Trends and risk factors of cutaneous melanoma in Europe

This thesis presents studies on different aspects of the epidemiology of melanoma: variations in disease frequency in time and place, determinants of melanoma incidence and variation in prognostic factor

IMPACT STRENGTH OF 3D-PRINTED POLYCARBONATE

A vertical wall printed by Fused Filament Fabrication consists of a ribbed surface profile, due to the layer wise deposition of molten plastic. The notches between the printed layers act as stress concentrators and decrease its resistance to impact. This article shows the relation between impact strength and layer height by experimental data and finite element simulations of the stress intensity factor and the plastic zone near the tip of the notch. The impact resistance increased from 6 to 32 kJ/m2, when the layer height was decreased from 1.8 to 0.2 mm. When notches were removed by sanding, the samples did not fail any more during impact testing, resembling the behavior of smooth molded test bars. Tensile strength values up to 61 MPa were measured independent of layer height. Birefringence measurements were done to determine the actual stress levels, which ranged from 2 to 5 MPa

Immuundeficiëntie bij kinderen en de rol van de arts-microbioloog

Met name jonge kinderen hebben vaak (luchtweg)infecties, meestal zelflimiterend. Wanneer is dit ‘niet meer normaal’? Kennis over het normale patroon van infecties en verwekkers, gerelateerd aan de leeftijd, is daarbij behulpzaam. Daarbij kan een arts-microbioloog een belangrijke rol spelen. Een voldragen kind heeft een volledig maar onrijp immuunsysteem. Vandaar dehogere infectiefrequentie bij jonge kinderen. Bij primaire immuundeficiëntie (PID) faalt het immuunsysteem intrinsiek. De ‘typische’ PID-patiënt heeft te veel, te ernstige, te therapieresistente infecties. Ook auto-immuniteit en maligniteit kunnen aanwezig zijn of zelfs op de voorgrond staan. Antistofdeficiënties komen het meeste voor; iedere arts microbioloog komt deze patiënten tegen. Ook worden bij kinderen toenemend biologicals gebruikt, waarbij ernstigeinfecties vaker voorkomen; ook minder ernstige infecties kunnen vaker optreden en voor het kind toch een grote belasting zijn. Er is weinig bekend over het effect van biologicals op het microbioom, zeker bij kinderen, er zijn wel aanwijzingen dat biologicals veranderingen in het microbioom induceren, wat weer zou kunnen bijdragen aan het vaker optreden van infecties

Planning is for doing: implementation intentions go beyond the mere creation of goal-directed associations

Studies on implementation intentions so far have mainly pointed towards strengthened cue-behavior associations as the mechanism underlying the effectiveness of this self-regulatory tool. However, we propose that because it triggers people to look into the future and to mentally simulate their future behavior, planning by means of implementation intentions might go beyond the creation of goal-directed associations and thus lead to more enduring effects on behavior. We tested this hypothesis in an experiment using a longitudinal design, where participants formed an intention for a behavior that deviates from their routine, and furnished it either with associative learning of cue and behavior, forming implementation intentions, or nothing at all. Results showed that initially, learning cue-behavior associations led to the same rate of goal completion as forming implementation intentions. However, only the effect of implementation intentions was maintained at the second measurement one week later. These findings suggest that planning does more than merely create goal-directed associations, which might offer a new perspective on the workings and use of this important tool for behavior change

Migration and cancer mortality among Colombian migrants in the USA: a death certification study

Este estudo teve como objetivo comparar padrões de mortalidade por câncer entre os imigrantes colombianos nos EUA e colombianos em sua terra natal. Dados de 2008 a 2012 foram coletados, e foram calculadas taxas de mortalidade por câncer de colombianos residindo em seu país natal e colombianos residindo em Califórnia, Flórida e Nova York, bem como taxas específicas de mortalidade por idade e sexo por cada 100.000 pessoas. Para comparar as duas populações, tanto antes como após a correção pela escolaridade, as razões de taxas de mortalidade (MRR) foram estimadas por modelo de regressão binomial negativa. Foi descoberto que colombianos em sua terra natal apresentam taxas de mortalidade por câncer mais altas quando comparados aos que residem nos EUA (MRR masculino 1,4 (IC 95%: 1,2-1,5), MRR feminino 1,5 (IC 95%: 1,3-1,7)). Essas diferenças persistem para a maioria dos tipos de câncer, mesmo após correção pela escolaridade. Os colombianos em sua terra natal apresentaram taxa de mortalidade por câncer gástrico (MRR masculino 2,6; feminino 2,8) e cervical (MRR 5,0) significativamente mais alta em comparação com os que residem nos EUA. As desigualdades educacionais na mortalidade por câncer foram mais acentuadas para aqueles que moram em sua terra natal. A menor taxa de mortalidade por câncer observada entre os colombianos nos EUA, porém, não pode ser atribuída às diferenças de escolaridade, um indicador de status socioeconômico. Em vez disso, provavelmente ocorre devido à maior acessibilidade aos serviços de saúde preventivos e curativos nos EUA.We aim to compare cancer mortality rates of USA Colombian migrants (USA Colombians) to Colombians in their country of origin (CO Colombians). Using Colombian national mortality data and data on cancer deaths among Colombians residing in the states of California, Florida, and New York (USA Colombians) for the period 2008-2012, we estimated sex-specific and age-standardized mortality rates (ASMR), expressed per 100,000 persons. For comparisons between the two populations before and after adjustment for educational level, negative binomial regression models were used to compute Mortality Rate Ratios (MRR). CO Colombians had higher cancer mortality rates compared with USA Colombians (male MRR 1.4 [95%CI: 1.2-1.5], female MRR 1.5 [95%CI: 1.3-1.7]). These differences persisted for most cancers even after adjustment for education. CO Colombians had significantly higher mortality from gastric (MRR 2.6 in males and 2.8 in females) and cervical cancer (MRR 5.0) compared with US Colombians. Educational inequalities in cancer mortality were more pronounced among CO Colombians than among USA Colombians. Lower cancer mortality observed among USA Colombians cannot be attributed to differences in education, an indicator of socio-economic status. Rather, it is likely due to better access to preventive and curative healthcare in the USA