Global surveillance of cancer survival 1995-2009: analysis of individual data for 25,676,887 patients from 279 population-based registries in 67 countries (CONCORD-2)

BACKGROUND: Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control. METHODS: Individual tumour records were submitted by 279 population-based cancer registries in 67 countries for 25·7 million adults (age 15-99 years) and 75,000 children (age 0-14 years) diagnosed with cancer during 1995-2009 and followed up to Dec 31, 2009, or later. We looked at cancers of the stomach, colon, rectum, liver, lung, breast (women), cervix, ovary, and prostate in adults, and adult and childhood leukaemia. Standardised quality control procedures were applied; errors were corrected by the registry concerned. We estimated 5-year net survival, adjusted for background mortality in every country or region by age (single year), sex, and calendar year, and by race or ethnic origin in some countries. Estimates were age-standardised with the International Cancer Survival Standard weights. FINDINGS: 5-year survival from colon, rectal, and breast cancers has increased steadily in most developed countries. For patients diagnosed during 2005-09, survival for colon and rectal cancer reached 60% or more in 22 countries around the world; for breast cancer, 5-year survival rose to 85% or higher in 17 countries worldwide. Liver and lung cancer remain lethal in all nations: for both cancers, 5-year survival is below 20% everywhere in Europe, in the range 15-19% in North America, and as low as 7-9% in Mongolia and Thailand. Striking rises in 5-year survival from prostate cancer have occurred in many countries: survival rose by 10-20% between 1995-99 and 2005-09 in 22 countries in South America, Asia, and Europe, but survival still varies widely around the world, from less than 60% in Bulgaria and Thailand to 95% or more in Brazil, Puerto Rico, and the USA. For cervical cancer, national estimates of 5-year survival range from less than 50% to more than 70%; regional variations are much wider, and improvements between 1995-99 and 2005-09 have generally been slight. For women diagnosed with ovarian cancer in 2005-09, 5-year survival was 40% or higher only in Ecuador, the USA, and 17 countries in Asia and Europe. 5-year survival for stomach cancer in 2005-09 was high (54-58%) in Japan and South Korea, compared with less than 40% in other countries. By contrast, 5-year survival from adult leukaemia in Japan and South Korea (18-23%) is lower than in most other countries. 5-year survival from childhood acute lymphoblastic leukaemia is less than 60% in several countries, but as high as 90% in Canada and four European countries, which suggests major deficiencies in the management of a largely curable disease. INTERPRETATION: International comparison of survival trends reveals very wide differences that are likely to be attributable to differences in access to early diagnosis and optimum treatment. Continuous worldwide surveillance of cancer survival should become an indispensable source of information for cancer patients and researchers and a stimulus for politicians to improve health policy and health-care systems

Lack of reciprocity in drug and light dose dependence of photodynamic therapy of pancreatic adenocarcinoma in vitro

Two human pancreatic cell lines, MIA PaCa 2 and Capan 2, were treated by photodynamic therapy in vitro with Photophrin (0.01-25 micrograms/ml; 24 h) and then light (1-50 J/cm2; lambda = 630 nm). The following model was fit to 6 datasets with weighted nonlinear regression: [sequence: see text] The symbols are: E, cell growth; Econ, control growth in the absence of the combination; B, background signal; m, slope parameter; gamma, interaction parameter; D, concentration of Photofrin; L, light dose; F, fraction of Photofrin not photobleached by the light dose; k, k1, k2, bleaching parameters; A, distribution parameter for biexponential bleaching equation. Simple reciprocity of photosensitizer concentration and light dose was not found; compensation for photobleaching was critical. MIA PaCa2 required the monoexponential bleaching factor, whereas Capan 2 required the biexponential bleaching factor. The greater photosensitivity of MIA PaCa2 over Capan 2 can be best explained not by differences in the interaction parameter but rather by differences in the photobleaching pattern and rate. It may be possible to further enhance the selectivity of photodynamic therapy if differences in photobleaching between different cell types can be exploited by adequate dosimetry

Phototoxic action of light emitting diode in the in vitro viability of Trichophyton rubrum Ação fototóxica do diodo emissor de luz na viabilidade de Trichophyton rubrum in vitro

BACKGROUND: Trichophyton rubrum is the most common agent of superficial mycosis of the skin and nails causing long lasting infections and high recurrence rates. Current treatment drawbacks involve topical medications not being able to reach the nail bed at therapeutic concentrations, systemic antifungal drugs failing to eradicate the fungus before the nails are renewed, severe side effects and selection of resistant fungal isolates. Photodynamic therapy (PDT) has been a promising alternative to conventional treatments. OBJECTIVES: This study evaluated the in vitro effectiveness of toluidine blue O (TBO) irradiated by Light emitting diode (LED) in the reduction of T. rubrum viability. METHODS: The fungal inoculums' was prepared and exposed to different TBO concentrations and energy densities of Light emitting diode for evaluate the T. rubrum sensibility to PDT and production effect fungicidal after photodynamic treatment. In addition, the profiles of the area and volume of the irradiated fungal suspensions were also investigated. RESULTS: A small reduction, in vitro, of fungal cells was observed after exposition to 100 µM toluidine blue O irradiated by 18 J/cm² Light emitting diode. Fungicidal effect occurred after 25 µM toluidine blue O irradiation by Light emitting diode with energy density of 72 J/cm². The analysis showed that the area and volume irradiated by the Light emitting diode were 52.2 mm² and 413.70 mm³, respectively. CONCLUSION: The results allowed to conclude that Photodynamic therapy using Light emitting diode under these experimental conditions is a possible alternative approach to inhibit in vitro T. rubrum and may be a promising new treatment for dermatophytosis caused by this fungus.<br>FUNDAMENTOS: Trichophyton rubrum é o agente mais comum das micoses superficiais de pele e unhas causando infecções de longa duração e altas taxas de recidiva. As desvantagens do tratamento atual envolvem medicações tópicas as quais não são capazes de alcançar o leito ungueal em concentrações terapêuticas, antifúngicos sistêmicos que não erradicam o fungo antes das unhas serem renovadas, efeitos colaterais graves e seleção de isolados fúngicos resistentes. A terapia fotodinâmica tem sido uma alternativa promissora aos tratamentos convencionais. OBJETIVOS: Este estudo avaliou a eficácia, in vitro, de azul de orto-toluidina irradiado por diodo emissor de luz na redução da viabilidade de T. rubrum. MÉTODOS: O inóculo fúngico foi preparado e exposto a diferentes concentrações de azul de orto-toluidina e densidades de energia do diodo emissor de luz, para avaliar a sensibilidade de T. rubrum e o efeito fungicida, após terapia fotodinâmica. Além disso, os perfis da área e volume das suspensões fúngicas irradiados também foram investigados. RESULTADOS: Uma pequena redução, in vitro, de células fúngicas foi observada após a exposição a 100 mM azul de orto-toluidina irradiados por diodo emissor de luz a 18 J/cm². Efeito fungicida ocorreu após irradiação 25 µM orto-toluidina por diodo emissor de luz com densidade de energia de 72 J/cm². A análise mostrou que a área e o volume irradiados pelo diodo emissor de luz foram 52,2 mm² e 413,70 mm³, respectivamente. CONCLUSÕES: Os resultados permitiram concluir que a terapia fotodinâmica com diodo emissor de luz, nas condições experimentais é uma abordagem alternativa para inibir, in vitro, T. rubrum e pode ser um tratamento promissor para as dermatofitoses causadas por este fungo

Multi-messenger characterization of Mrk 501 during historically low X-ray and γ\gamma-ray activity

We study the broadband emission of the TeV blazar Mrk501 using multi-wavelength (MWL) observations from 2017 to 2020 performed with a multitude of instruments, involving, among others, MAGIC, Fermi-LAT, NuSTAR, Swift, GASP-WEBT, and OVRO. During this period, Mrk501 showed an extremely low broadband activity, which may help to unravel its baseline emission. Despite the low activity, significant flux variations are detected at all wavebands, with the highest variations occurring at X-rays and VHE $\gamma$-rays. A significant correlation (>3$\sigma$) between X-rays and VHE $\gamma$-rays is measured, supporting leptonic scenarios to explain the variable parts of the spectral energy distribution (SED), also during low activity states. Extending our data set to 12-years (from 2008 to 2020), we find significant correlations between X-rays and HE $\gamma$-rays, indicating, for the first time, a common physical origin driving the variability between these two bands. We additionally find a correlation between HE $\gamma$-rays and radio, with the radio emission lagging the HE $\gamma$-ray emission by more than 100 days. This is consistent with the $\gamma$-ray emission zone being located upstream of the radio-bright regions of the Mrk501 jet. Furthermore, Mrk501 showed a historically low activity in both X-rays and VHE $\gamma$-rays from mid-2017 to mid-2019 with a stable VHE flux (>2TeV) of 5% the emission of the Crab Nebula. The broadband SED of this 2-year long low-state, the potential baseline emission of Mrk501, can be adequately characterized with a one-zone leptonic model, and with (lepto)-hadronic models that fulfill the neutrino flux constraints from IceCube. We explore the time evolution of the SED towards the historically low-state, revealing that the stable baseline emission may be ascribed to a standing shock, and the variable emission to an additional expanding or traveling shock

Multi-messenger characterization of Mrk 501 during historically low X-ray and γ\gamma-ray activity

International audienceWe study the broadband emission of the TeV blazar Mrk501 using multi-wavelength (MWL) observations from 2017 to 2020 performed with a multitude of instruments, involving, among others, MAGIC, Fermi-LAT, NuSTAR, Swift, GASP-WEBT, and OVRO. During this period, Mrk501 showed an extremely low broadband activity, which may help to unravel its baseline emission. Despite the low activity, significant flux variations are detected at all wavebands, with the highest variations occurring at X-rays and VHE $\gamma$-rays. A significant correlation (>3$\sigma$) between X-rays and VHE $\gamma$-rays is measured, supporting leptonic scenarios to explain the variable parts of the spectral energy distribution (SED), also during low activity states. Extending our data set to 12-years (from 2008 to 2020), we find significant correlations between X-rays and HE $\gamma$-rays, indicating, for the first time, a common physical origin driving the variability between these two bands. We additionally find a correlation between HE $\gamma$-rays and radio, with the radio emission lagging the HE $\gamma$-ray emission by more than 100 days. This is consistent with the $\gamma$-ray emission zone being located upstream of the radio-bright regions of the Mrk501 jet. Furthermore, Mrk501 showed a historically low activity in both X-rays and VHE $\gamma$-rays from mid-2017 to mid-2019 with a stable VHE flux (>2TeV) of 5% the emission of the Crab Nebula. The broadband SED of this 2-year long low-state, the potential baseline emission of Mrk501, can be adequately characterized with a one-zone leptonic model, and with (lepto)-hadronic models that fulfill the neutrino flux constraints from IceCube. We explore the time evolution of the SED towards the historically low-state, revealing that the stable baseline emission may be ascribed to a standing shock, and the variable emission to an additional expanding or traveling shock

Necrotroph Attacks on Plants: Wanton Destruction or Covert Extortion?

Necrotrophic pathogens cause major pre- and post-harvest diseases in numerous agronomic and horticultural crops inflicting significant economic losses. In contrast to biotrophs, obligate plant parasites that infect and feed on living cells, necrotrophs promote the destruction of host cells to feed on their contents. This difference underpins the divergent pathogenesis strategies and plant immune responses to biotrophic and necrotrophic infections. This chapter focuses on Arabidopsis immunity to necrotrophic pathogens. The strategies of infection, virulence and suppression of host defenses recruited by necrotrophs and the variation in host resistance mechanisms are highlighted. The multiplicity of intraspecific virulence factors and species diversity in necrotrophic organisms corresponds to variations in host resistance strategies. Resistance to host-specific necrotophs is monogenic whereas defense against broad host necrotrophs is complex, requiring the involvement of many genes and pathways for full resistance. Mechanisms and components of immunity such as the role of plant hormones, secondary metabolites, and pathogenesis proteins are presented. We will discuss the current state of knowledge of Arabidopsis immune responses to necrotrophic pathogens, the interactions of these responses with other defense pathways, and contemplate on the directions of future research