Glioblastoma is the most common primary brain tumour. Despite advances in treatment, its prognosis remains dismal, with a mean survival time of about 14 months. Many articles have addressed direct ...costs, those associated with the diagnosis and treatment of the disease. Indirect costs, those associated with loss of productivity due to the disease, have seldom been described.
We conducted a retrospective study in patients diagnosed with glioblastoma at Hospital Universitario Donostia between January 1, 2010 and December 31, 2013. We collected demographics, data regarding the treatment received, and survival times. We calculated the indirect costs with the human capital approach, adjusting the mean salaries of comparable individuals by sex and age and obtaining mortality data for the general population from the Spanish National Statistics Institute. Past salaries were updated to 2015 euros according to the annual inflation rate and we applied a discount of 3.5% compounded yearly to future salaries.
We reviewed the records of 99 patients: 46 women (mean age 63.53) and 53 men (mean age 59.94); 29 patients underwent a biopsy and the remaining 70 underwent excisional surgery. Mean survival was 18.092 months for the whole series. The total indirect cost for the series was €11 080 762 (2015). Mean indirect cost per patient was €111 926 (2015).
Although glioblastoma is a relatively uncommon type of tumour, accounting for only 4% of all cancers, its poor prognosis and potential sequelae generate disproportionately large morbidity and mortality rates which translate to high indirect costs. Clinicians should be aware of the societal impact of glioblastoma and indirect costs should be taken into account when cost effectiveness studies are performed to better illustrate the overall consequences of this disease.
Glioblastoma is the most common primary brain tumour. Despite advances in treatment, its prognosis remains dismal, with a mean survival time of about 14 months. Many articles have addressed direct ...costs, those associated with the diagnosis and treatment of the disease. Indirect costs, those associated with loss of productivity due to the disease, have seldom been described.
We conducted a retrospective study in patients diagnosed with glioblastoma at Hospital Universitario Donostia between January 1, 2010 and December 31, 2013. We collected demographics, data regarding the treatment received, and survival times. We calculated the indirect costs with the human capital approach, adjusting the mean salaries of comparable individuals by sex and age and obtaining mortality data for the general population from the Spanish National Statistics Institute. Past salaries were updated to 2015 euros according to the annual inflation rate and we applied a discount of 3.5% compounded yearly to future salaries.
We reviewed the records of 99 patients: 46 women (mean age 63.53) and 53 men (mean age 59.94); 29 patients underwent a biopsy and the remaining 70 underwent excisional surgery. Mean survival was 18.092 months for the whole series. The total indirect cost for the series was €11080762 (2015). Mean indirect cost per patient was €111926 (2015).
Although glioblastoma is a relatively uncommon type of tumour, accounting for only 4% of all cancers, its poor prognosis and potential sequelae generate disproportionately large morbidity and mortality rates which translate to high indirect costs. Clinicians should be aware of the societal impact of glioblastoma and indirect costs should be taken into account when cost effectiveness studies are performed to better illustrate the overall consequences of this disease.
El glioblastoma es el tumor cerebral más frecuente. A pesar de los avances en su tratamiento, el pronóstico sigue siendo pobre, con una supervivencia media en torno a los 14 meses. Los costes directos, aquellos asociados al diagnóstico y el tratamiento de la enfermedad, han sido descritos ampliamente. Los costes indirectos, aquellos derivados de la pérdida de productividad debido a la enfermedad, han sido descritos en escasas ocasiones.
Realizamos un estudio retrospectivo, incluyendo a los pacientes diagnosticados entre el 1 de enero del 2010 y el 31 de diciembre del 2013 de glioblastoma en el Hospital Universitario Donostia. Recogimos datos demográficos, relativos al tratamiento ofertado y la supervivencia. Calculamos los costes indirectos a través del método del capital humano, obteniendo datos de sujetos comparables según sexo y edad, y de mortalidad de la población general a través del Instituto Nacional de Estadística. Los salarios pasados fueron actualizados a euros de 2015 según la tasa de inflación interanual y los salarios futuros fueron descontados en un 3,5% anual en forma de interés compuesto.
Revisamos a 99 pacientes, 46 mujeres (edad media 63,53 años) y 53 hombres (edad media 59,94 años). En 29 pacientes se realizó una biopsia y en los 70 restantes se realizó una cirugía resectiva. La supervivencia global media fue de 18,092 meses. Los costes indirectos totales fueron de 11.080.762 € (2015). El coste indirecto medio por paciente fue de 111.926 € (2015).
A pesar de que el glioblastoma es un tipo relativamente poco frecuente de tumor, que supone el 4% de todos los tipos de cáncer, su mal pronóstico y sus posibles secuelas generan una mortalidad y morbilidad desproporcionadamente altas. Esto se traduce en unos costes indirectos muy elevados. El clínico debe ser consciente del impacto del glioblastoma en la sociedad y los costes indirectos deben ser tenidos en cuenta en los estudios de coste-efectividad para conocer las consecuencias globales de esta enfermedad.
Resumen Introducción El glioblastoma es el tumor cerebral más frecuente. A pesar de los avances en su tratamiento, el pronóstico sigue siendo pobre, con una supervivencia media en torno a los 14 ...meses. Los costes directos, aquellos asociados al diagnóstico y el tratamiento de la enfermedad, han sido descritos ampliamente. Los costes indirectos, aquellos derivados de la pérdida de productividad debido a la enfermedad, han sido descritos en escasas ocasiones. Material y método Realizamos un estudio retrospectivo, incluyendo a los pacientes diagnosticados entre el 1 de enero del 2010 y el 31 de diciembre del 2013 de glioblastoma en el Hospital Universitario Donostia. Recogimos datos demográficos, relativos al tratamiento ofertado y la supervivencia. Calculamos los costes indirectos a través del método del capital humano, obteniendo datos de sujetos comparables según sexo y edad, y de mortalidad de la población general a través del Instituto Nacional de Estadística. Los salarios pasados fueron actualizados a euros de 2015 según la tasa de inflación interanual y los salarios futuros fueron descontados en un 3,5% anual en forma de interés compuesto. Resultados Revisamos a 99 pacientes, 46 mujeres (edad media 63,53 años) y 53 hombres (edad media 59,94 años). En 29 pacientes se realizó una biopsia y en los 70 restantes se realizó una cirugía resectiva. La supervivencia global media fue de 18,092 meses. Los costes indirectos totales fueron de 11.080.762 € (2015). El coste indirecto medio por paciente fue de 111.926 € (2015). Discusión A pesar de que el glioblastoma es un tipo relativamente poco frecuente de tumor, que supone el 4% de todos los tipos de cáncer, su mal pronóstico y sus posibles secuelas generan una mortalidad y morbilidad desproporcionadamente altas. Esto se traduce en unos costes indirectos muy elevados. El clínico debe ser consciente del impacto del glioblastoma en la sociedad y los costes indirectos deben ser tenidos en cuenta en los estudios de coste-efectividad para conocer las consecuencias globales de esta enfermedad.
The spread to the cavernous sinus in laryngeal cancer means the presence of a disseminated disease and short survival. The aim of this paper is to report a case of laryngeal squamous carcinoma of the ...larynx. A search was conducted in the databases of Medline and SciELO DOYMA using the words "cavernous sinus metastasis". We found 10 published cases of laryngeal squamous carcinoma with metastasis to the cavernous sinus. The average survival of the 10 cases reported in the literature was 4.1 months; in our case it was 9 months. Patients who received radiotherapy improved symptomatically. In some cases the diagnosis was confirmed only after necropsy. In this type of lesions, surgery is used for diagnosis rather than as a therapeutic tool.
La afectación del seno cavernoso en el cáncer laríngeo supone la presencia de una enfermedad en estadio avanzado y de corta supervivencia. El objetivo del trabajo es presentar un caso de un paciente ...diagnosticado de carcinoma escamoso de laringe. Se realizó una revisión en las bases de datos Medline, DOYMA y Scielo con las palabras "metástasis en seno cavernoso". Encontramos publicados 10 casos de carcinoma escamoso de laringe con metástasis en seno cavernoso. La supervivencia media de los 10 casos publicados en la literatura fue 4,1 meses, en nuestro caso 9 meses. Los pacientes que recibieron radioterapia mejoraron sintomáticamente. El diagnóstico en algunos casos sólo se confirmó en la realización de una necropsia. En este tipo de lesiones, la cirugía se utiliza para diagnóstico más que como una herramienta terapéutica.
Sustainable agriculture in Mediterranean areas is compromised by the structural deficit of water resources. Under this situation, the impacts of alternative water managements on the microbial ...community, as a critical component of the soil quality, need to be properly understood. We evaluated the long-term impacts of irrigation systems differing on the quantity and quality of water, and their interactions, on the biomass (phospholipid fatty acid analysis), diversity and composition (16S rRNA gene profiling), and enzyme activities of the soil microbial community of an orchard cultivated with grapefruit trees in South-East Spain. The impact of water quantity was evaluated by irrigation with optimal amount of water or by irrigation with a reduced volume of water in the temporal frame when the crop is less sensitive, so-called regulated deficit irrigation (RDI). The impact of water quality was evaluated attending to the source of the irrigation water: water from a river channel-transfer (TW) or reclaimed water from a wastewater treatment plant (RW). Electrical conductivity was higher in soils irrigated with RW than in soils irrigated with TW. The content of total organic C in the soil was affected by water quality but not by water quantity. Soils irrigated with TW showed higher total organic C than soils irrigated with RW. As in the case of plant productivity, RDI had a negative impact on plant productivity, soil microbial biomass and enzyme activities in summer. This finding indicates a slow-down of organic matter decomposition under restricted irrigation. Bacterial biomass was more sensitive to RDI when RW was used, whereas the fungal biomass was more sensitive to RDI when TW was used.
Bacterial diversity and plant productivity were more sensitive to water quantity than to water quality. The increase of the abundance of Proteobacteria and Bacteroidetes in soils irrigated with RW in summer suggested a higher resilience of this treatment mediated by copiotrophic organisms. A recovery of the enzyme activity and microbial biomass of soils irrigated with RW and RDI was observed in January and June. The resilience of biogeochemical and the microbial biomass processes after RDI coursed through changes in the structure of the microbial community as revealed by the multivariate analyses of fatty acids. The utilisation of reclaimed water during RDI promoted a more-resilient community that translated into a recovery of microbial biomass and enzyme activities after the water restriction ended. These results imply potential ecological benefits of the irrigation with reclaimed water that should be considered under the water limitation predicted in climate change models in Mediterranean areas.
•The impacts of water-management strategies against climate change are analyzed.•Restricted irrigation reduced microbial biomass and enzyme activities.•Bacterial and fungal resistance to restricted irrigation depends on water quality.•Water quality altered community structure while restricted irrigation impacted bacterial diversity.
The performance parameters of a type of sensing device for temperature measurement are determined experimentally and theoretically using a technique of excitation of surface plasmon resonances in ...optical fibers. The developed device consists of a tapered optical fiber coated with silver nanoparticles (AgNPs) that were obtained using the green synthesis technique. For the verification of the experimental results, the transference matrix model, the Drude model and the theory of surface plasmon resonance in the Kretschmann configuration was used. During the investigation it is verified that the transmittance measured as a response signal of the optical fiber is in accordance with the theoretical results obtained from the mathematical modeling. To determine the performance parameters of the device developed for temperature measurement, the sensitivity
S
and the figure of merit
FOM
of the device were determined from the rate of change of the plasmon resonance wavelength shift as a function of the temperature gradients and transmission spectra at the output of the tapered optical fiber for different temperature values, observing a red shift of the plasmonic resonance wavelength with decreasing temperature. For the case of FOM, this was determined indirectly using
S
and Full Width at Half Maximum
FWHM
. Experimental results reveal that the developed devices exhibit sensitivities in the order of -0.18 nm/°C to -0.52 nm/°C with excellent reproducibility, while the FOM is in the order of 1.7 × 10
− 2
°C
− 1
to 2.4 × 10
− 2
°C
− 1
. Theoretical and experimental results reveal that the sensitivity of the sensor presents a dependence on the geometrical parameters of the device, the nature of the coating and the surface of the device.
This paper presents the implementation for the first time of a Multi-Particle Swarm Optimization (MPSO) algorithm in the tuning of a PID controller for Power Factor Correction (PFC), applied to a ...100W AC-DC boost converter. MPSO algorithm navigates in a search space where each dimension of the space corresponds to the controller constants (Proportional, Integral, Derivative and the Derivative Filter), prioritizing communication over exploration in the algorithm. The controller parameters are randomly initialized in a reduced sector of the space
,
,
,
, to optimize the search for a PID solution. In the first step, the algorithm is validated using a simulation model in Simulink and Matlab. Subsequently, a final implementation using a real converter is implemented with the PID tuned by MPSO, improving the PFC obtained in previous work. Although previous works have used evolutionary algorithms applied to heuristic optimization to tunning PID controllers, the MPSO algorithm is not usually used for this purpose, particularly to tunning a PID controller in a power electronics system. One advantage of MPSO over the PSO classical algorithm is the search at different points if the vectorial field looks for an optimal solution. PSO presents problems such as getting stuck in a locally optimal solution. The PID controller is trained offline, with the advantage of allowing the risk of damage in the Boost converter for transitory response, increasing the performance of the Power Factor Correction in the converter. This research opens the possibility to use the extended version of the PSO bioinspired algorithm to tune offline controllers to improve the power converter's performance, minimizing the risk presented in the real-time tuning process.
High levels of inflammatory factors including chemokines have been reported in peritoneal fluid and blood of women with endometriosis. CXCL12 mediates its action by interaction with its specific ...receptor, CXCR4, reported to be elevated in human endometriosis lesions and in the rat model of endometriosis. Activation of the CXCR4-CXCL12 axis increases cell proliferation, migration, and invasion of cancer cells. To obtain insights into the CXCR4 expression profile in lesions and endometrium, as well as functionality of the CXCR4-CXCL12 axis in endometriosis, we analyzed the expression of CXCR4 in tissues on a human tissue array and studied CXCL12- mediated activation of proliferation, invasion, and migration in vitro. We observed differences in levels of nuclear CXCR4 expression among lesion types, being higher in ovarian lesions. Endometriotic cell lines (12Z) showed higher levels of CXCR4, proliferative and migratory potential, and AKT phosphorylation/kinase activity compared to untreated control cells (endometrial epithelial cells). CXCL12 and endometriotic stromal cell-enriched media increased proliferation of non-endometriotic epithelial cells. CXCL12 caused a significant increase in 12Z cell invasion but had no effect on migration; AMD3100, a CXCR4-specific inhibitor, significantly increased invasion of 12Z cells but decreased their migration. However, treatment with CXCL12 plus AMD3100 significantly decreased invasion and migration of 12Z cells. In conclusion, the CXCR4-CXCL12 axis is functional in endometriosis cells, but the expression of CXCR4 varies among lesions. CXCL12 promoted proliferation, migration, and invasion of endometriotic cells, while inducing AKT phosphorylation and activity, but pharmacologically blocking this axis in the absence of the ligand induced their invasiveness. Summary Sentence CXCL12 treatment of endometriotic cells promoted their proliferation, migration, and invasion, while inducing AKT phosphorylation and activity, but pharmacologically blocking this axis in the absence of the ligand increased their invasion capacity.
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