. muciniphila reduced the levels of the relevant blood markers for liver dysfunction and inflammation while the overall gut microbiome structure was unaffected. In conclusion, this proof-of-concept study (clinical trial no. NCT02637115 ) shows that the intervention was safe and well tolerated and that supplementation with A. muciniphila improves several metabolic parameters.
Contestations over knowledge – and who controls its production – are a key focus of social movements and other actors that promote food sovereignty, agroecology and biocultural diversity. This book ...critically examines the kinds of knowledge and ways of knowing needed for food sovereignty, agroecology and biocultural diversity. ‘Food sovereignty’ is understood here as a transformative process that seeks to recreate the democratic realm and regenerate a diversity of autonomous food systems based on agroecology, biocultural diversity, equity, social justice and ecological sustainability. It is shown that alternatives to the current model of development require radically different knowledges and epistemologies from those on offer today in mainstream institutions (including universities, policy think tanks and donor organizations). To achieve food sovereignty, agroecology and biocultural diversity, there is a need to re-imagine and construct knowledge for diversity, decentralisation, dynamic adaptation and democracy. The authors critically explore the changes in organizations, research paradigms and professional practice that could help transform and co-create knowledge for a new modernity based on plural definitions of wellbeing. Particular attention is given to institutional, pedagogical and methodological innovations that can enhance cognitive justice by giving hitherto excluded citizens more power and agency in the construction of knowledge. The book thus contributes to the democratization of knowledge and power in the domain of food, environment and society.
Objective: To compare compliance with and effectiveness of adaptive servoventilation (ASV) versus continuous positive airway pressure (CPAP) in patients with the central sleep apnoea syndrome (CSA) ...with Cheyne-Stokes respiration (CSR) and with congestive heart failure in terms of the apnoea–hypopnoea index (AHI), quality of life, and left ventricular ejection fraction (LVEF) over six months. Methods: 25 patients (age 28–80 years, New York Heart Association (NYHA) class II–IV) with stable congestive heart failure and CSA-CSR were randomly assigned to either CPAP or ASV. At inclusion, both groups were comparable for NYHA class, LVEF, medical treatment, body mass index, and CSA-CSR. Results: Both ASV and CPAP decreased the AHI but, noticeably, only ASV completely corrected CSA-CSR, with AHI below 10/h. At three months, compliance was comparable between ASV and CPAP; however, at six months compliance with CPAP was significantly less than with ASV. At six months, the improvement in quality of life was higher with ASV and only ASV induced a significant increase in LVEF. Conclusion: These results suggest that patients with CSA-CSR may receive greater benefit from treatment with ASV than with CPAP.
Purpose
Determining the risk of recurrent instability following an arthroscopic Bankart repair can be challenging, as numerous risk factors have been identified that might predispose recurrent ...instability. However, an overview with quantitative analysis of all available risk factors is lacking. Therefore, the aim of this systematic review is to identify risk factors that are associated with recurrence following an arthroscopic Bankart repair.
Methods
Relevant studies were identified by searching PubMed, Embase/Ovid, Cochrane Database of Systematic Reviews/Wiley, Cochrane Central Register of Controlled Trials/Wiley, CINAHL/Ebsco, and Web of Science/Clarivate Analytics from inception up to November 12th 2020. Studies evaluating risk factors for recurrence following an arthroscopic Bankart repair with a minimal follow-up of 2 years were included.
Results
Twenty-nine studies met the inclusion criteria and comprised a total of 4582 shoulders (4578 patients). Meta-analyses were feasible for 22 risk factors and demonstrated that age ≤ 20 years (RR = 2.02;
P
< 0.00001), age ≤ 30 years (RR = 2.62;
P
= 0.005), participation in competitive sports (RR = 2.40;
P
= 0.02), Hill-Sachs lesion (RR = 1.77;
P
= 0.0005), off-track Hill-Sachs lesion (RR = 3.24;
P
= 0.002), glenoid bone loss (RR = 2.38;
P
= 0.0001), ALPSA lesion (RR = 1.90;
P
= 0.03), > 1 preoperative dislocations (RR = 2.02;
P
= 0.03), > 6 months surgical delay (RR = 2.86;
P
< 0.0001), ISIS > 3 (RR = 3.28;
P
= 0.0007) and ISIS > 6 (RR = 4.88;
P
< 0.00001) were risk factors for recurrence. Male gender, an affected dominant arm, hyperlaxity, participation in contact and/or overhead sports, glenoid fracture, SLAP lesion with/without repair, rotator cuff tear, > 5 preoperative dislocations and using ≤ 2 anchors could not be confirmed as risk factors. In addition, no difference was observed between the age groups ≤ 20 and 21–30 years.
Conclusion
Meta-analyses demonstrated that age ≤ 20 years, age ≤ 30 years, participation in competitive sports, Hill-Sachs lesion, off-track Hill-Sachs lesion, glenoid bone loss, ALPSA lesion, > 1 preoperative dislocations, > 6 months surgical delay from first-time dislocation to surgery, ISIS > 3 and ISIS > 6 were risk factors for recurrence following an arthroscopic Bankart repair. These factors can assist clinicians in giving a proper advice regarding treatment.
Level of evidence
Level IV.
The epidemic of psychosocial risks continues to increase and the COVID-19 pandemic has even worsened this threat on workers’ health. This inexorable and evidence-based rise seems to be impervious to ...the preventive strategies proposed for more than 40 years. Hypotheses are proposed to explain this serious problem that drastically impacts public health and the economy. The objectives of this paper are to present, in this broad context of societal and cultural changes, how the present shift in management paradigms may represent opportunities to reduce work-related diseases. In the first part of this paper, we will summarize the situation on three main issues and their relation with psychosocial risks: (1) evolution of the occupational safety and health field, (2) change in the nature of work, and (3) emerging models of governance. In the second part, we will describe, through a few examples (among many others), how emerging models of corporate governance may reduce and prevent stress and burnout. Work is changing fundamentally, and this impacts workers’ (and managers’) health and well-being; that is why approaches in line with these changes are necessary. The COVID-19 pandemic has produced major changes in work organization. This may offer promising opportunities to reanalyze working conditions for a better control of occupational diseases and stress with all the benefits these improvements will bring for society and for individuals.
Tracking snowmelt to jump the green wave Laforge, Michel P.; Bonar, Maegwin; Vander Wal, Eric
Ecology (Durham),
03/2021, Letnik:
102, Številka:
3
Journal Article
Recenzirano
In northern climates, spring is a time of rapid environmental change: for migrating terrestrial animals, melting snow facilitates foraging and travel, and newly emergent vegetation provides a ...valuable nutritional resource. These changes result in selection on the timing of important life-history events such as migration and parturition occurring when high-quality resources are most abundant. We examined the timing of female caribou (Rangifer tarandus, n = 94) migration and parturition in five herds across 7 yr in Newfoundland, Canada, as a function of two measures of environmental change—snowmelt and vegetation green-up. We generated resource selection functions to test whether caribou selected for areas associated with snowmelt and green-up during migration and following calving. We found that caribou migrated approximately 1 wk prior to snowmelt, with the flush of emergent vegetation occurring during the weeks following parturition. The results indicate that caribou “jump” the green wave of emergent forage and do so by tracking the receding edge of melting snow, likely reducing movement and foraging costs related to snow cover. Our research further broadens the ecological scope of resource tracking in animals. We demonstrate that resource tracking extends beyond resources directly related to foraging to those related to movement. We also show that snowmelt provides an environmental cue that may provide a buffer against changing environmental conditions.
Aims
Pulse palpation and ankle brachial index are recommended to screen for peripheral arterial occlusive disease in people with diabetes. However, vascular calcification can be associated with false ...negative tests (arteriopathy present despite normal screening tests). We therefore studied the impact of peripheral vascular calcification on the performance of these tests.
Methods
This cross‐sectional study included 200 people with diabetes at high risk of cardiovascular disease. The main exclusion factor was an estimated glomerular filtration rate < 30ml/min. Peripheral arterial occlusive disease was diagnosed by colour duplex ultrasonography and peripheral vascular calcification scored by computed tomography scan. We measured sensitivity, specificity, predictive values, accuracy and likelihood ratios of pulse palpation and ankle brachial index, and looked for the impact of calcification on false negative tests (arteriopathy present despite normal screening tests).
Results
Ankle brachial index alone had poor sensitivity and negative predictive value and high negative likelihood ratio. Pulse palpation had higher sensitivity and negative predictive value. An abnormal pulse palpation, defined by weak or missing pulses, combined with an abnormal ankle brachial index, had the highest sensitivity and negative predictive value (92.3 and 89.8%, respectively). Vascular calcification score was higher in patients with false negative tests, for both pulse palpation and ankle brachial index (P < 0.0001 for all). Ankle systolic blood pressure was higher in patients with false negative tests for pulse palpation (P = 0.004).
Conclusions
Below‐knee vascular calcification gave a high rate of false negative results for ankle brachial index. Refined pulse palpation combined with ankle brachial index remained the best strategy to screen for peripheral arteriopathy.
What's new?
We used an objective method for scoring vascular calcification (computed tomography scan) to assess the impact of peripheral vascular calcification on performance of ankle brachial index and pulse palpation.
We then assessed the performance of combining ankle brachial index with refined pulse palpation to screen for peripheral arterial occlusive disease in people with diabetes.
The high rate of false negative results in screening tests for peripheral arterial occlusive disease is associated with vascular calcification.
Screening for peripheral arterial occlusive disease is improved by associating ankle brachial index with refined pulse palpation.
Summary Background Cancer survival varies widely between countries. The CONCORD study provides survival estimates for 1·9 million adults (aged 15–99 years) diagnosed with a first, primary, invasive ...cancer of the breast (women), colon, rectum, or prostate during 1990–94 and followed up to 1999, by use of individual tumour records from 101 population-based cancer registries in 31 countries on five continents. This is, to our knowledge, the first worldwide analysis of cancer survival, with standard quality-control procedures and identical analytic methods for all datasets. Methods To compensate for wide international differences in general population (background) mortality by age, sex, country, region, calendar period, and (in the USA) ethnic origin, we estimated relative survival, the ratio of survival noted in the patients with cancer, and the survival that would have been expected had they been subject only to the background mortality rates. 2800 life tables were constructed. Survival estimates were also adjusted for differences in the age structure of populations of patients with cancer. Findings Global variation in cancer survival was very wide. 5-year relative survival for breast, colorectal, and prostate cancer was generally higher in North America, Australia, Japan, and northern, western, and southern Europe, and lower in Algeria, Brazil, and eastern Europe. CONCORD has provided the first opportunity to estimate cancer survival in 11 states in USA covered by the National Program of Cancer Registries (NPCR), and the study covers 42% of the US population, four-fold more than previously available. Cancer survival in black men and women was systematically and substantially lower than in white men and women in all 16 states and six metropolitan areas included. Relative survival for all ethnicities combined was 2–4% lower in states covered by NPCR than in areas covered by the Surveillance Epidemiology and End Results (SEER) Program. Age-standardised relative survival by use of the appropriate race-specific and state-specific life tables was up to 2% lower for breast cancer and up to 5% lower for prostate cancer than with the census-derived national life tables used by the SEER Program. These differences in population coverage and analytical method have both contributed to the survival deficit noted between Europe and the USA, from which only SEER data have been available until now. Interpretation Until now, direct comparisons of cancer survival between high-income and low-income countries have not generally been available. The information provided here might therefore be a useful stimulus for change. The findings should eventually facilitate joint assessment of international trends in incidence, survival, and mortality as indicators of cancer control. Funding Centers for Disease Control and Prevention (Atlanta, GA, USA), Department of Health (London, UK), Cancer Research UK (London, UK).
Planar laser-plasma interaction (LPI) experiments at the National Ignition Facility (NIF) have allowed access for the first time to regimes of electron density scale length (∼500 to 700 μm), ...electron temperature (∼3 to 5 keV), and laser intensity (6 to 16×10^{14} W/cm^{2}) that are relevant to direct-drive inertial confinement fusion ignition. Unlike in shorter-scale-length plasmas on OMEGA, scattered-light data on the NIF show that the near-quarter-critical LPI physics is dominated by stimulated Raman scattering (SRS) rather than by two-plasmon decay (TPD). This difference in regime is explained based on absolute SRS and TPD threshold considerations. SRS sidescatter tangential to density contours and other SRS mechanisms are observed. The fraction of laser energy converted to hot electrons is ∼0.7% to 2.9%, consistent with observed levels of SRS. The intensity threshold for hot-electron production is assessed, and the use of a Si ablator slightly increases this threshold from ∼4×10^{14} to ∼6×10^{14} W/cm^{2}. These results have significant implications for mitigation of LPI hot-electron preheat in direct-drive ignition designs.
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