Consumer Law and Policy Relating to Change of Circumstances Due to the COVID-19 Pandemic

An unprecedented number of consumer problems has been caused by the COVID-19 pandemic, not least with regard to refunds of prepayments and the ability of consumers to keep up their monthly payments under loan and rental agreements. Based on a notion of societal force majeure sketched in this paper, we propose guiding principles in respect of the introduction of moratoria on recurring payments, the use of refunds or vouchers in respect of prepayments, and associated enforcement challenges. This analysis draws on experiences around the globe.Non peer reviewe

Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000–2014 (CONCORD-3)

Background: Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology. Methods: We analyzed individual data for adults (15–99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000–2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator. Results: The study included 556,237 adults. In 2010–2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%–38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000–2004 and 2005–2009. These improvements were more noticeable among adults diagnosed aged 40–70 years than among younger adults. Conclusions: To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines

Worldwide trends in population-based survival for children, adolescents, and young adults diagnosed with leukaemia, by subtype, during 2000–14 (CONCORD-3) : analysis of individual data from 258 cancer registries in 61 countries

Background Leukaemias comprise a heterogenous group of haematological malignancies. In CONCORD-3, we analysed data for children (aged 0–14 years) and adults (aged 15–99 years) diagnosed with a haematological malignancy during 2000–14 in 61 countries. Here, we aimed to examine worldwide trends in survival from leukaemia, by age and morphology, in young patients (aged 0–24 years). Methods We analysed data from 258 population-based cancer registries in 61 countries participating in CONCORD-3 that submitted data on patients diagnosed with leukaemia. We grouped patients by age as children (0–14 years), adolescents (15–19 years), and young adults (20–24 years). We categorised leukaemia subtypes according to the International Classification of Childhood Cancer (ICCC-3), updated with International Classification of Diseases for Oncology, third edition (ICD-O-3) codes. We estimated 5-year net survival by age and morphology, with 95% CIs, using the non-parametric Pohar-Perme estimator. To control for background mortality, we used life tables by country or region, single year of age, single calendar year and sex, and, where possible, by race or ethnicity. All-age survival estimates were standardised to the marginal distribution of young people with leukaemia included in the analysis. Findings 164563 young people were included in this analysis: 121328 (73·7%) children, 22963 (14·0%) adolescents, and 20272 (12·3%) young adults. In 2010–14, the most common subtypes were lymphoid leukaemia (28205 [68·2%] patients) and acute myeloid leukaemia (7863 [19·0%] patients). Age-standardised 5-year net survival in children, adolescents, and young adults for all leukaemias combined during 2010–14 varied widely, ranging from 46% in Mexico to more than 85% in Canada, Cyprus, Belgium, Denmark, Finland, and Australia. Individuals with lymphoid leukaemia had better age-standardised survival (from 43% in Ecuador to ≥80% in parts of Europe, North America, Oceania, and Asia) than those with acute myeloid leukaemia (from 32% in Peru to ≥70% in most high-income countries in Europe, North America, and Oceania). Throughout 2000–14, survival from all leukaemias combined remained consistently higher for children than adolescents and young adults, and minimal improvement was seen for adolescents and young adults in most countries. Interpretation This study offers the first worldwide picture of population-based survival from leukaemia in children, adolescents, and young adults. Adolescents and young adults diagnosed with leukaemia continue to have lower survival than children. Trends in survival from leukaemia for adolescents and young adults are important indicators of the quality of cancer management in this age group.peer-reviewe

Perancangan Interior Pusat Seni Rupa Murni Di Surabaya

Art is an aspect that cannot be separated from human life, but the state of the arts in the city of Surabaya is so undeveloped that public interest in the arts tend to be low, especially in visual art. Seeing the state of visual art in Surabaya that is not accommodated, and thus it needs a facility that can fulfill those needs which encompasses the functions of exhibition, education, recreation, and information.In this design process the problems are how to design the interior of visual art center that not only accommodate the needs of the arts in the city of Surabaya, but also attract visitors in accordance with the lifestyle of the metropolitan youth nowadays.The method used in this design follows the diagram Zeisel with additional adjustments of the drafting process, which explains the design process that rotates from the end result that can be returned to the initial stages of design to be fixed in order to achieve the most optimal results. Six of these methods include basic eb knowledge (preliminary stages of data collection), programming research (programming phase), design and design review (transformation stage design), construction (design development stage), use + adaptation (the final design stage), and evaluation research (evaluation phase).The final design is applied in the concept of \u27recreational\u27, and accommodate the needs of visual art in Surabaya by providing facilities such as spaces for education, information, exhibitions, and recreational which are exhibition area, library, lecture theater and studio, as well as supporting spaces such as cafes and offices. Meanwhile, in order to attract visitors in accordance with the lifestyle and culture of the people, the concept of \u27recreation\u27 is applied by creating new experiences and improving the quality of those experiences

The strain-generated electrical potential in cartilaginous tissues: a role for piezoelectricity

The strain-generated potential (SGP) is a well-established mechanism in cartilaginous tissues whereby mechanical forces generate electrical potentials. In articular cartilage (AC) and the intervertebral disc (IVD), studies on the SGP have focused on fluidand ionic-driven effects, namely Donnan, diffusion and streaming potentials. However, recent evidence has indicated a direct coupling between strain and electrical potential. Piezoelectricity is one such mechanism whereby deformation of most biological structures, like collagen, can directly generate an electrical potential. In this review, the SGP in AC and the IVD will be revisited in light of piezoelectricity and mechanotransduction. While the evidence base for physiologically significant piezoelectric responses in tissue is lacking, difficulties in quantifying the physiological response and imperfect measurement techniques may have underestimated the property. Hindering our understanding of the SGP further, numerical models to-date have negated ferroelectric effects in the SGP and have utilised classic Donnan theory that, as evidence argues, may be oversimplified. Moreover, changes in the SGP with degeneration due to an altered extracellular matrix (ECM) indicate that the significance of ionic-driven mechanisms may diminish relative to the piezoelectric response. The SGP, and these mechanisms behind it, are finally discussed in relation to the cell response

Piezoelectricity in the intervertebral disc

Lower back pain is a major global health challenge that can often be caused by degeneration of the Intervertebral Disc (IVD). While IVD biomechanics are a key factor in the degenerative cycle, many mechanotransduction pathways remain unknown, in particular the electro-mechanical coupling in the loaded tissue. However, despite evidence for a role in the mechanically-induced remodelling of similar tissue, piezoelectricity has been overlooked in the IVD. In this study, we investigate the piezoelectric properties of the Annulus Fibrosus (AF) and the Nucleus Pulposus (NP) by measuring the direct piezoelectric effect of mechanically-induced electrical potential change. To verify these findings, we conducted Piezoresponse Force Microscopy (PFM) to measure the inverse effect of electrically-induced deformation. We demonstrate that, for the first time, piezoelectricity is generated throughout the IVD. Piezoelectric effects were greater in the AF than the NP, owing to the organised collagen networks present. However, the piezoresponse found in the NP indicates piezoelectric properties of non-collagenous proteins that have not yet been studied. The voltage generated by longitudinal piezoelectricity in-vivo has been calculated to be ~1 nV locally, indicating that piezoelectric effects may directly affect cell alignment in the AF and may work in conjunction with streaming potentials throughout the IVD. In summary, we have highlighted an intricate electro-mechanical coupling that appears to have distinct physiological roles in the AF and NP. Further study is required to elucidate the cell response and determine the potential role of piezoelectric effects in regeneration and preventative measures from degeneration

For patients with breast cancer, geographic and social disparities are independent determinants of access to specialized surgeons. A eleven-year population-based multilevel analysis

<p>Abstract</p> <p>Background</p> <p>It has been shown in several studies that survival in cancer patients who were operated on by a high-volume surgeon was better. Why then do all patients not benefit from treatment by these experienced surgeons? The aim of our work was to study the hypothesis that in breast cancer, geographical isolation and the socio-economic level have an impact on the likelihood of being treated by a specialized breast-cancer surgeon.</p> <p>Methods</p> <p>All cases of primary invasive breast cancer diagnosed in the Côte d’Or from 1998 to 2008 were included. Individual clinical data and distance to the nearest reference care centre were collected. The Townsend Index of each residence area was calculated. A Log Rank test and a Cox model were used for survival analysis, and a multilevel logistic regression model was used to determine predictive factors of being treated or not by a specialized breast cancer surgeon.</p> <p>Results</p> <p>Among our 3928 patients, the ten-year survival of the 2931 (74.6 %) patients operated on by a high-volume breast cancer surgeon was significantly better (LogRank p < 0.001), independently of age at diagnosis, the presence of at least one comorbidity, circumstances of diagnosis (screening or not) and TNM status (Cox HR = 0.81 [0.67-0.98]; p = 0.027). In multivariate logistic regression analysis, patients who lived 20 to 35 minutes, and more than 35 minutes away from the nearest reference care centre were less likely to be operated on by a specialized surgeon than were patients living less than 10 minutes away (OR = 0.56 [0.43; 0.73] and 0.38 [0.29; 0.50], respectively). This was also the case for patients living in rural areas compared with those living in urban areas (OR = 0.68 [0.53; 0.87]), and for patients living in the two most deprived areas (OR = 0.69 [0.48; 0.97] and 0.61 [0.44; 0.85] respectively) compared with those who lived in the most affluent area.</p> <p>Conclusions</p> <p>A disadvantageous socio-economic environment, a rural lifestyle and living far from large specialized treatment centres were significant independent predictors of not gaining access to surgeons specialized in breast cancer. Not being treated by a specialist surgeon implies a less favourable outcome in terms of survival.</p

Cell-Penetrating Nanobiosensors for Pointillistic Intracellular Ca 2+

International audience: Small-molecule chemical calcium (Ca2+) indicators are invaluable tools for studying intracellular signaling pathways but have severe shortcomings for detecting local Ca2+ entry. Nanobiosensors incorporating functionalized quantum dots (QDs) have emerged as a promising alternative, but their use to monitor intracellular processes is still a major challenge. We designed cell-penetrating FRET-based Ca2+ nanobiosensors for the detection of local Ca2+ concentration transients, using commercially available CANdot®565QD as a donor and CaRuby, a custom red-emitting Ca2+ indicator as an acceptor. With Ca2+ -binding affinity in the range of 3 to 20 µM, our CaRubies allow sensors to be scalable for detecting intracellular Ca2+ transients at various concentrations. To facilitate their cytoplasmic delivery, QDs were further functionalized with a small cell-penetrating peptide (CPP) derived from hadrucalcin (HadUF1-11: H11), a ryanodine receptor-directed scorpion toxin identified within the venom of Hadrurus gertschi. Efficient internalization of QDs doubly functionalized with PEG5-CaRuby and H11 (in a molar ratio of 1:10:10, respectively) is demonstrated. In BHK cells expressing a N-methyl-D-aspartate receptor (NMDAR) construct, these nanobiosensors report rapid intracellular near-membrane Ca2+concentration changes following agonist application as evidenced by TIRF imaging. Our work presents the synthesis of cell-penetrating FRET-based nanobiosensors and validates their function for detection of intracellular Ca2+ transients