RESUMO
The dynamics of infectious disease in a population critically involves both within-host pathogen replication and between host pathogen transmission. While modeling efforts have recently explored how within-host dynamics contribute to shaping population transmission, fewer have explored how ongoing circulation of an epidemic infectious disease can impact within-host immunological dynamics. We present a simple, influenza-inspired model that explores the potential for re-exposure during a single, ongoing outbreak to shape individual immune response and epidemiological potential in non-trivial ways. We show how even a simplified system can exhibit complex ongoing dynamics and sensitive thresholds in behavior. We also find epidemiological stochasticity likely plays a critical role in reinfection or in the maintenance of individual immunological protection over time.
RESUMO
The annual Eastern Canadian Gastrointestinal Cancer Consensus Conference was held in Halifax, Nova Scotia, 20-22 September 2018. Experts in radiation oncology, medical oncology, surgical oncology, and pathology who are involved in the management of patients with gastrointestinal malignancies participated in presentations and discussion sessions for the purpose of developing the recommendations presented here. This consensus statement addresses multiple topics in the management of pancreatic cancer, pancreatic neuroendocrine tumours, hepatocellular cancer, and rectal and colon cancer, including â surgical management of pancreatic adenocarcinoma,â adjuvant and metastatic systemic therapy options in pancreatic adenocarcinoma,â the role of radiotherapy in the management of pancreatic adenocarcinoma,â systemic therapy in pancreatic neuroendocrine tumours,â updates in systemic therapy for patients with advanced hepatocellular carcinoma,â optimum duration of adjuvant systemic therapy for colorectal cancer, andâ sequence of therapy in oligometastatic colorectal cancer.