Colorectal cancer population screening programs worldwide in 2016: An update

Colorectal cancer (CRC) is the third most commonly diagnosed cancer in the world. The incidence and mortality show wide geographical variations. Screening is recommended to reduce both incidence and mortality. However, there are significant differences among studies in implementation strategies and detection. This review aimed to present the results and strategies of different screening programs worldwide. We reviewed the literature on national and international screening programs published in PubMed, on web pages, and in clinical guidelines. CRC Screening programs are currently underway in most European countries, Canada, specific regions in North and South America, Asia, and Oceania. The most extensive screening strategies were based on fecal occult blood testing, and more recently, the fecal immunochemical test (FIT). Participation in screening has varied greatly among different programs. The Netherlands showed the highest participation rate (68.2%) and some areas of Canada showed the lowest (16%). Participation rates were highest among women and in programs that used the FIT test. Men exhibited the greatest number of positive results. The FIT test has been the most widely used screening program worldwide. The advent of this test has increased participation rates and the detection of positive results

Le processus incapacitant au cours du vieillissement : rôle de l’exercice/activité physique

Le vieillissement est un phénomène d’importance croissante dans les sociétés actuelles. Bien que le rôle exercé par la pratique d’exercice/activité physique sur le maintien d’une capacité physique fonctionnelle optimale durant le vieillissement soit bien établi, l’inactivité physique est encore un comportement largement présent chez les personnes âgées, ce qui facilite le développement du processus incapacitant. Le but de cette revue de synthèse est d’exposer la chaîne de déclins physiologiques et fonctionnels au cours du vieillissement. Cette étude vise aussi à élucider le rôle exercé par la pratique d’exercice/activité physique afin d’empêcher ou retarder le début de tels déclins, et de renverser ou diminuer leur impact négatif sur des individus qui vieillissent. Ce travail explore l’influence des principales composantes du processus incapacitant (fragilité, limitation physique fonctionnelle, dépendance), et de la pratique d’exercice/activité physique sur la capacité physique fonctionnelle. Concernant le rapport « exercice/activité physique – processus incapacitant », certaines incohérences apparaissent parmi les études, ce qui réduit la possibilité de comparaison entre elles, et limite les conclusions. La définition du concept de fragilité, ainsi que la façon de mesurer les variables exercice/activité physique et fragilité constituent une des principales incohérences parmi ces études. Malgré cela, il ressort de ces études que la pratique régulière d’exercice/activité physique réduit des déclins liés à l’âge, tant sur le plan physiologique que sur celui de la capacité physique fonctionnelle. La pratique régulière d’exercice/activité physique contribue ainsi au maintien de l’indépendance des personnes âgées, à travers une minimisation des effets négatifs du processus incapacitant.Aging is a phenomenon of increased importance in contemporaneous societies. Although it is well established that physical exercise/activity contributes to maintain functional fitness at optimal levels, physical inactivity is a largely prevalent behaviour among elderly people, thus facilitating the disablement process. The purpose of this review is to study physiological and functional declines during aging. This article also tries to clarify the role played by physical exercise/activity in avoiding or delaying those declines, and in reverting or diminishing their negative impacts on older adults’ health. The influences of both disablement process main components (frailty, disability, and dependence) and of physical exercise/activity on functional fitness are examined. Concerning the relationships between physical exercise/activity and disablement process, some inconsistencies arise among articles, making difficult to compare them and to draw conclusions. The definitions of frailty, as well as the ways to measure physical exercise/activity, constitute the main inconsistencies among studies. However, most of the researches show that a regular practice of physical exercise/activity decreases the age-related declines in both physiological status and functional fitness. Then, exercising regularly can contribute to maintain independence in older adults by reducing the negative effects of the disablement process

V-Proportion: a method based on the Voronoi diagram to study spatial relations in neuronal mosaics of the retina

The visual system plays a predominant role in the human perception. Although all components of the eye are important to perceive visual information, the retina is a fundamental part of the visual system. In this work we study the spatial relations between neuronal mosaics in the retina. These relations have shown its importance to investigate possible constraints or connectivities between different spatially colocalized populations of neurons, and to explain how visual information spreads along the layers before being sent to the brain. We introduce the V-Proportion, a method based on the Voronoi diagram to study possible spatial interactions between two neuronal mosaics. Results in simulations as well as in real data demonstrate the effectiveness of this method to detect spatial relations between neurons in different layers

Effect of aspirin on the diagnostic accuracy of the faecal immunochemical test for colorectal advanced neoplasia

Background: Aspirin (ASA) is a drug that can cause gastrointestinal lesions and symptoms. Colorectal cancer (CRC) is the most prevalent type of cancer in Western countries. We assessed the effect of aspirin on the diagnostic accuracy of the faecal immunochemical test (FIT) for CRC and/or advanced neoplasia (AN) in patients undergoing colonoscopy for gastrointestinal symptoms. Methods: We conducted a prospective multicentre observational study of diagnostic tests that included patients with gastrointestinal symptoms undergoing colonoscopy between March 2012 and 2014 (the COLONPREDICT study). Symptoms were assessed and a FIT and blood tests assessing haemoglobin and carcinoembryonic antigen (CEA) levels were performed. Results: The study included 3052 patients: A total of 2567 did not take aspirin (non-user group) and 485 (16%) took aspirin (user group). Continuous treatment with ASA did not change the AUC (0.88, 0.82; p = 0.06), sensitivity (92%, 88%; p = 0.5) or specificity (71%, 67%; p = 0.2) of the FIT for CRC detection. Similarly, we found no differences in the AUC (0.81, 0.79; p = 0.6), sensitivity (74%, 75.5%; p = 0.3) or specificity (76%, 73.6%; p = 0.3) for AN detection. Patients with an aspirin use of = 300 mg/day had a lower prevalence of AN and the sensitivity, specificity and AUC for AN for these patients were 54%, 68% and 0.66, significantly lower than for the non-user group (p = 0.03). Conclusions: Aspirin does not modify the diagnostic accuracy of FIT for CRC and/or AN in patients with gastrointestinal symptoms. Aspirin use of = 300 mg/day decreases the accuracy of the test

Stress detection using wearable physiological and sociometric sensors

Stress remains a significant social problem for individuals in modern societies. This paper presents a machine learning approach for the automatic detection of stress of people in a social situation by combining two sensor systems that capture physiological and social responses. We compare the performance using different classifiers including support vector machine, AdaBoost, and k-nearest neighbour. Our experimental results show that by combining the measurements from both sensor systems, we could accurately discriminate between stressful and neutral situations during a controlled Trier social stress test (TSST). Moreover, this paper assesses the discriminative ability of each sensor modality individually and considers their suitability for real time stress detection. Finally, we present an study of the most discriminative features for stress detection

A comparative study of legitimation strategies in hybrid regimes

The Institutions of Politics; Design, Workings, and implications ( do not use, ended 1-1-2020

Predictive Value of Carcinoembryonic Antigen in Symptomatic Patients without Colorectal Cancer: A Post-Hoc Analysis within the COLONPREDICT Cohort

We aimed to assess the risk of cancer in patients with abdominal symptoms after a complete colonoscopy without colorectal cancer (CRC), according to the carcinoembryonic antigen (CEA) concentration, as well as its diagnostic accuracy. For this purpose, we performed a post-hoc analysis within a cohort of 1431 patients from the COLONPREDICT study, prospectively designed to assess the fecal immunochemical test accuracy in detecting CRC. Over 36.5 +/- 8.4 months, cancer was detected in 115 (8%) patients. Patients with CEA values higher than 3 ng/mL revealed an increased risk of cancer (HR 2.0, 95% CI 1.3-3.1), CRC (HR 4.4, 95% CI 1.1-17.7) and non-gastrointestinal cancer (HR 1.7, 95% CI 1.0-2.8). A new malignancy was detected in 51 (3.6%) patients during the first year and three variables were independently associated: anemia (OR 2.8, 95% CI 1.3-5.8), rectal bleeding (OR 0.3, 95% CI 0.1-0.7) and CEA level >3 ng/mL (OR 3.4, 95% CI 1.7-7.1). However, CEA was increased only in 31.8% (95% CI, 16.4-52.7%) and 50% (95% CI, 25.4-74.6%) of patients with and without anemia, respectively, who would be diagnosed with cancer during the first year of follow-up. On the basis of this information, CEA should not be used to assist in the triage of patients presenting with lower bowel symptoms who have recently been ruled out a CRC

An artificial intelligence method using FDG PET to predict treatment outcome in diffuse large B cell lymphoma patients

Convolutional neural networks (CNNs) may improve response prediction in diffuse large B-cell lymphoma (DLBCL). The aim of this study was to investigate the feasibility of a CNN using maximum intensity projection (MIP) images from 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) baseline scans to predict the probability of time-to-progression (TTP) within 2 years and compare it with the International Prognostic Index (IPI), i.e. a clinically used score. 296 DLBCL 18F-FDG PET/CT baseline scans collected from a prospective clinical trial (HOVON-84) were analysed. Cross-validation was performed using coronal and sagittal MIPs. An external dataset (340 DLBCL patients) was used to validate the model. Association between the probabilities, metabolic tumour volume and Dmaxbulk was assessed. Probabilities for PET scans with synthetically removed tumors were also assessed. The CNN provided a 2-year TTP prediction with an area under the curve (AUC) of 0.74, outperforming the IPI-based model (AUC = 0.68). Furthermore, high probabilities (> 0.6) of the original MIPs were considerably decreased after removing the tumours (< 0.4, generally). These findings suggest that MIP-based CNNs are able to predict treatment outcome in DLBCL

Factors related to the development of health-promoting community activities in Spanish primary healthcare: two case-control studies.

Objective Spanish primary healthcare teams have the responsibility of performing health-promoting community activities (CAs), although such activities are not widespread. Our aim was to identify the factors related to participation in those activities. Design Two case–control studies. setting Performed in primary care of ve Spanish regions. subjects In the rst study, cases were teams that performed health-promoting CAs and controls were those that did not. In the second study (on case teams from the rst study), cases were professionals who developed these activities and controls were those who did not. Main outcome measures Team, professional and community characteristics collected through questionnaires (team managers/professionals) and from secondary sources. results The rst study examined 203 teams (103 cases, 100 controls). Adjusted factors associated with performing CAs were percentage of nurses (OR 1.07, 95% CI 1.01 to 1.14), community socioeconomic status (higher vs lower OR 2.16, 95% CI 1.18 to 3.95) and performing undergraduate training (OR 0.44, 95% CI 0.21 to 0.93). In the second study, 597 professionals responded (254 cases, 343 controls). Adjusted factors were professional classi cation (physicians do fewer activities than nurses and social workers do more), training in CAs (OR 1.9, 95% CI 1.2 to 3.1), team support (OR 2.9, 95% CI 1.5 to 5.7), seniority (OR 1.06, 95% CI 1.03 to 1.09), nursing tutor (OR 2.0, 95% CI 1.1 to 3.5), motivation (OR 3.7, 95% CI 1.8 to 7.5), collaboration with non-governmental organisations (OR 1.9, 95% CI 1.2 to 3.1) and participation in neighbourhood activities (OR 3.1, 95% CI 1.9 to 5.1). Conclusions Professional personal characteristics, such as social sensitivity, profession, to feel team support or motivation, have in uence in performing health-promoting CAs. In contrast to the opinion expressed by many professionals, workload is not related to performance of health-promoting CAs