Crosstalk and error analysis of fat layer on continuous wave near-infrared spectroscopy measurements.

Accurate estimation of concentration changes in muscles by continuous wave near-IR spectroscopy for muscle measurements suffers from underestimation and crosstalk problems due to the presence of superficial skin and fat layers. Underestimation error is basically caused by a homogeneous medium assumption in the calculations leading to the partial volume effect. The homogeneous medium assumption and wavelength dependence of mean partial path length in the muscle layer cause the crosstalk. We investigate underestimation errors and crosstalk by Monte Carlo simulations with a three layered (skin-fat-muscle) tissue model for a two-wavelength system where the choice of first wavelength is in the 675- to 775-nm range and the second wavelength is in the 825- to 900-nm range. Means of absolute underestimation errors and crosstalk over the considered wavelength pairs are found to be higher for greater fat thicknesses. Estimation errors of concentration changes for Hb and HbO(2) are calculated to be close for an ischemia type protocol where both Hb and HbO(2) are assumed to have equal magnitude but opposite concentration changes. The minimum estimation errors are found for the 700825- and 725825-nm pairs for this protocol.

First Scandinavian Protocol for Controlled Donation After Circulatory Death Using Normothermic Regional Perfusion.

BACKGROUND: Donation after circulatory death (DCD) can increase the pool of available organs for transplantation. This pilot study evaluates the implementation of a controlled DCD (cDCD) protocol using normothermic regional perfusion in Norway. METHODS: Patients aged 16 to 60 years that are in coma with documented devastating brain injury in need of mechanical ventilation, who would most likely attain cardiac arrest within 60 minutes after extubation, were eligible. With the acceptance from the next of kin and their wish for organ donation, life support was withdrawn and cardiac arrest observed. After a 5-minute no-touch period, extracorporeal membrane oxygenation for post mortem regional normothermic regional perfusion was established. Cerebral and cardiac reperfusion was prevented by an aortic occlusion catheter. Measured glomerular filtration rates 1 year postengraftment were compared between cDCD grafts and age-matched grafts donated after brain death (DBD). RESULTS: Eight cDCD were performed from 2014 to 2015. Circulation ceased median 12 (range, 6-24) minutes after withdrawal of life-sustaining treatment. Fourteen kidneys and 2 livers were retrieved and subsequently transplanted. Functional warm ischemic time was 26 (20-51) minutes. Regional perfusion was applied for 97 minutes (54-106 minutes). Measured glomerular filtration rate 1 year postengraftment was not significantly different between cDCD and donation after brain death organs, 75 (65-76) vs 60 (37-112) mL/min per 1.73 m2 (P = 0.23). No complications have been observed in the 2 cDCD livers. CONCLUSION: A protocol for cDCD is successfully established in Norway. Excellent transplant outcomes have encouraged us to continue this work addressing the shortage of organs for transplantation.

[The incidence of malignant tumors and mortality caused by them in Commonwealth of Independent States in 2005].

The world's incidence of cancer is 10.9 million new cases each year. In developed countries cancer in the second cause of death after cardiovascular diseases. In Russia, the number of patients with a newly established diagnosis of a malignant tumor increased by 4.6% in 2000-2005 reaching 469.2 thousands. Standardized indices of cancer incidence in Commonwealth of Independent States (CIS) were the highest in Belarus (312.5 per tens of thousand in men and 217.6 per tens of thousand in women), Russia (270.8 per tens of thousand and 196.8 per tens of thousand), and Kazakhstan (234.0 per tens of thousand and 171.4 per tens of thousand), lower in Armenia (201.3 per tens of thousand and 143.2 per tens of thousand) and Moldova (185 per tens of thousand and 162.2 per tens of thousand), and minimal in Azerbaydzhan (85.6 per tens of thousand and 73.5 per tens of thousand) and Kyrgyzstan (104.8 per tens of thousand and 115.3 per tens of thousand). The number of deaths caused by cancer is 6.7 million per year. In CIS, cancer-related mortality fell in Belarus (by 6.7% and 4.7% among men and women, respectively) and Kazakhstan (by 9.3% and 7.7%), while in Armenia it grew significantly (by 37.5% and 24.7%). In Russia, cancer-related mortality in 2000-2005 decreased by 2.6% in men and 0.8% in women. In Russia, Kazakhstan, and Armenia, the incidence of cancer of prostate grew more intensively than that of other localizations. Mortality caused by colon cancer grew in Russia and Armenia (both genders) and Belarus (women); skin cancer mortality grew in Belarus and Kazakhstan (men); breast cancer mortality grew in Armenia.

Cancer mortality in Russia and Ukraine: validity, competing risks and cohort effects.

BACKGROUND: The dramatic increase in mortality in Russia and Ukraine in the late 1980s and 1990s has been due to increases in certain causes of death, particularly cardiovascular disease and accidents and violence. In contrast, there has been a slight fall in mortality from cancer. METHODS: This paper presents an analysis of trends and patterns in cancer mortality and examines four possible explanations for its recent fall: changes in data collection; cohort effects; competing mortality from other causes of death; and improvements in health care. RESULTS: All contribute to some extent to the observed changes, with each affecting predominantly different age groups. There is evidence of a significant underrecording of cancer deaths among the elderly especially in rural areas and of significant changes in coding practices in the early 1990s. Competing mortality from cardiovascular diseases and accidents can explain some reduction in male deaths from cancer in middle age. Birth cohort effects can explain some reduction among males after early middle age and among females at all ages. The impact of changes in health care are more difficult to identify with certainty but there is evidence of reduced deaths from childhood leukaemia. IMPLICATIONS: Recent changes in mortality in Russia are complex and their understanding will require a multidisciplinary approach embracing demography, epidemiology and health services research.

Dioxin exposure and public health in Chapaevsk, Russia.

One of the largest environmental polluters in Chapaevsk (Samara Region, Russia) is the Middle Volga chemical plant. From 1967 to 1987, it produced hexachlorocyclohexane (lindane) and its derivatives. Currently, it produces crop protection chemicals (liquid chlorine acids, methyl chloroform, vinyl chloride, and some other chemicals). Dioxins were detected in air (0.116 pg/m3), in soil (8.9-298 ng/kg), in the town's drinking water (28.4-74.1 pg/liter), and in the cow's milk (the content of 2,3,7,8-TCDD was 17.32 pg TEQ/g fat). The mean content of dioxins in seven pooled samples of human milk (40 individual trials) was 42.26 pg TEQ/g fat, in four female workers' blood samples -412.4 pg TEQ/g fat, in six residents blood samples (those who lived 1-3 km from the chemical plant) -75.2 pg TEQ/g fat, in four residents' blood samples (5-8 km from the plant) -24.5 pg TEQ/g fat. To assess cancer risk and reproductive health status, official medical statistical information was used. In general, the male cancer mortality observed rate in Chapaevsk is higher than expected. The SMR is higher for lung cancer 3.1(C.I. 2.6-3.8), urinary organs 2.6(C.I. 1.7-3.6). Chapaevsk women have a higher risk overall due to breast cancer 2.1(C.I. 1.6-2.7) and cervix cancer 1.8(C.I. 1.0-3.1). The incidence rates were higher for lung cancer in males and for female breast cancer in all age groups compared to Russia and Samara Region in 1998. Significant disruptions in reproductive function were detected. The mean frequency of spontaneous abortions in the last seven years was statistically higher 24.4% in Chapaevsk (compared to other of the towns region). The average rate of premature labor was 45.7 per 1000 women in Chapaevsk that is significantly higher than in most Samara Region towns. The frequency of newborns with low birth weight was 7.4%. In Russia and in most of the Samara Region towns, this rate is lower (6.2-5.1%) but not statistically different. For the determination of congenital morphogenetic conditions (CMGC), 369 children born between 1990 and 1995 were examined. The average number of CMGC per child was significantly higher, 4.5 for boys and 4.4 for girls. The first results indicated serious disruptions associated with high dioxin levels in human milk and blood in Chapaevsk. We suggest that Chapaevsk is an incredibly interesting site for further environmental-epidemiological research to assess the impact of dioxins on human health.

[Indicators of the state and effectiveness of cancer control in Russia]. / Pokazateli sostoianiia i éffektivnosti protivorakovoi bor'by v Rossii.

The paper analyses mortality rates due to malignant neoplasms and resultant socioeconomic losses, the risk of having and dying of these diseases throughout the coming life, the average longevity among cancer patients. These summarized indicators are considered by the authors as criteria for planning, managing, and implementing anticancer measures in the community.

[Statistics of lung, stomach and esophageal cancer: status of oncological care, morbidity and mortality]. / Statistika raka legkogo, zheludka i pishevoda: sostoianie onkologicheskoé pomoshchi, zabolevaemost' i smertnost'.

Lung cancer is the most common pattern of malignant neoplasms in males, gastric cancer ranks next. In the female pattern of cancer morbidity, gastric cancer is third in the incidence of tumors, pulmonary cancer occupies the 9th place. Esophageal cancer accounts for 3%. In the mortality pattern, lung cancer holds the lead in males and ranks 4th in females, gastric cancer is second in both sexes, esophageal cancer occupies the 7th place in males. In 1999 the standardized incidence rates of cancer of the lung were 64.8 and 6.8 in males and females, respectively. Those of the stomach and esophagus were 33.6 and 7.2 in males and 6.8 and 1.2 in females, respectively. There were tendencies for decreases in the morbidity and mortality of cancer at these sites in 1990 to 1999. The morphological verification of diagnosis of lung cancer does not reached 50%, this is higher for cancer of the stomach (71.6%) and esophagus (67.7%). There has been an increase in the proportion of patients with Stage IV disease in all tumor forms in question. The basic treatment for cancer of the stomach and lung was surgical (82.2 and 38.6%, respectively) and that for esophageal cancer is radiation (47.6%). As little as 10% of patients with gastric and lung cancer survive over 5 years. In esophageal cancer, this figure is much less (5%).

[Effects of dioxins in the development of malignant tumors and disorders of reproductive health of the population]. / O vliianii dioksinov na vozniknovenie zlokachestvennykh novoobrazovanii i narushenii reproduktivnogo zdorov'ia naseleniia.

The mortality caused by malignant tumors in the town of Chapaevsk, characterized by increased level of dioxins in the environment, is statistically higher than the expected values. For men the relative risk of general morbidity is 1.9 and mortality, 1.8; for lung cancer: morbidity, 3.3 and mortality 3.1; for urogenital cancer: morbidity, 3.6 and mortality, 2.6; for gastric cancer: morbidity 1.9 and mortality, 1.7. In women the morbidity and mortality due to breast cancer (relative risks 1.9 and 2.1, respectively) and cancer of the cervix uteri (relative risks 2.1 and 1.8, respectively) are increased. Changes in the reproductive health of residents of this town are as follows: high incidence of spontaneous abortions, appearance of small-for-date babies, and genital disorders in body (cryptorchidism, phimosis, hypospadia, delayed sexual development).

[Statistics of oncourologic diseases in Russia in 1996]. / Statistika onkourologicheskikh zabolevanii v Rossii v 1996 g.

The trends in male urinary and genital cancer morbidity and mortality are specified. Statistics on separate malignant urological diseases are provided. In 1996 the number of patients with cancer of male urinary and sex organs reached 31.700. A growth in morbidity was due rather to a higher risk to develop the disease than because of changes in the population age. Urological cancer reduces mean life span of Russian population by 2 months, and the patients' life terminates 10-19 years earlier. Financial losses due to deaths of urological cancer stand as high as 197 million roubles as estimated in 1990 prices.

[Statistics on oncological urologic diseases in Russia]. / Statistika onkourologicheskikh zabolevanii v Rossii.

Incidence rate of male urogenital cancer has increased for 1975-1993 by 138.7% reaching 27,700. The disease-specific trends in prevalence, morbidity and mortality are outlined. The rise in urogenital cancer incidence is attributed to higher risk to develop the disease rather than to growing percentage of the elderly among overall population. Mean lifespan of Russian population due to urological cancer mortality is cut by 2 months. Fatal cases live by 11-19 years less than healthy subjects. Economical losses because of deaths of urological cancer make up 187.3 million rubles in 1990 prices.