Determination of the historical changes in primary and secondary risk factors for cancer using U.S. public health records

Thesis (Sc. D.)--Massachusetts Institute of Technology, Division of Bioengineering and Environmental Health, 2001.Includes bibliographical references (p. 346-354).Overall cancer mortality rates have risen from about 4% of all deaths in the early 20th century to about 25% of all deaths by the end of the century in the United States. To assess any potential hypotheses for this increase required knowledge of the mortality rate changes specific to each form of cancer, and the time points when these rates had changed. For this purpose, population and cancer mortality data of the U.S. were collected and organized to create age-specific mortality rates for each birth decade from the 1800s forward, delineated by the organ of incidence. Concurrently, cancer survival data were collected so as to correct for any effect of improved treatment on historical changes in cancer mortality rates. To analyze these data, a mathematical model for the three-stage process of carcinogenesis (initiation, promotion, and progression) was developed to estimate for each birth decade cohort the value of the fraction of the cohort at lifetime risk for that cancer, the value of the growth rate of the respective precancerous lesion, and the values for the mutation rates of normal and precancerous cells in the organ of incidence. This methodology permits the analysis of the potential historical effect of new chemical exposures during the last century on cancer mortality rates. These chemical exposures represent potential risk factors that determine the fraction of the population at risk of developing cancer (lifetime, primary risk factor), or that hasten death by cancer by altering either mutation or cell kinetic rates (accelerating, secondary risk factor.)(cont.) COLON CANCER: Application of this model on the colon cancer mortality data resulted in the estimate that 42% of the population in the U.S. was at risk for developing colon cancer, independent of gender or race. More importantly, there was no significant historical change in the calculated fraction at risk for birthyear cohorts from 1860 to 1940, suggesting that the primary risk factors for colon cancer are not environmental. Although direct observation of in vivo mutation rates of colonic cells does not yet exist, the calculated rate for the first initiation mutation in the colon was interestingly found to be similar to the mutation rate observed for the hprt locus in human peripheral T-cells (-2.1 x 10-7 per cell year) and the spontaneous mutation rate of the hprt locus of human B-cells in culture. The estimate for initiation mutation rates increased no more than two-fold from the birthyear cohort of 1860 to the birthyear cohort of 1940, except for European American females for which calculated initiation mutation rates were historically invariant, but since the accuracy of primary data for mortality rates and survival rates cannot be ascertained, the apparent small differences might admittedly arise from unknown biases. Evaluation of the parameter of the growth rate of precancerous lesions showed no significant historical change on this parameter. Curiously, the calculated doubling rate of these lesions (-0.17-0.21) was found to be similar to the growth rate of children, suggesting that the required initiation events have the net effect of potentially reactivating pathways involved in child development.(cont.) The predominant historical change in the observed mortality rates for colon cancer occurred only at old ages. ...by Pablo Herrero Jimenez.Sc.D

Effectiveness of cognitive stimulation personalized by the preexisting cognitive level in older adults: a randomized clinical trial

This randomized clinical trial analyzed whether a personalized cognitive stimulation based on the individual''s preexisting cognitive levels may be more effective in the short and long terms than a standard cognitive stimulation program. In total, 288 older adults were randomized into an intervention group and a control group, stratified according to their cognitive levels. There were significant differences between groups, with a small effect size at postintervention (10 weeks), follow-up I (26 weeks), and follow-up II (52 weeks) (P < .001, 0.2 <r < 0.4) and in the cognitive category (P < .001). The personalization of cognitive stimulation is effective to maintain normal cognitive functioning and to delay cognitive decline

The discourse on COVID-19: a study in the Italian, Spanish and German press

Esta investigación analiza los artículos de opinión referidos a la COVID-19 publicados en los principales periódicos de Italia, España y Alemania. Para ello se ha empleado una metodología de análisis de contenido inductivo-deductivo de corte cualitativo a través de dos fases complementarias. Una primera, mediante el examen pormenorizado de la muestra y una segunda en la que se ha seguido un método de análisis textual comparado mediante el uso del software Sketch Engine. Los resultados muestran que existen unos temas comunes sobre el virus, aunque con enfoques diferentes según los países: una visión marcada por la política nacional en el caso español, más interpretativa en el caso alemán y más social-humanística en el italiano. Así, en los tres países estudiados un discurso contrario a generar pánico, pero con una clara subestimación del virus en sus primeros meses de aparición en el caso de la prensa de España e Italia.This research analyses the opinion articles about the COVID-19 published in the main newspapers of Italy, Spain and Germany. To this purpose, a qualitative inductive-deductive content analysis methodology has been used along two complementary phases. The first included the detailed analysis of the sample, and the second involved a method of comparative textual analysis using the Sketch Engine software. The results show the existence of some common issues about the virus, although with different approaches depending on the country: a certain vision marked by national politics in the Spanish case, an interpretative view in the case of Germany and a more social-humanistic perspective in the Italian dailies. A discourse contrary to generating panic is common in the three countries studied, but with a clear underestimation of the virus’ potential consequences in the first couple of months after the outbreak in Wuhan as regards the Spanish and Italian press

Recent advances on dendrogeomorphological research applied to flood hazard analysis in Spain.

Estudios dendroecológicos para el análisis de regímentes torrenciales y avenida

Flood Hazard Analysis in the ”Caldera de Taburiente” National Park (La Palma, Canary Islands, Spain) using Dendrogeomorphology

Aplicación de técnicas dendroecológicas para el estudio de avenidas torrenciales

Angiocrine polyamine production regulates adiposity.

Reciprocal interactions between endothelial cells (ECs) and adipocytes are fundamental to maintain white adipose tissue (WAT) homeostasis, as illustrated by the activation of angiogenesis upon WAT expansion, a process that is impaired in obesity. However, the molecular mechanisms underlying the crosstalk between ECs and adipocytes remain poorly understood. Here, we show that local production of polyamines in ECs stimulates adipocyte lipolysis and regulates WAT homeostasis in mice. We promote enhanced cell-autonomous angiogenesis by deleting Pten in the murine endothelium. Endothelial Pten loss leads to a WAT-selective phenotype, characterized by reduced body weight and adiposity in pathophysiological conditions. This phenotype stems from enhanced fatty acid β-oxidation in ECs concomitant with a paracrine lipolytic action on adipocytes, accounting for reduced adiposity. Combined analysis of murine models, isolated ECs and human specimens reveals that WAT lipolysis is mediated by mTORC1-dependent production of polyamines by ECs. Our results indicate that angiocrine metabolic signals are important for WAT homeostasis and organismal metabolism.We thank members of the Endothelial Pathobiology and Microenvironment Group for helpful discussions. We thank the CERCA Program/Generalitat de Catalunya and the Josep Carreras Foundation for institutional support. The research leading to these results has received funding from la Fundación BBVA (Ayuda Fundacion BBVA a Equipos de Investigación Científica 2019, PR19BIOMET0061) and from SAF2017-82072-ERC from Ministerio de Ciencia, Innovación y Universidades (MCIU) (Spain). The laboratory of M.G. is also supported by the research grants SAF2017-89116R-P (FEDER/EU) co-funded by European Regional Developmental Fund (ERDF), a Way to Build Europe and PID2020-116184RB-I00 from MCEI; by the Catalan Government through the project 2017-SGR; PTEN Research Foundation (BRR-17-001); La Caixa Foundation (HR19-00120 and HR21-00046); by la Asociación Española contra el Cancer-Grupos Traslacionales (GCTRA18006CARR, also to A.C.); European Foundation for the Study of Diabetes/Lilly research grant, also to M.C.); and by the People Programme (Marie Curie Actions; grant agreement 317250) of the European Union’s Seventh Framework Programme FP7/2007-2013 and the Marie Skłodowska-Curie (grant agreement 675392) of the European Union’s Horizon 2020 research. The laboratory of A.C. is supported by the Basque Department of Industry, Tourism and Trade (Elkartek) and the department of education (IKERTALDE IT1106-16), the MCIU (PID2019-108787RB-I00 (FEDER/ EU); Severo Ochoa Excellence Accreditation SEV-2016-0644; Excellence Networks SAF2016-81975-REDT), La Caixa Foundation (ID 100010434), under the agreement LCF/PR/HR17, the Vencer el Cancer foundation and the European Research Council (ERC) (consolidator grant 819242). CIBERONC was co-funded with FEDER funds and funded by Instituto de Salud Carlos III (ISCIII). The laboratory of M.C. is supported by the ERC under the European Union’s Horizon 2020 research and innovation programme (grant agreement 725004) and CERCA Programme/Generalitat de Catalunya (M.C.). The laboratory of D.S. is supported by research grants from MINECO (SAF2017- 83813-C3-1-R, also to L.H., cofounded by the ERDF), CIBEROBN (CB06/03/0001), Government of Catalonia (2017SGR278) and Fundació La Marató de TV3 (201627- 30). The laboratory of R.N. is supported by FEDER/Ministerio de Ciencia, Innovación y Universidades-Agencia Estatal de Investigación (RTI2018-099413-B-I00 and and RED2018-102379-T), Xunta de Galicia (2016-PG057 and 2020-PG015), ERC under the European Union’s Horizon 2020 research and innovation programme (grant agreement 810331), Fundación BBVA, Fundacion Atresmedia and CIBEROBN, which is an initiative of the ISCIII of Spain, which is supported by FEDER funds. The laboratory of J.A.V. is supported by research grants from MICINN (RTI2018-099250-B100) and by La Caixa Foundation (ID 100010434, LCF/PR/HR17/52150009). P.M.G.-R. is supported by ISCIII grant PI15/00701 cofinanced by the ERDF, A Way to Build Europe. Personal support was from Marie Curie ITN Actions (E.M.), Juan de la Cierva (IJCI-2015-23455, P.V.), CONICYT fellowship from Chile (S.Z.), Vetenskapsradet (Swedish Research Council, 2018-06591, L.G.) and NCI K99/R00 Pathway to Independence Award (K99CA245122, P. Castel).S

Socio-Demographic Health Determinants Are Associated with Poor Prognosis in Spanish Patients Hospitalized with COVID-19

Introduction Social vulnerability is a known determinant of health in respiratory diseases. Our aim was to identify whether there are socio-demographic factors among COVID-19 patients hospitalized in Spain and their potential impact on health outcomes during the hospitalization. Methods A multicentric retrospective case series study based on administrative databases that included all COVID-19 cases admitted in 19 Spanish hospitals from 1 March to 15 April 2020. Socio-demographic data were collected. Outcomes were critical care admission and in-hospital mortality. Results We included 10,110 COVID-19 patients admitted to 18 Spanish hospitals (median age 68 (IQR 54–80) years old; 44.5% female; 14.8% were not born in Spain). Among these, 779 (7.7%) cases were admitted to critical care units and 1678 (16.6%) patients died during the hospitalization. Age, male gender, being immigrant, and low hospital saturation were independently associated with being admitted to an intensive care unit. Age, male gender, being immigrant, percentile of average per capita income, and hospital experience were independently associated with in-hospital mortality. Conclusions Social determinants such as residence in low-income areas and being born in Latin American countries were associated with increased odds of being admitted to an intensive care unit and of in-hospital mortality. There was considerable variation in outcomes between different Spanish centers.JPA is under contract within the Ramón y Cajal Program (RYC-2016-20155, Ministerio de Economía, Industria y Competitividad, Spain). Investigators of Spanish Social-Environmental COVID-19 Register: Steering Committee: F. Javier Martín-Sánchez, Adrián Valls Carbó, Carmen Martínez Valero, Juan de D. Miranda, Juan Pedro Arrebola, Marta Esteban López, Annika Parviainen, Òscar Miró, Pere Llorens, Sònia Jiménez, Pascual Piñera, Guillermo Burillo, Alfonso Martín, Jorge García Lamberechts, Javier Jacob, Aitor Alquézar, Juan González del Castillo, Amanda López Picado and Iván Núñez. Participating centers: Oscar Miró y Sonia Jimenez. Hospital Clinic de Barcelona. José María Ferreras Amez. Hospital Clínico Universitario Lozano Blesa. Rafael Rubio Díaz. Complejo Hospitalario de Toledo. Julio Javier Gamazo del Rio. Hospital Universitario de Galdakao. Héctor Alonso. Hospital Universitario Miguel de Valdecilla. Pablo Herrero. Hospital Universitario Central de Asturias. Noemí Ruiz de Lobera. Hospital San Pedro de Logroño. Carlos Ibero. Complejo Hospitalario de Navarra. Plácido Mayan. Hospital Clínico Universitario de Santiago. Rosario Peinado. Complejo Hospitalario Universitario de Badajoz. Carmen Navarro Bustos. Hospital Universitario Virgen de la Macarena. Jesús Álvarez Manzanares. Hospital Universitario Rio Hortega. Francisco Román. Hospital Universitario General de Alicante. Pascual Piñera. Hospital Universitario Reina Sofia de Murcia. Guillermo Burillo. Hospital Universitario de Canarias de Tenerife. Javier Jacob. Hospital Universitario de Bellvitge. Carlos Bibiano. Hospital Universitario Infanta Leonor.Peer reviewe

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks