Exploration of the possible effect on survival of lead-time associated with implementation of cancer patient pathways among symptomatic first-time cancer patients in Denmark

BackgroundImplementation of standardised cancer patient pathways (CPPs) has provided faster diagnosis of cancer. Cancer survival has improved during the same time period. Concern has been raised that the faster diagnosis may have introduced lead-time bias by elongating the period from diagnosis to death.AimWe aimed to analyse the possible effect of lead time on survival due to expedited cancer diagnosis after the implementation of national CPPs among incident cancer patients diagnosed through Danish primary care.Material and methodsWe used actual observed differences in diagnostic intervals to estimate the lead-time effect. We used data from sub-cohorts from the Danish Cancer in Primary Care (CaP) cohort of first-time cancer patients: before and after CPP implementation. To calculate differences in absolute survival, we estimated the survival function after advancing the date of diagnosis in the before cohort to an earlier point in time and hereby adjusting for lead time for nine cancer types and all combined by using Kaplan-Meier analysis.ResultsAdvancing the date of diagnosis implied that the absolute one-year survival increased from 68.5% to 69.4%. This accounted for 13% of the observed differences in absolute one-year survival from before to after CPPs.ConclusionThe lead time caused by shorter diagnostic intervals after implementation of Cancer Patient Pathways seems to explain less than 15% of the observed changes in the one-year survival estimates for cancer patients in Denmark.     

Impacts of natural factors and farming practices on greenhouse gas emissions in the North China Plain: A meta‐analysis

Requirements for mitigation of the continued increase in greenhouse gas (GHG ) emissions are much needed for the North China Plain (NCP ). We conducted a meta‐analysis of 76 published studies of 24 sites in the NCP to examine the effects of natural conditions and farming practices on GHG emissions in that region. We found that N₂O was the main component of the area‐scaled total GHG balance, and the CH ₄ contribution was <5%. Precipitation, temperature, soil pH , and texture had no significant impacts on annual GHG emissions, because of limited variation of these factors in the NCP . The N₂O emissions increased exponentially with mineral fertilizer N application rate, with y  =  0.2389e^0.0058x for wheat season and y  =  0.365e^0.0071x for maize season. Emission factors were estimated at 0.37% for wheat and 0.90% for maize at conventional fertilizer N application rates. The agronomic optimal N rates (241 and 185 kg N ha^?1 for wheat and maize, respectively) exhibited great potential for reducing N₂O emissions, by 0.39 (29%) and 1.71 (56%) kg N₂O‐N ha^?1 season^?1 for the wheat and maize seasons, respectively. Mixed application of organic manure with reduced mineral fertilizer N could reduce annual N₂O emissions by 16% relative to mineral N application alone while maintaining a high crop yield. Compared with conventional tillage, no‐tillage significantly reduced N₂O emissions by ~30% in the wheat season, whereas it increased those emissions by ~10% in the maize season. This may have resulted from the lower soil temperature in winter and increased soil moisture in summer under no‐tillage practice. Straw incorporation significantly increased annual N₂O emissions, by 26% relative to straw removal. Our analysis indicates that these farming practices could be further tested to mitigate GHG emission and maintain high crop yields in the NCP .     

Bioethics,Disability, and the Good Life: Remembering Christopher Newell, 1964–2008

The untimely passing of Reverend Canon Dr Christopher Newell, AM, came as a shock to many in the bioethics world. As well as an obituary, this article notes a number of important themes in his work, and provides a select bibliography. Christopher's major contribution to this field is that he was one of a handful of scholars who made disability not only an acceptable area of bioethics—indeed a vital, central, fertile area of enquiry. Crucially Christopher emphasised that where we do ethics is actually in everyday life—while we mourn his passing, his rich work and example will continue to inspire bioethical inquiry.     

福建省耕地土壤重金属含量和可浸提性研究

测定了福建省6市、县耕地土壤中的Cu、Zn、Cd、Ni、Pb、Hg、As等7种重金属元素的全量和可浸提态含量,并对测定结果进行了数理统计。结果表明,福建省耕地土壤存在着不同程度的重金属污染,但依元素不同而不同,重金属可浸提态含量占全量的10.0?52.2 Cu、Zn、Cd、Pb、Ni的可浸提态含量与全量之间的相关达极显著水平,Zn、Cd、Pb、As等4元素含量之间存在着显著正相关,而Ni则只与Zn元素有极显著正相关,Cu和Hg与其它重金属元素的相关则均不显著。     

Bridging the Gap: How Can Information Access and Exchange Between Conservation Biologists and Field Practitioners be Improved for Better Conservation Outcomes?

It is widely accepted that there is a considerable gap between the science of conservation biology and the design and execution of biodiversity conservation projects in the field and science is failing to inform the practice of conservation. There are many reasons why this implementation gap exists. A high proportion of papers published in scientific journals by conservation biologists are seldom read outside of the academic world and there are few incentives for academics to convert their science into practice. In turn, field practitioners rarely document their field experiences and experiments in a manner that can meaningfully inform conservation scientists. Issues related to access to scientific literature, scientific relevance in multidisciplinary environments, donor expectations and a lack of critical analysis at all levels of conservation theory and practice are factors that exacerbate the divide. The contexts in which conservation biologists and field practitioners operate are also often highly dissimilar, and each has differing professional responsibilities and expectations that compromise the ability to learn from each other's expertise. Building on recent debate in the literature, and using case studies to illustrate the issues that characterize the divide, this paper draws on the authors' experiences of project management as well as academic research. We identify five key issues related to information exchange: access to scientific literature, levels of scientific literacy, lack of interdisciplinarity, questions of relevance and lack of sharing of conservation-related experiences and suggest new ways of working that could assist in bridging the gap between conservation scientists and field practitioners.     

The Monstering of Tamarisk: How Scientists made a Plant into a Problem

Dispersal of biota by humans is a hallmark of civilization, but the results are often unforeseen and sometimes costly. Like kudzu vine in the American South, some examples become the stuff of regional folklore. In recent decades, “invasion biology,” conservation-motivated scientists and their allies have focused largely on the most negative outcomes and often promoted the perception that introduced species are monsters. However, cases of monstering by scientists preceded the rise of popular environmentalism. The story of tamarisk (Tamarix spp.), flowering trees and shrubs imported to New England sometime before 1818, provides an example of scientific “monstering” and shows how slaying the monster, rather than allaying its impacts, became a goal in itself. Tamarisks’ drought and salt tolerance suggested usefulness for both coastal and inland erosion control, and politicians as well as academic and agency scientists promoted planting them in the southern Great Plains and Southwest. But when erosion control efforts in Arizona, New Mexico and Texas became entangled with water shortages, economic development during the Depression and copper mining for national defense during World War Two, federal hydrologists moved quickly to recast tamarisks as water-wasting foreign monsters. Demonstrating significant water salvage was difficult and became subsidiary to focusing on ways to eradicate the plants, and a federal interagency effort devoted specifically to the latter purpose was organized and continued until it, in turn, conflicted with regional environmental concerns in the late 1960s.     

平衡施肥及雨强对紫色土养分流失的影响

利用人工降雨装置模拟3种不同强度的降雨,采用模拟径流小区,研究了四川紫色丘陵区玉米净作条件下雨强及平衡施肥对土壤养分损失量及载体的影响.结果表明:雨强是影响地表径流量、径流总量及土壤侵蚀量的最主要因素.在小雨强条件下,无地表径流及土壤侵蚀发生;随着雨强的增大,地表径流量、径流总量及土壤侵蚀量都急剧增加.磷素和钾素流失总量也随雨强的增加而增加,而雨强对氮素流失的影响不大.在3种雨强条件下,3种施肥处理的氮素流失总量表现为:高氮施肥>农户习惯施肥>平衡施肥,平衡施肥能减少氮素流失,而高氮施肥增加氮素的流失.农户习惯施肥处理的磷流失总量和钾流失总量均高于平衡施肥和高氮施肥两种施钾处理,在紫色土坡耕地增施钾肥能减少磷、钾养分的流失.     

Comparative evaluation of techniques for the manufacturing of dendritic cell-based cancer vaccines

Manufacturing procedures for cellular therapies are continuously improved with particular emphasis on product safety. We previously developed a dendritic cell (DC) cancer vaccine technology platform that uses clinical grade lipopolysaccharide (LPS) and interferon (IFN)-y for the maturation of monocyte derived DCs. DCs are frozen after 6 hrs exposure at a semi-mature stage (smDCs) retaining the capacity to secret interleukin (IL)-12 and thus support cytolytic T-cell responses, which is lost at full maturation. We compared closed systems for monocyte enrichment from leucocyte apheresis products from healthy individuals using plastic adherence, CD14 selection, or CD2/19 depletion with magnetic beads, or counter flow centrifugation (elutriation) using a clinical grade in comparison to a research grade culture medium for the following DC generation. We found that elutriation was superior compared to the other methods showing 36 ± 4% recovery, which was approximately 5-fold higher as the most frequently used adherence protocol (8 ± 1%), and a very good purity (92 ± 5%) of smDCs. Immune phenotype and IL-12 secretion (adherence: 1.4 ± 0.4; selection: 20 ± 0.6; depletion: 1 ±0.5; elutriation: 3.6 ± 1.5 ng/ml) as well as the potency of all DCs to stimulate T cells in an allogeneic mixed leucocyte reaction did not show statistically significant differences. Research grade and clinical grade DC culture media were equally potent and freezing did not impair the functions of smDCs. Finally, we assessed the functional capacity of DC cancer vaccines manufactured for three patients using this optimized procedure thereby demonstrating the feasibility of manufacturing DC cancer vaccines that secret IL-12 (9.4 ± 6.4 ng/ml). We conclude that significant steps were taken here towards clinical grade DC cancer vaccine manufacturing.     

Ethical issues in medical research in the developing world: a report on a meeting organised by Fondation Mérieux

This paper reports on a multidisciplinary meeting held to discuss ethical issues in medical research in the developing world. Many studies, including clinical trials, are conducted in developing countries with a high burden of disease. Conditions under which this research is conducted vary because of differences in culture, public health, political, legal and social contexts specific to these countries. Research practices, including standards of care for participants, may vary as a result. It is therefore not surprising that ethical issues emerge. This meeting sought to identify and discuss these issues from the perspectives of the many actors in such research, including community representatives, with a view to finding ethical and pragmatic solutions to these issues. Dialogue between these actors was also promoted, with a view to identifying the need to develop such dialogue in future.
Drawing from the experiences of the speakers, the colloquium attempted to outline some answers to several key questions characterising the field today. Experiences related to epidemiologic research, vaccine trials, drug trials, diagnostic tests and to some fundamental ethical issues in health research. Speakers were from different countries, disciplines and professions. The meeting provided a forum for consultation and debate between different ethics actors. Both encouraging findings and challenges emerged.     

Practice on castration of piglets in Europe

PIGCAS (Attitudes, practices and state of the art regarding piglet castration in Europe) is to our knowledge the first project that has focused on castration practice across European countries (European Union minus Bulgaria, Malta and Romania, plus Norway and Switzerland). About 250 million pigs are slaughtered in Europe each year. Of the 125 million male pigs, approximately 20% are left entire, less than 3% are castrated with anaesthesia and the rest is castrated without anaesthesia. The study identified large variations in castration procedures, both within and between countries. In females, castration is very rare, but is practiced without anaesthesia in special breeds/production systems in some of the southern countries.