19 research outputs found

    The IDENTIFY study: the investigation and detection of urological neoplasia in patients referred with suspected urinary tract cancer - a multicentre observational study

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    Objective To evaluate the contemporary prevalence of urinary tract cancer (bladder cancer, upper tract urothelial cancer [UTUC] and renal cancer) in patients referred to secondary care with haematuria, adjusted for established patient risk markers and geographical variation. Patients and Methods This was an international multicentre prospective observational study. We included patients aged ≄16 years, referred to secondary care with suspected urinary tract cancer. Patients with a known or previous urological malignancy were excluded. We estimated the prevalence of bladder cancer, UTUC, renal cancer and prostate cancer; stratified by age, type of haematuria, sex, and smoking. We used a multivariable mixed-effects logistic regression to adjust cancer prevalence for age, type of haematuria, sex, smoking, hospitals, and countries. Results Of the 11 059 patients assessed for eligibility, 10 896 were included from 110 hospitals across 26 countries. The overall adjusted cancer prevalence (n = 2257) was 28.2% (95% confidence interval [CI] 22.3–34.1), bladder cancer (n = 1951) 24.7% (95% CI 19.1–30.2), UTUC (n = 128) 1.14% (95% CI 0.77–1.52), renal cancer (n = 107) 1.05% (95% CI 0.80–1.29), and prostate cancer (n = 124) 1.75% (95% CI 1.32–2.18). The odds ratios for patient risk markers in the model for all cancers were: age 1.04 (95% CI 1.03–1.05; P < 0.001), visible haematuria 3.47 (95% CI 2.90–4.15; P < 0.001), male sex 1.30 (95% CI 1.14–1.50; P < 0.001), and smoking 2.70 (95% CI 2.30–3.18; P < 0.001). Conclusions A better understanding of cancer prevalence across an international population is required to inform clinical guidelines. We are the first to report urinary tract cancer prevalence across an international population in patients referred to secondary care, adjusted for patient risk markers and geographical variation. Bladder cancer was the most prevalent disease. Visible haematuria was the strongest predictor for urinary tract cancer

    Factors influencing stream baseflow transit times in tropical montane watersheds

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    Stream water mean transit time (MTT) is a fundamental hydrologic parameter that integrates the distribution of sources, flow paths, and storages present in catchments. However, in the tropics little MTT work has been carried out, despite its usefulness for providing important information on watershed functioning at different spatial scales in (largely) ungauged basins. In particular, very few studies have quantified stream MTTs or have related these to catchment characteristics in tropical montane regions. Here we examined topographic, land use/cover and soil hydraulic controls on baseflow transit times for nested catchments (0.1–34 km2) within a humid mountainous region, underlain by volcanic soil (Andisols) in central Veracruz (eastern Mexico). We used a 2-year record of bi-weekly isotopic composition of precipitation and stream baseflow data to estimate MTT. Land use/cover and topographic parameters (catchment area and form, drainage density, slope gradient and length) were derived from geographic information system (GIS) analysis. Soil water retention characteristics, and depth and permeability of the soil–bedrock interface were obtained from intensive field measurements and laboratory analysis. Results showed that baseflow MTTs ranged between 1.2 and 2.7 years across the 12 study catchments. Overall, MTTs across scales were mainly controlled by catchment slope and the permeability observed at the soil–bedrock interface. In association with topography, catchment form and the depth to the soil–bedrock interface were also identified as important features influencing baseflow MTTs. The greatest differences in MTTs were found both within groups of small (0.1–1.5 km2) and large (14–34 km2) catchments. Interestingly, the longest stream MTTs were found in the headwater cloud forest catchments

    Using “isotopic spike” from tropical storm to understand water exchange on large scale: case study of Hurricane Rafael in the Lesser Antilles archipelago, October 2012.

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    International audienceRATIONALE:Studies of wetland eco-hydrology in tropical coastal area are scarce, and the use of water stable isotopes can be of great help. Key constraints for their analysis are (i) the small difference in ÎŽ18 O values between seawater and old evaporated freshwater, and (ii) the fact that the presence of old brackish water limits the determination of the water origin and dynamic.METHODS:The water of tropical storms displays distinctively depleted heavy stable isotopes, in comparison with usual tropical rainfall without strong convective thunderstorms. During tropical storms, such as Hurricane Rafael in mid-October 2012, the rainfall ÎŽ18 O signal can be decreased by many units. This effect is called an "isotopic spike", and it could be used as a temporal marker of the water fluxes.RESULTS:Water samples, with ÎŽ18 O values as low as = -8.9 ‰, were collected in the islands of Guadeloupe and Saint-Martin during Hurricane Rafael, whereas the usual range of groundwater or mean rainfall ÎŽ18 O values is around -2.8 ± 0.5 ‰, as measured from 2009 to 2012. These water "isotopic spikes" allow us to show a surface fresh water uptake by mangrove trees in Guadeloupe, and in Saint-Martin, to calculate the water renewal of the salt ponds and pools.CONCLUSIONS:The "isotopic spikes" generated by tropical storms, are generally used to track back past storm events, as recorded in trees and stalagmites. Here, the propagation of isotopic spike is followed to improve the understanding of the freshwater circulation and the water dynamic within coastal ecosystems influenced by seawater
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