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2.
Int J Cancer ; 150(1): 91-99, 2022 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34398966

RESUMO

A number of organizations are producing resource stratified guidelines (RSGs) for cancer. Despite using similar definitions of resource levels, systemic treatment recommendations often differ between organizations. We systematically searched for RSGs focusing on solid tumors. We qualitatively compared the methods used to generate guidelines using the AGREE-II appraisal tool. We extracted systemic treatment recommendations and assessed interguideline concordance using the Gwet AC1 coefficient, stratified by resource level, treatment setting and cancer type. We identified 69 RSGs cancer covering 15 solid tumors produced by four organizations. Despite using common resource-level definitions (Basic, Core/Limited, Enhanced and Maximal), recommendations differed between organizations. Concordance for chemotherapy recommendations was poor in Basic (58.3%, Gwet 0.20), fair in Core (58.3%, Gwet 0.32) and excellent in Enhanced (92.4%, Gwet 0.92) and Maximal settings (95.4%, Gwet 0.95). Concordance rates for endocrine therapy were good in Basic (80% Gwet 0.61), and excellent in Core (90%, Gwet 0.87), Enhanced (90%, Gwet 0.89) and Maximal settings (90%, Gwet 0.89). There was moderate to excellent concordance in targeted therapy recommendations across all resource levels. Differences in recommendations appeared driven by different opinions among the chosen panel of experts regarding what is resource appropriate. Overall, we found that countries looking to base treatment and health-policy on RSGs will find conflicting information depending on which guidelines are used, particularly for chemotherapy in Basic and Core settings. Improved transparency regarding the methods used to determine the value of a therapy for a given resource level is needed.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Atenção à Saúde/normas , Recursos em Saúde/normas , Neoplasias/tratamento farmacológico , Guias de Prática Clínica como Assunto/normas , Saúde Global , Humanos , Neoplasias/patologia
3.
Dermatol Clin ; 40(1): 103-108, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34799031

RESUMO

Language is used to convey thought, but it also influences thought and perception, in turn affecting health care delivery. In this review, we seek to highlight ways in which dermatologists can incorporate inclusive language into practice. By using patient-centered and patient-affirming language, avoiding labels, and naming medical conditions with terminology rooted in pathophysiology rather than outmoded, racist convention or eponyms, dermatologists can strengthen therapeutic relationships and improve patient care.


Assuntos
Dermatologia , Dermatologistas , Humanos , Idioma
4.
Artigo em Inglês | MEDLINE | ID: mdl-34862736

RESUMO

INTRODUCTION: Trends in the use of short-course radiation therapy (RT) for rectal cancer in Australia are unknown. The purpose of this study was to compare short-course RT and long-course chemoradiation (CRT) utilisation in the neoadjuvant treatment of rectal cancer in New South Wales (NSW). METHODS: Patients who received neoadjuvant RT (2009-2014) for rectal cancer were identified from the NSW Central Cancer Registry. Univariate and multivariable analyses were performed to investigate factors associated with receipt of short-course RT. RESULTS: A total of 1196 (81%) patients received long-course CRT, and 274 (19%) patients received short-course RT. Receipt of short-course RT was associated with older age: 54% in patients ≥80 years, and 11% in patients <50 years (P < 0.0001). Patients with T2 disease (30%) were more likely to receive short-course RT, compared with T3 (19%) or T4 (8%) disease (P = 0.002). Patients with N0 (23%) disease were more likely to be treated with short-course RT, compared with N+ (16%) (P = 0.03). The proportion of short-course RT delivered to patients with Charlson Comorbidity Index (CCI) ≥ 2 (28%) was higher than patients with CCI = 0 (17%) (P = 0.002). There was wide variation in the proportion of short-course RT used across residence local health districts (5-29%) (P < 0.0001). CONCLUSION: In rectal cancer patients treated with neoadjuvant RT in NSW, 19% received short-course RT. The use of short-course RT was associated with older age, comorbidities and less advanced disease. Wide variation across NSW was identified and future research investigating factors for the variation will be useful.

5.
J Phys Chem B ; 125(38): 10720-10735, 2021 09 30.
Artigo em Inglês | MEDLINE | ID: mdl-34533024

RESUMO

Mutations in the cardiac ryanodine receptor type 2 (RyR2) have been linked to a variety of cardiac arrhythmias, such as catecholaminergic polymorphic ventricular tachycardia (CPVT). RyR2 is regulated by calmodulin (CaM), and mutations that disrupt their interaction can cause aberrant calcium release, leading to an arrhythmia. It was recently shown that increasing the RyR2-CaM binding affinity could rescue a defective CPVT-related RyR2 channel to near wild-type behavior. However, the interactions that determine the binding affinity at the RyR2-CaM binding interface are not well understood. In this study, we identify the key domains and interactions, including several new interactions, involved in the binding of CaM to RyR2. Also, our comparison between the wild-type and V3599K mutant suggests how the RyR2-CaM binding affinity can be increased via a change in the central and N-terminal lobe binding contacts for CaM. This computational approach provides new insights into the effect of a mutation at the RyR2-CaM binding interface, and it may find utility in drug design for the future treatment of cardiac arrhythmias.


Assuntos
Canal de Liberação de Cálcio do Receptor de Rianodina , Taquicardia Ventricular , Cálcio/metabolismo , Sinalização do Cálcio , Calmodulina/genética , Calmodulina/metabolismo , Humanos , Mutação , Canal de Liberação de Cálcio do Receptor de Rianodina/genética , Canal de Liberação de Cálcio do Receptor de Rianodina/metabolismo
6.
Pediatr Dermatol ; 38(5): 1393-1395, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34467544

RESUMO

High-risk infantile hemangiomas may be associated with significant patient comorbidity. The American Academy of Pediatrics published clinical practice guidelines with recommendations to refer high-risk hemangiomas early. The results of this study suggest that these guidelines may have resulted in an earlier referral age of patients with high-risk IH to hemangioma specialists.


Assuntos
Hemangioma Capilar , Hemangioma , Neoplasias Cutâneas , Criança , Hemangioma/diagnóstico , Hemangioma/terapia , Humanos , Lactente , Guias de Prática Clínica como Assunto , Encaminhamento e Consulta , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/terapia , Resultado do Tratamento
8.
Elife ; 102021 08 26.
Artigo em Inglês | MEDLINE | ID: mdl-34435953

RESUMO

The interaction between the SARS-CoV-2 virus Spike protein receptor binding domain (RBD) and the ACE2 cell surface protein is required for viral infection of cells. Mutations in the RBD are present in SARS-CoV-2 variants of concern that have emerged independently worldwide. For example, the B.1.1.7 lineage has a mutation (N501Y) in its Spike RBD that enhances binding to ACE2. There are also ACE2 alleles in humans with mutations in the RBD binding site. Here we perform a detailed affinity and kinetics analysis of the effect of five common RBD mutations (K417N, K417T, N501Y, E484K, and S477N) and two common ACE2 mutations (S19P and K26R) on the RBD/ACE2 interaction. We analysed the effects of individual RBD mutations and combinations found in new SARS-CoV-2 Alpha (B.1.1.7), Beta (B.1.351), and Gamma (P1) variants. Most of these mutations increased the affinity of the RBD/ACE2 interaction. The exceptions were mutations K417N/T, which decreased the affinity. Taken together with other studies, our results suggest that the N501Y and S477N mutations enhance transmission primarily by enhancing binding, the K417N/T mutations facilitate immune escape, and the E484K mutation enhances binding and immune escape.


Assuntos
Enzima de Conversão de Angiotensina 2/metabolismo , Mutação , SARS-CoV-2/genética , Glicoproteína da Espícula de Coronavírus/genética , Glicoproteína da Espícula de Coronavírus/metabolismo , Enzima de Conversão de Angiotensina 2/química , Sítios de Ligação , COVID-19/virologia , Humanos , Cinética , Ligantes , Simulação de Dinâmica Molecular , Ligação Proteica , Domínios Proteicos , Domínios e Motivos de Interação entre Proteínas , SARS-CoV-2/classificação , SARS-CoV-2/metabolismo , Glicoproteína da Espícula de Coronavírus/química
9.
Phys Imaging Radiat Oncol ; 18: 26-33, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34258404

RESUMO

Background and purpose: Prediction of chemoradiotherapy response (CRT) in locally advanced rectal cancer would enable stratification of management. The purpose was to prospectively evaluate multi-parametric magnetic resonance imaging (MRI) assessment of tumour heterogeneity combining diffusion weighted imaging (DWI) and dynamic contrast enhanced (DCE) MRI for the prediction of CRT response in locally advanced rectal cancer. Materials and methods: Patients with Stage II or III rectal adenocarcinoma undergoing neoadjuvant CRT and surgery underwent MRI (DWI and DCE) before, during (week 3), and after CRT (1 week before surgery). Patients with histopathology tumour regression grade (TRG) 0-1 were classified as responders, and TRG 2-3 were classified as non-responders. A whole tumour voxel-wise technique was used to produce apparent diffusion coefficient (ADC) and Ktrans (Tofts model) histograms derived from DWI and DCE-MRI, respectively. Logistic regression was used to predict response status for ADC and Ktrans quantiles. Results: Thirty-three patients were included in this analysis; 16 responders, and 17 non-responders. On heterogeneity analysis, odds of being a responder were significantly higher after CRT (before surgery) for higher ADC 75th (p = 0.049) and ADC 90th (p = 0.034) percentile values. The Ktrans quantiles were lower in non-responders than responders before and during CRT, and higher after CRT although no significant association with response status was observed (p ≥ 0.10). Conclusions: DWI-MRI after CRT (before surgery) incorporating a histogram analysis of whole tumour heterogeneity was predictive of CRT response in patients with locally advanced rectal cancer. DCE-MRI did not add value in response prediction. Clinical trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR) number ACTRN12616001690448.

10.
JCO Glob Oncol ; 7: 1074-1083, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34228485

RESUMO

PURPOSE: Resource-stratified guidelines (RSG) for cancer provide a hierarchy of interventions, based on resource availability. We quantify treatment need and cost if National Comprehensive Cancer Network (NCCN) RSGs for breast cancer (BC) are adopted globally. METHODS: We developed decision trees for first-course systemic therapy, merged with SEER and Global Cancer Observatory 2018 incidence data to estimate treatment need and cost if NCCN RSG are implemented globally based on country-level income. Simulations were used to quantify need and cost of globally scaling up services to Maximal. RESULTS: Based on NCCN RSG, first-course chemotherapy is indicated in 0% (Basic), 87% (Core), and 86% (Enhanced) but declined to 50% (Maximal) because of incorporation of genomic profiling. First-course endocrine therapy (ET) is indicated in 80% in all settings. In 2018, treatment need was 1.4 million people for chemotherapy, 183,943 for human epidermal growth factor receptor 2 (HER2) therapies and 1.6 million for ET. The cost per person for chemotherapy or HER2 or immunotherapy increased by 17-fold from Core to Maximal ($1,278-$22,313 Australian dollars [AUD]). The cost of ET per person rose eight-fold from Basic to Maximal ($1,236-$9,809 AUD). If all patients with BC globally were treated with Maximal resources, the need for chemotherapy would decline by 28%, whereas cost of first-course treatment would rise by 1.8-fold ($21-$37 billion AUD) because of more costly therapies. CONCLUSION: NCCN RSGs for BC could result in chemotherapy overtreatment in Core and Enhanced settings. The absence of chemotherapy in Basic settings should be reconsidered, and future iterations of RSG should perform cross-tumor comparisons to ensure equitable resource distribution and maximize population-level outcomes. Our model is flexible and can be tailored to the costs, population attributes, and resource availability of any institution or country for health-services planning.


Assuntos
Neoplasias da Mama , Austrália , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/epidemiologia , Feminino , Serviços de Saúde , Humanos
11.
Intern Med J ; 51(6): 975-979, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34155769

RESUMO

Regulatory changes now permit the availability and prescribing of medicinal cannabis in Australia. Public awareness and patient interest are high. Using a co-design approach involving cancer patients, carers and oncology and palliative care clinicians, two information resources were developed to provide readily available sources of important information for cancer patients and clinicians who are considering the use of medicinal cannabis. Focus groups and evaluation interviews revealed some areas of dissonance between consumers and clinicians concerning aspects of medicinal cannabis.


Assuntos
Cannabis , Maconha Medicinal , Neoplasias , Cuidadores , Grupos Focais , Humanos , Neoplasias/tratamento farmacológico , Cuidados Paliativos
12.
Med J Aust ; 214(6): 271-278, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33665811

RESUMO

OBJECTIVES: To describe patterns of care in New South Wales for men with prostate cancer, and to ascertain factors associated with receiving different types of treatment. DESIGN: Individual patient data record linkage study. SETTING, PARTICIPANTS: 4003 New South Wales men aged 45 years or more enrolled in the population-based 45 and Up Study in whom prostate cancer was first diagnosed during 2006-2013. MAIN OUTCOME MEASURES: Prostate cancer treatment type received; factors statistically associated with treatment received; proportions of patients who consulted radiation oncologists prior to treatment. RESULTS: In total, 1619 of 4003 patients underwent radical prostatectomy (40%), 893 external beam radiotherapy (EBRT) (22%), 183 brachytherapy (5%), 87 chemotherapy (2%), 373 androgen deprivation therapy alone (9%), and 848 no active treatment (21%). 205 of 1628 patients who had radical prostatectomies (13%) had radiation oncology consultations prior to surgery. Radical prostatectomy was more likely for patients aged 45-59 years, with regional stage disease, living 100 km or more from the nearest radiotherapy centre, having partners, or having private health insurance, while lower physical functioning, obesity, and living in areas of greater socio-economic disadvantage reduced the likelihood. EBRT was more likely for patients aged 70-79 years, with non-localised or unknown stage disease, living less than 100 km from the nearest radiotherapy centre, or not having private health insurance, while the likelihood was lower for patients aged 45-59 years or more than 80 years and for those who had several comorbid conditions. CONCLUSIONS: Men with prostate cancer were twice as likely to have radical prostatectomy as to receive EBRT, and fewer than one in seven had consulted radiation oncologists prior to prostatectomy. The treatment received was influenced by several socio-demographic factors. Given the treatment-specific side effects and costs, policies that affect access to different treatments for prostate cancer should be reviewed.


Assuntos
Padrões de Prática Médica , Neoplasias da Próstata/terapia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Registro Médico Coordenado , Pessoa de Meia-Idade , New South Wales
13.
Artigo em Inglês | MEDLINE | ID: mdl-33629530

RESUMO

AIM: To review the expected increasing demand for cancer services among low and middle-income countries (LMICs) in the Asia-Pacific (APAC), and to describe ways in which Australia and New Zealand (ANZ) can provide support to improve cancer outcomes in our region. METHODS: We first review the current and projected incidence of cancer within the APAC between 2018 and 2040, and the estimated demand for chemotherapy, radiotherapy and surgery. We then explore potential ways in which ANZ can increase regional collaborations to improve cancer outcomes. RESULTS: We identify 6 ways that ANZ can collaborate with LMICs to improve cancer care in the APAC through the ANZ Regional Oncology Collaboration Strategy: Increasing education and institutional collaborations in the APAC region through in-country training, twinning partnerships, observerships and formalised training programs in order to increase cancer care quality and capacity. Promoting and assisting in the establishment and maintenance of population-based cancer registries in LMICs. Increasing research capacity in LMICs through collaboration and promoting high quality global oncology research within ANZ. Engaging and training Australian and New Zealand clinicians in global oncology, increasing awareness of this important career path, and increasing health policy engagement. Increasing web-based endeavours through virtual tumour boards, web-based advocacy platforms and web-based teaching programs. Continuing to leverage for funding through professional bodies, government, industry, not-for-profit organisations and local hospital funds. CONCLUSION: We propose the creation of an Australian and New Zealand Interest Group to provide formalised and sustained collaboration between researchers, clinicians and stakeholders.

14.
Lancet Oncol ; 22(2): 182-189, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33485458

RESUMO

BACKGROUND: The growing demand for cancer surgery has placed a global strain on health systems. In-depth analyses of the global demand for cancer surgery and optimal workforce requirements are needed to plan service provision. We estimated the global demand for cancer surgery and the requirements for an optimal surgical and anaesthesia workforce, using benchmarks based on clinical guidelines. METHODS: Using models of benchmark surgical use based on clinical guidelines, we estimated the proportion of cancer cases with an indication for surgery across 183 countries, stratified by income group. These proportions were multiplied by age-adjusted national estimates of new cancer cases using GLOBOCAN 2018 data and then aggregated to obtain the estimated number of surgical procedures required globally. The numbers of cancer surgical procedures in 44 high-income countries were divided by the actual number of surgeons and anaesthetists in the respective countries to calculate cancer procedures per surgeon and anaesthetist ratios. Using the median (IQR) of these ratios as benchmarks, we developed a three-tiered optimal surgical and anaesthesia workforce matrix, and the predictions were extrapolated up to 2040. FINDINGS: Our model estimates that the number of cancer cases globally with an indication for surgery will increase by 5 million procedures (52%) between 2018 (9 065 000) and 2040 (13 821 000). The greatest relative increase in surgical demand will occur in 34 low-income countries, where we also observed the largest gaps in workforce requirements. To match the median benchmark for high-income countries, the surgical workforce in these countries would need to increase by almost four times and the anaesthesia workforce by nearly 5·5 times. The greatest increase in optimal workforce requirements from 2018 to 2040 will occur in low-income countries (from 28 000 surgeons to 58 000 surgeons; 107% increase), followed by lower-middle-income countries (from 166 000 surgeons to 277 000 surgeons; 67% increase). INTERPRETATION: The global demand for cancer surgery and the optimal workforce are predicted to increase over the next two decades and disproportionately affect low-income countries. These estimates provide an appropriate framework for planning the provision of surgical services for cancer worldwide. FUNDING: University of New South Wales Scientia Scholarship and UK Research and Innovation Global Challenges Research Fund.


Assuntos
Anestesia/tendências , Planos de Sistemas de Saúde/tendências , Mão de Obra em Saúde/tendências , Neoplasias/cirurgia , Anestesia/economia , Atenção à Saúde/economia , Atenção à Saúde/tendências , Saúde Global/economia , Planos de Sistemas de Saúde/economia , Mão de Obra em Saúde/economia , Humanos , Renda , Neoplasias/economia , Neoplasias/epidemiologia , Cirurgiões/economia
15.
Lancet Oncol ; 22(2): 173-181, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33485459

RESUMO

BACKGROUND: Estimating a population-level benchmark rate for use of surgery in the management of cancer helps to identify treatment gaps, estimate the survival impact of such gaps, and benchmark the workforce and other resources, including budgets, required to meet service needs. A population-based benchmark for use of surgery in high-income settings to inform policy makers and service provision has not been developed but was recommended by the Lancet Oncology Commission on Global Cancer Surgery. We aimed to develop and validate a cancer surgery benchmarking model. METHODS: We examined the latest clinical guidelines from high-income countries (Australia, the UK, the EU, the USA, and Canada) and mapped surgical treatment pathways for 30 malignant cancer sites (19 individual sites and 11 grouped as other cancers) that were notifiable in Australia in 2014, broadly reflecting contemporary high-income models of care. The optimal use of surgery was considered as an indication for surgery where surgery is the treatment of choice for a given clinical scenario. Population-based epidemiological data, such as cancer stage, tumour characteristics, and fitness for surgery, were derived from Australia and other similar high-income settings for 2017. The probabilities across the clinical pathways of each cancer were multiplied and added together to estimate the population-level benchmark rates of cancer surgery, and further validated with the comparisons of observed rates of cancer surgery in the South Western Sydney Local Health District in 2006-12. Univariable and multivariable sensitivity analyses were done to explore uncertainty around model inputs, with mean (95% CI) benchmark surgery rates estimated on the basis of 10 000 Monte Carlo simulations. FINDINGS: Surgical treatment was indicated in 58% (95% CI 57-59) of newly diagnosed patients with cancer in Australia in 2014 at least once during the course of their treatment, but varied by site from 23% (17-27) for prostate cancer to 99% (96-99) for testicular cancer. Observed cancer surgery rates in South Western Sydney were comparable to the benchmarks for most cancers, but were higher for some cancers, such as prostate (absolute increase of 29%) and lower for others, such as lung (-14%). INTERPRETATION: The model provides a new template for high-income and emerging economies to rationally plan and assess their cancer surgery provision. There are differences in modelled versus observed surgery rates for some cancers, requiring more in-depth analysis of the observed differences. FUNDING: University of New South Wales Scientia Scholarship, UK Research and Innovation-Global Challenges Research Fund.


Assuntos
Países Desenvolvidos/economia , Neoplasias Embrionárias de Células Germinativas/economia , Neoplasias/economia , Neoplasias Testiculares/economia , Austrália/epidemiologia , Benchmarking/economia , Canadá/epidemiologia , Gerenciamento de Dados , Guias como Assunto/normas , Humanos , Neoplasias/epidemiologia , Neoplasias/cirurgia , Neoplasias Embrionárias de Células Germinativas/epidemiologia , Neoplasias Testiculares/epidemiologia , Reino Unido/epidemiologia
16.
Eur J Cancer Care (Engl) ; 30(1): e13352, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33146449

RESUMO

OBJECTIVE: To investigate the value (survival benefit and cost) of first-line chemotherapy and targeted therapy in breast cancer at a population level. METHODS: Based on guideline recommendations, a model of optimal utilisation was constructed for first-line chemotherapy and targeted therapy in breast cancer, calculating the survival benefit and average cost of all regimens recommended for each treatment indication at 5 years and at 10 years. RESULTS: Survival benefits from chemotherapy and targeted therapy differ markedly depending on the treatment indications. The cost per life-year gained at 5 years is $38,044 for stages I and II, $33,749 for stage III and $ 151,668 for patients presenting with stage IV breast cancer. The cost per life-year gained at 10 years is $ 13,587 for early breast cancer. The most expensive chemotherapy indication in breast cancer is the treatment of metastatic HER2-positive breast cancer costing $330,978 per LYG for a survival benefit of 11% at 5 years falling to zero survival benefit at 10 years. CONCLUSION: There are large differences in value between the different indications for first-course chemotherapy and targeted therapy in the treatment of breast cancer that should be considered when pricing cancer drugs.


Assuntos
Antineoplásicos , Neoplasias da Mama , Antineoplásicos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Análise Custo-Benefício , Feminino , Humanos
17.
Asia Pac J Clin Oncol ; 17(5): e217-e225, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32978819

RESUMO

BACKGROUND: Pacific Island Countries and Territories (PICTs) have experienced an increase in cancer burden in the recent years. There is need for major investments in the cancer treatment facilities including radiotherapy (RT). AIMS: This study aimed to provide a quantitative estimation of the effect of establishing new RT facilities on patient access through Geographic Information System (GIS) modelling of population density and service availability to assess the best location for a new RT centre when there are multiple competing locations. METHODS: Methods involved cancer epidemiological data collection and assessing RT demand (proportion needing RT) in 2040, assessment of current RT facilities meeting the demand, GIS-based assessment of minimal travel distance in relation to RT demand and scenario-based location planning with adoption of the principles of efficiency, availability and equity for establishment of suitability of new RT facilities. RESULTS: In 2040, three highest new cancer case projections are for Papua New Guinea (PNG) (22662), Fiji (2058) and New Caledonia (2037). Twenty-nine megavoltage machines (MVMs) are needed to meet adequate RT demand with three existing in New Caledonia, Guam and French Polynesia meeting 2-6% demand. PNG with highest RT demand of 68% and Fiji with second highest (6%) demand are found as the choice venues for maximum accessibility of cancer population within the PICTs. CONCLUSION: The travel distance-based GIS modelling estimation of establishment of new RT facilities will provide useful information for planning of RT services in the PICTS with improved patient outcome.


Assuntos
Neoplasias , Coleta de Dados , Humanos , Neoplasias/epidemiologia , Neoplasias/radioterapia , Ilhas do Pacífico/epidemiologia
18.
J Interpers Violence ; 36(13-14): NP7045-NP7069, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-30646815

RESUMO

Social research has long argued that collective resources and major events like disasters have an important impact on violent crime, but it has been difficult to show their effects because data are scarce. We conducted a large survey in New Orleans after Hurricane Katrina that included questions about collective resources. We aggregated our sample to the census tract level and merged it with data on concentrated disadvantage and violent crime. Our analyses show that bridging social networks are associated with lower levels of violent crime, while bonding social networks are associated with higher levels. Social trust is associated with lower levels of violent crime, but civic engagement has no impact. Concentrated disadvantage is associated with higher levels of violent crime. Finally, our results suggest that disaster recovery increased the importance of collective resources but not concentrated disadvantage on violent crime.


Assuntos
Tempestades Ciclônicas , Desastres , Crime , Humanos , Nova Orleans , Inquéritos e Questionários
19.
Front Microbiol ; 11: 572131, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33240229

RESUMO

Cyanobacteria are found in most illuminated environments and are key players in global carbon and nitrogen cycling. Although significant efforts have been made to advance our understanding of this important phylum, still little is known about how members of the cyanobacteria affect and respond to changes in complex biological systems. This lack of knowledge is in part due to our dependence on pure cultures when determining the metabolism and function of a microorganism. We took advantage of the Culture Collection of Microorganisms from Extreme Environments (CCMEE), a collection of more than 1,000 publicly available photosynthetic co-cultures maintained at the Pacific Northwest National Laboratory, and assessed via 16S rRNA amplicon sequencing if samples readily available from public culture collection could be used in the future to generate new insights into the role of microbial communities in global and local carbon and nitrogen cycling. Results from this work support the existing notion that culture depositories in general hold the potential to advance fundamental and applied research. Although it remains to be seen if co-cultures can be used at large scale to infer roles of individual organisms, samples that are publicly available from existing co-cultures depositories, such as the CCMEE, might be an economical starting point for such studies. Access to archived biological samples, without the need for costly field work, might in some circumstances be one of the few remaining ways to advance the field and to generate new insights into the biology of ecosystems that are not easily accessible. The current COVID-19 pandemic, which makes sampling expeditions almost impossible without putting the health of the participating scientists on the line, is a very timely example.

20.
Comput Aided Des ; 127: 102909, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32834068
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