Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000-2014 (CONCORD-3)

BACKGROUND

Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology.

METHODS

We analyzed individual data for adults (15-99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000-2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator.

RESULTS

The study included 556,237 adults. In 2010-2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%-38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000-2004 and 2005-2009. These improvements were more noticeable among adults diagnosed aged 40-70 years than among younger adults.

CONCLUSIONS

To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines.

The impact of minor trauma on pregnancy

Purpose

To determine the impact of a single episode of minor trauma during pregnancy on maternal and fetal outcomes.

Methods

This is a retrospective cohort study of pregnant women who experienced minor trauma at ≥24 weeks gestation between 2004 and 2014. The subjects who experienced minor trauma (minor trauma group) were matched by gestational age at the time of minor trauma, body mass index, and age to a cohort of women who did not experience trauma in pregnancy (control group). The primary obstetrical outcome was preterm delivery and the primary neonatal outcomes were APGAR scores and neonatal intensive care unit admission.

Results

There were no significant differences between the two groups with respect to demographics or other risk factors for preterm delivery. Average gestational age at the time of delivery was 39 weeks regardless of whether a woman experienced minor trauma. Preterm delivery occurred more often in the control group (11.8% versus 7.9%, p = 0.0428) as did the rate of neonatal intensive care unit admissions (8.6% versus 5%, p = 0.0273). A subgroup analysis was performed excluding patients with a medically indicated delivery and there was no difference in the rate of preterm delivery (6.4% in the control group, 4% in the minor trauma group, p-value 0.9052). Among women with a spontaneous preterm delivery, the rates of preterm labor (3.0% control versus 2.0% minor trauma, p-value 0.75) and preterm premature rupture of membranes were found to be similar between the two groups (3.8% control versus 2.0% minor trauma PPROM, p-value 0.75).

Conclusions

One episode of minor trauma in pregnancy does not increase the risk for preterm delivery, premature rupture of membranes, or poor neonatal outcomes.

Domain I of the 5' non-translated genomic region in coxsackievirus B3 RNA is not required for productive replication

Domain I is a cloverleaf-like secondary structure at the 5' termini of all enterovirus genomes, comprising part of a cis-acting replication element essential for efficient enteroviral replication. 5' genomic terminal deletions up to as much as 55% of domain I can occur without lethality following coxsackie B virus infections. We report here that the entire CVB structural domain I can be deleted without lethality.

Wing geometric morphometrics and molecular assessment of members in the Albitarsis Complex from Colombia

Malaria parasites are transmitted to humans by female mosquitoes of the genus Anopheles. The Albitarsis Complex harbours at least eight species not readily differentiable by morphology. This complicates the determination of those species involved in malaria transmission and the implementation of targeted and effective vector control strategies. In Colombia, there is little information about the identity and distribution of the Albitarsis Complex members. In this work, COI DNA barcoding was used to assign specimens Anopheles albitarsis s.l. to any of the previously designated species of the Albitarsis Complex. Two molecular operational taxonomic units (MOTUs), differentially distributed in Colombia, were detected, A. albitarsis I in the NW and NE, and A. albitarsis F, E and NE Colombia. In contrast, nuclear white gene and ITS2 sequence analyses did not allow differentiating between the MOTUs. Wing landmark-based geometric morphometrics applied to explore intertaxa phenotypic heterogeneity showed a subtle but significant difference in size, while shape did not allow the separation of the MOTUs. In general, the multiple marker analysis was not supportive of the existence in Colombia of more than one species of the Albitarsis Complex.

Educating the community about violence through a gun turn-in program

The Ceasefire Oregon gun turn in program was initiated to educate the community regarding violence through a gun turn-in program with voluntary surrender of firearms, educational efforts about violence, and institution of public safety policies. The community board of directors was composed of multiple community leadership organizations. A multi-intervention education, outreach and media program consisting of distribution of brochures, presentations, school education programs, and workshops was implemented throughout the year in addition to the gun turn-in program held in May for two days. A survey was administered to participants in the program at the turn-in sites. The cumulative total for guns turned in years 1994 to 1999 was 4,345. Half of the respondents reported possession of a gun at home. The most common reasons for participating in the gun turn in were obtaining gift certificates and not wanting the gun any more. A successful community grassroots program, Ceasefire Oregon has shown sustainability over six years with increased participation secondary to education, advertising and incentives. Community and statewide efforts can assist with building the infrastructure for programs, however more tools for quantitative performance program evaluation would facilitate measuring the impact on the community.

Purification and characterization of an adhesin from Pasteurella haemolytica

We purified an adhesin from Pasteurella. haemolytica by affinity chromatography using glutaraldehyde treated rabbit erythrocytes stroma. The adhesin is a protein of 68 kDa, as determined by SDS-PAGE, and the most abundant amino acids constituting this protein were Gly, Ser, Glx, and Ala, and low concentrations of Cys, Met, and Tyr residues were also found. The N-terminal sequence of the adhesin is ANEVNVYIYKQPYLI. No carbohydrate residues were detected. The adhesin agglutinated rabbit erythrocytes but when the latter were desialylated or pronase treated the agglutinating activity was abolished. The agglutinating activity of the adhesin was inhibited with N-acetyl-D-glucosamine (GlcNAc), and in a lesser degree with N-acetyl-neuraminic acid (NeuAc). GalNAc, N-glycolyl-neuraminic acid, N-deacetylated GlcNAc, or neutral sugars do not modify the activity of the adhesin. The equatorial -OH on C4 and the NH-acetylated group on C2 from GlcNAc, as well as the 4-OH and NH-acetylated group on C5 from NeuAc seem to be responsible for the interaction with the adhesin. The protein is divalent cation-dependent and thermolabile. As for the agglutinating activity, the adhesion of P.haemolytica to tracheal cell-cultures was inhibited by GlcNAc, NeuAc or the purified adhesin, strongly suggesting that the P.haemolytica adhesin plays an important role in infection.

Epidemiological and clinical correlates of familial and sporadic schizophrenia

We studied 68 schizophrenic cases with a schizophrenic first-degree relative (familial group) and 62 cases without such a family history (sporadic group). We compared them on: (i) clinical variables, including premorbid adjustment, age of onset and severity of symptoms; (ii) neural abnormalities, including abnormal involuntary movements, neural "soft" and "hard signs"; (iii) neuropsychological tests, including the Wechsler Adult Intelligence Scale and the Continuous Performance Test and (iv) environmental risk factors, including winter birth and obstetrical complications. Sporadic cases were more likely to be born in winter and had more severe psychotic symptoms, but most analyses yielded no difference between the groups. Our results offer some support that sporadic schizophrenia is a more environmental subtype, but they also suggest that the familial vs sporadic distinction of schizophrenia has limited power to identify distinct subgroups.

[Evaluation of phagocytosis, bactericidal effect, and cytotoxicity of Pasteurella haemolytica and Pasteurella multocida in bovine alveolar macrophages]

Evaluation of phagocytosis and bactericidal effect of Pasteurella haemolytica and P. multocida was conducted on bovine alveolar macrophages freshly obtained through bronchioalveolar washings from live animals. Cytotoxic activity of these bacteria on the alveolar macrophages was evaluated through the simple visual assay in microplates, using bovine blood leukocytes as a comparative target cell. In order to evaluate phagocytosis the following variables were considered P. haemolytica and P. multocida (independently) in contact with alveolar macrophages, P. haemolytica and P. multocida in suspension as a positive control of bacterial growth, and RPMI-1640 medium alone, as a negative control of bacterial growth. To measure bactericidal capacity, bacteria were incubated with plastic adhered alveolar macrophages at 30 minutes and 3 hours intervals. Samples incubated 30 minutes were taken as phagocytosis-base readings and at the 3 h interval to evaluate bactericidal capacity of the alveolar macrophages on phagocytized bacteria. Reading of the samples of each evaluation was conducted in a spectrophotometer a 380 nm. Phagocytosis results indicated that bacterial proliferation was higher when bacteria were alone as compared when they were with alveolar macrophages (p < 0.05). Bactericidal capacity of the macrophages was efficient because bacterial numbers were higher in the first evaluation as compared to the second (p < 0.05). It was demonstrated that the cytotoxic effect of P. haemolytica was more severe on blood leukocytes as compared to alveolar macrophages (p < 0.05). There was no evidence of P. multocida cytotoxicity on the evaluated cells. With the development of this technique for the obtention of alveolar macrophages and using spectrophotometry for the phagocytosis and bactericidal effect evaluations, numerous variables and samples can be tested, such as opsonized bacteria or to measure the behaviour of alveolar macrophages infected with different agents involved in the bovine pneumonic complex.

Automated analysis of antiepileptic drugs in serum by column-switching high-performance liquid chromatography

An automated high-performance liquid chromatographic column-switching system is presented for the analysis of antiepileptic drugs in serum. Initial results show that a reversed-phase extraction column works best overall when fitted with screens versus frits, and when packed with porous 30-micron particles as opposed to a pellicular packing of similar size or with smaller porous particles. The continuous analysis of primidone for over 2000 serum samples is achieved at a rate of twelve samples per hour with a single analytical column. An analogous boxcar high-performance liquid chromatographic system is also assembled and used to analyze two of four injected antiepileptic drugs at a rate of 40 samples per hour. For 1000 of these analyses, the coefficient of variation is 1% without an internal standard.