The new socio-territorial conflicts and geographical space in Chile

Se presenta una discusión teórica sobre la construcción de espacio geográfico en comunidades rurales, la intervención de la industria del cobre y de centrales hidroeléctricas en el territorio y el desarrollo de movimientos sociales ambientales. Esta discusión surge a raíz de la situación de un grupo de localidades rurales ubicadas en la zona del Alto Cachapoal (región de O´Higgins), en la zona central de Chile, que desde comienzos del siglo XX han visto intervenidos su paisaje natural por la industria pesada.A theoretical discussion is introduced about the construction of geographical space in rural communities, the copper industry and hydroelectric power plants interventions over the territory, and the environmental social movements development. This discussion emerges regarding the situation of a group of rural towns located in Alto Cachapoal (O'Higgins Region), in central Chile, that since the beginning of 20th century have seen their natural landscape intervened by the heavy industry

Clinical Audit of the Radiotherapy Process in Rectal Cancer: Clinical Practice guidelines and Quality Certification Do Not Avert Variability in Clinical Practice

Background: The therapeutic approach to cancer is complex and multidisciplinary. Radiotherapy is among the essential treatments, whether used alone or in conjunction with other therapies. This study reports a clinical audit of the radiotherapy process to assess the process of care, evaluate adherence to agreed protocols and measure the variability to improve therapeutic quality for rectal cancer. Methods: Multicentre retrospective cohort study in a representative sample of patients diagnosed with rectal cancer in the Institut Català d'Oncologia, a comprehensive cancer centre with three different settings. We developed a set of indicators to assess the key areas of the radiotherapy process. The clinical audit consisted of a review of a random sample of 40 clinical histories for each centre. Results: The demographic profile, histology and staging of patients were similar between centres. The MRI reports did not include the distance from tumour to mesorectal fascia (rCRM) in 38.3% of the cases. 96.7% of patients received the planned dose, and 57.4% received it at the planned time. Surgery followed neoadjuvant treatment in 96.7% of the patients. Among this group, postoperative CRM was recorded in 65.5% of the cases and was negative in 93.4% of these. With regard to the 34.5% (n = 40) of cases where no CRM value was stated, there were differences between the centres. Mean follow-up was 3.4 (SD 0.6) years, and overall survival at four years was 81.7%. Conclusions: The audit revealed a suboptimal degree of adherence to clinical practice guidelines. Significant variability between centres exists from a clinical perspective but especially with regard to organization and process

Millora de l’atenció al càncer de recte a Catalunya en el període 2005-2016

Càncer de recte; Atenció; IndicadorsCáncer de recto; Atención; IndicadoresRectal cancer; Attention; IndicatorsL’objectiu d’aquest informe és el d’analitzar l’evolució de l’atenció al càncer de recte al llarg del període cobert per les tres auditories bianuals efectuades (2005-7, 2011-12 i 2015-16)

Limit theorems for self-similar tilings

We study deviation of ergodic averages for dynamical systems given by self-similar tilings on the plane and in higher dimensions. The main object of our paper is a special family of finitely-additive measures for our systems. An asymptotic formula is given for ergodic integrals in terms of these finitely-additive measures, and, as a corollary, limit theorems are obtained for dynamical systems given by self-similar tilings.Comment: 36 pages; some corrections and improved exposition, especially in Section 4; references adde

Improved personalized survival prediction of patients with diffuse large B-cell Lymphoma using gene expression profiling

BACKGROUND: Thirty to forty percent of patients with Diffuse Large B-cell Lymphoma (DLBCL) have an adverse clinical evolution. The increased understanding of DLBCL biology has shed light on the clinical evolution of this pathology, leading to the discovery of prognostic factors based on gene expression data, genomic rearrangements and mutational subgroups. Nevertheless, additional efforts are needed in order to enable survival predictions at the patient level. In this study we investigated new machine learning-based models of survival using transcriptomic and clinical data. METHODS: Gene expression profiling (GEP) of in 2 different publicly available retrospective DLBCL cohorts were analyzed. Cox regression and unsupervised clustering were performed in order to identify probes associated with overall survival on the largest cohort. Random forests were created to model survival using combinations of GEP data, COO classification and clinical information. Cross-validation was used to compare model results in the training set, and Harrel's concordance index (c-index) was used to assess model's predictability. Results were validated in an independent test set. RESULTS: Two hundred thirty-three and sixty-four patients were included in the training and test set, respectively. Initially we derived and validated a 4-gene expression clusterization that was independently associated with lower survival in 20% of patients. This pattern included the following genes: TNFRSF9, BIRC3, BCL2L1 and G3BP2. Thereafter, we applied machine-learning models to predict survival. A set of 102 genes was highly predictive of disease outcome, outperforming available clinical information and COO classification. The final best model integrated clinical information, COO classification, 4-gene-based clusterization and the expression levels of 50 individual genes (training set c-index, 0.8404, test set c-index, 0.7942). CONCLUSION: Our results indicate that DLBCL survival models based on the application of machine learning algorithms to gene expression and clinical data can largely outperform other important prognostic variables such as disease stage and COO. Head-to-head comparisons with other risk stratification models are needed to compare its usefulness

Snow and ice in the desert: reflections from a decade of connecting cryospheric science with communities in the semiarid Chilean Andes

Citizen science and related engagement programmes have proliferated in recent years throughout the sciences but have been reasonably limited in the cryospheric sciences. In the semiarid Andes we at the Centro de Estudios Avanzados en Zonas Áridas have developed a range of initiatives together with the wider community and stakeholder institutions to improve our understanding of the role snow and ice play in headwater catchments. In this paper we reflect on ongoing engagement with communities living and working in and near study sites of cryospheric science in northern Chile as a strategy that can both strengthen the research being done and empower local communities

Avaluació dels resultats de la concentració de la cirurgia oncològica digestiva d’alta especialització a Catalunya: actualització 2014-2015

Cirurgia oncològica; Avaluació; IndicadorsCirugía oncológica; Evaluación; IndicadoresOncological surgery; Evaluation; IndicatorsEl presente trabajo corresponde a la segunda evaluación de los resultados de la cirugía oncológica digestiva de alta especialización con intención curativa de cirugía de esófago, de páncreas y de hígado (que incluye metástasis hepáticas desde la primera evaluación, actualmente ampliado a vías biliares y tumor hepático primario) para los años 2014 y 2015. A diferencia de la primera evaluación basada en el uso de la auditoría clínica "externa", la metodología aplicada en esta segunda evaluación incorpora información directa de los propios profesionales. En ambos casos ha habido feedback, y validación de los resultados finales por su parte.El present treball correspon a la segona avaluació dels resultats de la cirurgia oncològica digestiva d’alta especialització amb intenció curativa de cirurgia d’esòfag, de pàncrees i de fetge (que inclou metàstasis hepàtiques des de la primera avaluació, actualment ampliat a vies biliars i tumor hepàtic primari) per als anys 2014 i 2015. A diferència de la primera avaluació basada en l’ús de l’auditoria clínica “externa”, la metodologia aplicada en aquesta segona avaluació incorpora informació directa dels propis professionals. En ambdós casos hi ha hagut feedback, i validació dels resultats finals per part seva.The present work corresponds to the second evaluation of the results of the digestive oncology surgery of high specialization with a curative intention of surgery of the esophagus, pancreas and liver (which includes hepatic metastases from the first evaluation, currently extended to bile ducts and primary hepatic tumor) for the years 2014 and 2015. Unlike the first evaluation based on the use of the "external" clinical audit, the methodology applied in this second evaluation incorporates direct information from the professionals themselves. In both cases there has been feedback, and validation of the final results on his part

Six hundred years of South American tree rings reveal an increase in severe hydroclimatic events since mid-20th century

South American (SA) societies are highly vulnerable to droughts and pluvials, but lack of long-term climate observations severely limits our understanding of the global processes driving climatic variability in the region. The number and quality of SA climate-sensitive tree ring chronologies have significantly increased in recent decades, now providing a robust network of 286 records for characterizing hydroclimate variability since 1400 CE. We combine this network with a self-calibrated Palmer Drought Severity Index (scPDSI) dataset to derive the South American Drought Atlas (SADA) over the continent south of 12°S. The gridded annual reconstruction of austral summer scPDSI is the most spatially complete estimate of SA hydroclimate to date, and well matches past historical dry/wet events. Relating the SADA to the Australia–New Zealand Drought Atlas, sea surface temperatures and atmospheric pressure fields, we determine that the El Niño–Southern Oscillation (ENSO) and the Southern Annular Mode (SAM) are strongly associated with spatially extended droughts and pluvials over the SADA domain during the past several centuries. SADA also exhibits more extended severe droughts and extreme pluvials since the mid-20th century. Extensive droughts are consistent with the observed 20th-century trend toward positive SAM anomalies concomitant with the weakening of midlatitude Westerlies, while low-level moisture transport intensified by global warming has favored extreme rainfall across the subtropics. The SADA thus provides a long-term context for observed hydroclimatic changes and for 21st-century Intergovernmental Panel on Climate Change (IPCC) projections that suggest SA will experience more frequent/severe droughts and rainfall events as a consequence of increasing greenhouse gas emissions

Clinical and pathological characteristics of peripheral T‐cell lymphomas in a Spanish population: a retrospective study

We investigated the clinicopathological features and prognostic factors of patients with peripheral T-cell lymphoma (PTCL) in 13 sites across Spain. Relevant clinical antecedents, CD30 expression and staining pattern, prognostic indices using the International Prognostic Index and the Intergruppo Italiano Linfomi system, treatments, and clinical outcomes were examined. A sizeable proportion of 175 patients had a history of immune-related disorders (autoimmune 16%, viral infections 17%, chemo/radiotherapy-treated carcinomas 19%). The median progression-free survival (PFS) and overall survival (OS) were 7·9 and 15·8 months, respectively. Prognostic indices influenced PFS and OS, with a higher number of adverse factors resulting in shorter survival (P 15% of cells were positive in anaplastic lymphoma kinase-positive and -negative anaplastic large-cell lymphoma and extranodal natural killer PTCL groups. We observed PTCL distribution across subtypes based on haematopathological re-evaluation. Poor prognosis, effect of specific prognostic indices, relevance of histopathological sub-classification, and response level to first-line treatment on outcomes were confirmed. Immune disorders amongst patients require further examination involving genetic studies and identification of associated immunosuppressive factors

Clinical and pathological characteristics of peripheral T-cell lymphomas in a Spanish population: a retrospective study

We investigated the clinicopathological features and prognostic factors of patients with peripheral T-cell lymphoma (PTCL) in 13 sites across Spain. Relevant clinical antecedents, CD30 expression and staining pattern, prognostic indices using the International Prognostic Index and the Intergruppo Italiano Linfomi system, treatments, and clinical outcomes were examined. A sizeable proportion of 175 patients had a history of immune-related disorders (autoimmune 16%, viral infections 17%, chemo/radiotherapy-treated carcinomas 19%). The median progression-free survival (PFS) and overall survival (OS) were 7·9 and 15·8 months, respectively. Prognostic indices influenced PFS and OS, with a higher number of adverse factors resulting in shorter survival (P 15% of cells were positive in anaplastic lymphoma kinase-positive and -negative anaplastic large-cell lymphoma and extranodal natural killer PTCL groups. We observed PTCL distribution across subtypes based on haematopathological re-evaluation. Poor prognosis, effect of specific prognostic indices, relevance of histopathological sub-classification, and response level to first-line treatment on outcomes were confirmed. Immune disorders amongst patients require further examination involving genetic studies and identification of associated immunosuppressive factors.This study was sponsored by Takeda