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

Exclusive gamma gamma -> mu(+)mu(-) production in proton-proton collisions at root s=7TeV

A measurement of the exclusive two-photon production of muon pairs in proton-proton collisions at root s = 7 TeV, pp -> p mu(+)mu(-) p, is reported using data corresponding to an integrated luminosity of 40 pb-1. For muon pairs with invariant mass greater than 11.5 GeV, transverse momentum p(T)(mu) > 4 GeV and pseudorapidity 1770.1) p mu(+)mu(-) p) - 3.38(-0.55)(+0.58) (stat.)+/- 0.16 (syst.) +/- 0.14 (lumi.) pb, consistent with the theoretical prediction evaluated with the event generator LPAIR. The ratio to the predicted cross section is 0.83+(0.14)(-0.13) (stat.) +/- 0.04 (syst.) +/- 0.03 (lumi.). The characteristic distributions of the muon pairs produced via Ty fusion, such as the muon acoplanarity, the muon pair invariant mass and transverse momentum agree with those from the theory

Exposure therapy for specific phobias in children and adolescents

Among children and adolescents, specific phobia is one of the most common anxiety disorders. Although phobias are usually considered to have a relatively "simple" clinical presentation, they can interfere substantially with daily life for youth. Evidence-based treatments are available for specific phobia in youth. In all evidence-based treatments, exposure is the key working element. This chapter advises clinicians how to setup and carry out exposure treatment for specific phobia with children and adolescents in clinical practice. This chapter offers recommendations on the assessment process, developing and carrying out a treatment plan, involving the family in treatment, maintaining therapeutic improvements and handling challenging issues

Identifying subtypes of trichotillomania (hair pulling disorder) and excoriation (skin picking) disorder using mixture modeling in a multicenter sample

Body-focused repetitive behavior disorders (BFRBs) include Trichotillomania (TTM; Hair pulling disorder) and Excoriation (Skin Picking) Disorder (SPD). These conditions are prevalent, highly heterogeneous, under-researched, and under-treated. In order for progress to be made in optimally classifying and treating these conditions, it is necessary to identify meaningful subtypes. 279 adults (100 with TTM, 81 with SPD, 40 with both TTM and SPD, and 58 controls) were recruited for an international, multi-center between-group comparison using mixture modeling, with stringent correction for multiple comparisons. The main outcome measure was to examine distinct subtypes (aka latent classes) across all study participants using item-level data from gold-standard instruments assessing detailed clinical measures. Mixture models identified 3 subtypes of TTM (entropy 0.98) and 2 subtypes of SPD (entropy 0.99) independent of the control group. Significant differences between these classes were identified on measures of disability, automatic and focused symptoms, perfectionism, trait impulsiveness, and inattention and hyperactivity. These data indicate the existence of three separate subtypes of TTM, and two separate subtypes of SPD, which are distinct from controls. The identified clinical differences between these latent classes may be useful to tailor future treatments by focusing on particular traits. Future work should examine whether these latent subtypes relate to treatment outcomes, or particular psychobiological findings using neuroimaging techniques

Xanthium strumarium L. antimicrobial activity and carboxyatractyloside analysis through electrospray ionization mass spectrometry Atividade antimicrobiana e análise de carboxiatractilosideo por espectrometria de massas com ionização por electrospray de Xanthium strumarium L

The aim of this work was to evaluate the antimicrobial activity of Xanthium strumarium L. leaf extracts against Staphylococcus aureus, Escherichia coli, Salmonella typhimurium, Pseudomonas aeruginosa and Clostridium perfringens, as well as to investigate the presence of the toxic compound carboxyatractyloside in different plant parts. S. aureus and C. perfringens were more sensitive to non-polar than to polar fractions, and there was no difference between extracts for the remaining bacteria. All extracts had strong antimicrobial activity against the evaluated microorganisms. Carboxyatractyloside was found in cotyledons and seeds but not in adult leaves and burrs. Thus, only Xanthium strumarium leaves in adult stage can be used for medicinal purposes.<br>O objetivo do presente trabalho foi avaliar a atividade antimicrobiana de extratos de folhas de Xanthium strumarium L. sobre os microrganismos Staphylococcus aureus, Escherichia coli, Salmonella thyphimurium, Pseudomonas aeruginosa e Clostridium perfringens, bem como verificar a presença do composto tóxico carboxiatractilosideo em diferentes partes da planta. As bactérias S. aureus e C. perfringens foram mais sensíveis às frações não polares do que as polares, sendo que para as outras bactérias não foi verificada diferença entre os extratos. Todos os extratos apresentaram uma forte ação antimicrobiana sobre os microrganismos avaliados. O carboxiatractilosideo foi encontrado nos cotilédones e nas sementes da planta, entretanto, não foi encontrado nas folhas em estádio adulto e na carapaça espinhosa que envolve a semente. Portanto, somente as folhas de Xanthium strumarium na fase adulta podem ser utilizadas para o uso medicinal