A classification prognostic score to predict OS in stage IV well-differentiated neuroendocrine tumors

No validated prognostic tool is available for predicting overall survival (OS) of patients with well-differentiated neuroendocrine tumors (WDNETs). This study, conducted in three independent cohorts of patients from five different European countries, aimed to develop and validate a classification prognostic score for OS in patients with stage IV WDNETs. We retrospectively collected data on 1387 patients: (i) patients treated at the Istituto Nazionale Tumori (Milan, Italy; n = 515); (ii) European cohort of rare NET patients included in the European RARECAREnet database (n = 457); (iii) Italian multicentric cohort of pancreatic NET (pNETs) patients treated at 24 Italian institutions (n = 415). The score was developed using data from patients included in cohort (i) (training set); external validation was performed by applying the score to the data of the two independent cohorts (ii) and (iii) evaluating both calibration and discriminative ability (Harrell C statistic). We used data on age, primary tumor site, metastasis (synchronous vs metachronous), Ki-67, functional status and primary surgery to build the score, which was developed for classifying patients into three groups with differential 10-year OS: (I) favorable risk group: 10-year OS >= 70%; (II) intermediate risk group: 30% <= 10-year OS < 70%; (III) poor risk group: 10-year OS < 30%. The Harrell C statistic was 0.661 in the training set, and 0.626 and 0.601 in the RARECAREnet and Italian multicentric validation sets, respectively. In conclusion, based on the analysis of three 'field-practice' cohorts collected in different settings, we defined and validated a prognostic score to classify patients into three groups with different long-term prognoses

Distribution patterns of ichthyoplankton communities in different ecosystems of the northeast atlantic

Results are presented of an extensive ichthyoplankton survey that covered the continental slope, the offshore banks and oceanic regions west of Ireland. Oceanographic measurements revealed domes of cold, less saline water over the Porcupine, Rockall and Faroese Banks, constituting Taylor columns. The most species-rich stations were those found on and close to the offshore banks and the shelf edge. Larvae found in these areas were mainly from demersal fish species, including some commercial species such as haddock Melanogrammus aeglefinus, lemon sole Microstomus kitt (Walbaum, 1792), ling Molva molva (L.) and witch Glyptocephalus cynoglossus (L.). The deep water stations of the Rockall Trough and the north and west stations off the Rockall and Hatton Banks were characterized by a low number of species and high numbers of individuals of mesopelagic species such as Maurolicus muelleri and Benthosema glaciale. Results from multivariate statistical analysis confirmed that species compositions varied significantly at different sites and were related to environmental conditions, whereby sites of similar temperature, salinity and bottom depth harboured similar species assemblages. Generalized additive mixed modelling was used to model the relationship between species richness and environmental variables and confirmed that there was a significant negative relationship between species richness and bottom depth indicating that the offshore banks and the slope stations present favourable habitats for a large number of species

Distribution patterns of ichthyoplankton communities in different ecosystems of the northeast atlantic

Results are presented of an extensive ichthyoplankton survey that covered the continental slope, the offshore banks and oceanic regions west of Ireland. Oceanographic measurements revealed domes of cold, less saline water over the Porcupine, Rockall and Faroese Banks, constituting Taylor columns. The most species-rich stations were those found on and close to the offshore banks and the shelf edge. Larvae found in these areas were mainly from demersal fish species, including some commercial species such as haddock Melanogrammus aeglefinus, lemon sole Microstomus kitt (Walbaum, 1792), ling Molva molva (L.) and witch Glyptocephalus cynoglossus (L.). The deep water stations of the Rockall Trough and the north and west stations off the Rockall and Hatton Banks were characterized by a low number of species and high numbers of individuals of mesopelagic species such as Maurolicus muelleri and Benthosema glaciale. Results from multivariate statistical analysis confirmed that species compositions varied significantly at different sites and were related to environmental conditions, whereby sites of similar temperature, salinity and bottom depth harboured similar species assemblages. Generalized additive mixed modelling was used to model the relationship between species richness and environmental variables and confirmed that there was a significant negative relationship between species richness and bottom depth indicating that the offshore banks and the slope stations present favourable habitats for a large number of species

Strengthening TB infection prevention and control (IPC) in health care facilities in the Western Cape, South Africa

Commissioned by the Centres for Disease Control, JanuaryIn South Africa, the Department of Health advocates IPC as a pillar for a sound healthcare delivery system. TB-IPC policies are in place although it is difficult to monitor compliance. This project evaluated a training programme for IPC at 8 public healthcare facilities in the WCP. A context specific multi-stage methodology was applied. Following a baseline IPC assessment at 2 hospitals and 6 primary health clinics, a 5-day staff training course was delivered. Impact evaluation of the training was completed 12 months later. There were significant improvements at post-intervention follow-up (n=91) for the following components of IPC: level of knowledge in the use of multi dose vials (p= 0.04) and primed administration sets (p<0.05); health and occupational safety (100% knew their HIV status vs 88% pre-intervention, 31% improvement in handling of sharps and a 16.4% improvement in the use of surgical masks). Monitoring of compliance with IPC policies must be on-going. Cost-effective programmes, including staff training at health facilities as well as regular supervision and evaluation are essential to strengthen IPC and prevent TB transmission