Epidemiology of pancreatic cancer

© The Author(s) 2016. Cancer of the pancreas remains one of the deadliest cancer types. Based on the GLOBOCAN 2012 estimates, pancreatic cancer causes more than 331000 deaths per year, ranking as the seventh leading cause of cancer death in both sexes together. Globally, about 338000 people had pancreatic cancer in 2012, making it the 11th most common cancer. The highest incidence and mortality rates of pancreatic cancer are found in developed countries. Trends for pancreatic cancer incidence and mortality varied considerably in the world. A known cause of pancreatic cancer is tobacco smoking. This risk factor is likely to explain some of the international variations and gender differences. The overall five-year survival rate is about 6% (ranges from 2% to 9%), but this vary very small between developed and developing countries. To date, the causes of pancreatic cancer are still insufficiently known, although certain risk factors have been identified, such as smoking, obesity, genetics, diabetes, diet, inactivity. There are no current screening recommendations for pancreatic cancer, so primary prevention is of utmost importance. A better understanding of the etiology and identifying the risk factors is essential for the primary prevention of this disease

Future Associates: An Overview of the EU-Georgia Association Agreement

This paper provides an overview of some legal aspects of the EU-Georgia Association Agreement (AA) in the system of European Union law as an important foreign policy instrument for the regulation of bilateral relations. It outlines the history and mechanisms of the political and economic cooperation between the European Union and Georgia prior to the conclusion of the Association Agreement. The article also examines the implication of the AA for the process of European integration of Georgia and analyses some legal challenges and results of the implementation process. In addition, the Deep and Comprehensive Free Trade Area (DCFTA), which forms an integral part to the AA, is scrutinized as particularly significant forthe economic integration of Georgia in the EU and for the mutual liberalization of trade

The time-dependent vehicle routing problem

In der Tourenplanung wird meistens angenommen, dass die Reisezeiten während des gesamten Planungshorizonts konstant sind. In der Realität ist es jedoch so, dass es während des Tages zu variablen Reisezeiten kommt. Vor allem im urbanen Bereich führen Staus zu längeren Reisezeiten. Im tageszeitabhängigen Tourenplanungsproblem wird dieser Aspekt berücksichtigt indem man annimmt, dass die Reisezeiten von der Tageszeit abhängen. Die vorliegende Diplomarbeit gibt einen Überblick über die tageszeitabhängige Tourenplanung und präsentiert die Ergebnisse einer experimentellen Studie. Im ersten Teil dieser Arbeit werden das klassische Tourenplanungsproblem und verschiedene Lösungsverfahren vorgestellt. Danach wird das tageszeitabhängige Tourenplanungsproblem beschrieben. Im zweiten Teil wird zunächst ein Algorithmus basierend auf der Tabu Suche entwickelt um das kapazitierte Tourenplanungsproblem zu lösen. Die Lösungen werden dann mit tageszeitabhängigen Szenarien evaluiert, wobei jedes Szenario einen anderen Grad an Zeitabhängigkeit repräsentiert. Es wird gezeigt, dass die Gesamtkosten im Vergleich zu den ursprünglichen Kosten steigen. Desweiteren werden die Tourlängenbeschränkungen von vielen Touren nicht mehr erfüllt. Schließlich wird der ursprüngliche Algorithmus adaptiert um das tageszeitabhängige kapazitierte Tourenplanungsproblem zu lösen. Es wird gezeigt, dass die Gesamtkosten verbessert werden können wenn man tageszeitabhängige Reisezeiten einsetzt. Die Verbesserung ist umso stärker, je höher der Grad an Zeitabhängigkeit. Zusätzlich erfüllen die neuen Lösungen alle Tourlängenbeschränkungen.Most vehicle routing models assume constant travel times throughout the whole planning horizon. In reality, however, travel times vary during the day. This is especially true for urban areas where daily traffic congestion leads to longer travel times. The time-dependent vehicle routing problem (TDVRP) takes this aspect into account by assuming that travel times depend on the time of the day. This diploma thesis gives an overview of the TDVRP and presents the results of an experimental study. The first part introduces the VRP and different solution methods. This is followed by a detailed description of the TDVRP. The second part of the thesis presents an algorithm based on tabu search to solve the capacitated VRP (CVRP). Afterwards, the best solutions of the CVRP are evaluated with five time-dependent scenarios, each representing a different degree of time-dependency. Compared to the original CVRP results, the total costs increase significantly and several routes become infeasible. In the next step, the original algorithm is adapted to solve the TD-CVRP. It is shown that the total costs can be improved when assuming time-dependent travel times. The improvement is higher, the higher the degree of time-dependency. Furthermore, the new solutions satisfy all tour length constraints

STUDENTS’ OPINIONS ABOUT INTEGRATION OF STUDY COURSES

These articles are a result of the bilateral cooperation project ”Assumptions and possibilities of developing innovative models of teaching for accomplishing transparency of university education and for raising competitiveness in national and international knowledge markets”, carried out and financied by the University of Kragujevac, Faculty of Education, Jagodina (Republic of Serbia) and the University of Primorska, Faculty of Education, Koper (Republic of Slovenia), in the period 2017–2019Searching for the possibilities of improving the quality of university education, we noticed that the programs (syllabuses) of study courses contain common and mutually related elements or parts of content which can be successfully integrated. By integrating the content of study courses, university education becomes innovative, modernized and creates a space where the teachers can express their creativity and professional competences. The aim of this research was to determine the opinions of students (N=116) of III and IV year of undergraduate studies at the department Preschool teacher regarding the possibilities of improvement of the quality of university education through the integration of study courses. By analyzing those opinions, we tried to determine the impact of integrative university education on quality, application of knowledge, motivation and self-confidence of students. The research was conducted by applying the descriptive method and surveying procedure. Research results confirm that the opinions of students, when it comes to the impact of integrative education on the understanding of the material, the quality of acquired knowledge and success in exams, their commitment and motivation for studying, self-confidence and preparedness for working with children, are positivePublishe

Variation of vascular ring as a cause of extubation failure

We report on an unexpected extubation failure in a two year old boy. In our patient, failure of extubation led to a diagnostic examination. The result of our examination was discovery of a congenital anomaly of the aortic arch and great vessels (vascular ring) with compression of the trachea. The presence of this anomaly in this patient was unknown to us before. A successful surgical procedure eliminated the underlying cause of the persistent extubation failures

Tuberculosis outbreak in a grammar school, Serbia, 2016

Serbia has a low incidence of tuberculosis (TB), with a decreasing trend in the last decade. The purpose of this manuscript is to describe an outbreak of TB infection that occurred in 2016 among students of a grammar school in Novi Pazar. February and November 2016. A 17-year-old girl, third-grade student of a grammar school (the index case), was diagnosed with smear-positive tuberculosis. Contact investigation was conducted, including chest X-ray examinations of over 1100 persons. After the index case was detected, a total of 16 (10 pulmonary and 6 extrapulmonary) tuberculosis patients were newly diagnosed during 2016. Among 11 culture positive cases, MIRU-VNTR method revealed that all Mycobacterium tuberculosis isolates were identical. Diagnostic delay contributed to the transmission of infection

Application of Sentinel Lymph Node Biopsy in Cutaneous Basosquamous Carcinoma

Basosquamous carcinoma of the skin is a relatively rare cutaneous neoplasm that has significant metastatic potential and a metastatic rate greater than that of basal cell and squamous cell carcinoma. We describe the use of lymphatic mapping and sentinel lymph node biopsy in a 63-year-old man after identification of basosquamous carcinoma. Sentinel lymph node biopsy, which is a standard tool to detect regional lymphatic metastasis in cutaneous melanoma, has been rarely employed to detect lymphatic metastasis of basosquamous carcinoma. The approach was successful in detecting a regional lymphatic metastasis of two nodal basins with minor morbidity. Sentinel lymph node biopsy may be useful for certain high-risk lesions of basosquamous carcinoma

Predictors of unfavourable outcome in aneurysmal subarachnoid haemorrhage

Background. Mortality rates following aneurysmal subarachnoid haemorrhage (aSAH) have decreased due to improvements in diagnoses and the management of complications, as well as early obliteration of the aneurysms. Neurogenic pulmonary oedema (NPO) is a clinical syndrome associated with an acute increase in intracranial pressure and a release of catecholamines into the circulation. This study investigated independent predictors of unfavourable outcomes (Glasgow Outcome Scores 1, 2 or 3) in patients with aSAH. Materials and methods. A total of 262 patients with aSAH (162 females) were included in this prospective study. Clinical characteristics were assessed, and electrocardiographic, serum cardiac and inflammatory biomarker measurements were recorded on admission. Outcomes were assessed three months after admission. Univariate and multivariate analyses of these data were used to predict unfavourable outcomes. Results. A total of 156 patients (59.54%) had unfavourable outcomes. Compared to those who had favourable outcomes, patients with unfavourable outcomes were significantly older (54.37 ± 10.56 vs. 49.13 ± 10.77 years; p < 0.001) and had more severe aSAHs (Hunt and Hess grades ≥ 3: 82.7% vs. 39.6%; p < 0.001). Patients with unfavourable outcomes were more likely to have NPO (10.3% vs. 2.8%; p = 0.023), hydrocephalus (34.0% vs. 20.8%; p = 0.02), and aneurysm reruptures (28.2% vs. 3.8%; p < 0.001).Independent predictors of an unfavourable outcome included Hunt and Hess grades ≥ 3 (odds ratio [OR], 4.291; 95% confidence interval [CI], 2.168–8.491; p < 0.001), increased systolic blood pressure on admission (OR, 1.020; 95% CI, 1.002–1.038; p = 0.03), increased heart rate (HR) on admission (OR, 1.024; 95% CI, 1.001–1.048; p = 0.04), and aneurysm rerupture (OR, 4.961; 95% CI, 1.461–16.845; p = 0.01).Conclusions. These findings suggest that aneurysm reruptures, as well as increased blood pressure and HR, are associated with unfavourable outcomes in patients with aSAH

The Burden of Type 1 and Type 2 Diabetes Among Adolescents and Young Adults in 24 Western European Countries, 1990–2019:Results From the Global Burden of Disease Study 2019

Objectives: As little is known about the burden of type 1 (T1DM) and type 2 diabetes (T2DM) in adolescents in Western Europe (WE), we aimed to explore their epidemiology among 10–24 year-olds. Methods: Estimates were retrieved from the Global Burden of Diseases Study (GBD) 2019. We reported counts, rates per 100,000 population, and percentage changes from 1990 to 2019 for prevalence, incidence and years lived with disability (YLDs) of T1DM and T2DM, and the burden of T2DM in YLDs attributable to high body mass index (HBMI), for 24 WE countries. Results: In 2019, prevalence and disability estimates were higher for T1DM than T2DM among 10–24 years old adolescents in WE. However, T2DM showed a greater increase in prevalence and disability than T1DM in the 30 years observation period in all WE countries. Prevalence increased with age, while only minor differences were observed between sexes. Conclusion: Our findings highlight the substantial burden posed by DM in WE among adolescents. Health system responses are needed for transition services, data collection systems, education, and obesity prevention.</p