12 research outputs found
Brain evolution in bats (Mammalia, Chiroptera): auditory, Olfactory and Sensorimotor systems
No full textData for brain structure volumes was analysed using multiple regression to test for correlated volumetric evolution in bats (Mammalia, Chiroptera). Significant partial correlations were found between major brain subdivisions, and between structures within the Auditory, Olfactory and Sensonmotor Systems that were predicted to have evolved together on the basis of anatomical connectivity and known functional relationships. Results were clearest in the auditory and sensorimotor systems and weakest for the olfactory system which included many limbic structures. Megachiroptera and microchiroptera were analysed separately; there was good general agreement between the patterns of correlated evolution in both of these clades. When compared to previous studies of con elated volumetric evolution in Insectivores and Primates, it was found that the pattern of correlations found in bats showed features that are unique to the order. These results strongly suggest that brain evolution in bats has proceeded in a mosaic fashion with individual functional systems being the targets of selection
Assessment and optimisation of MRI measures of atrophy as potential markers of disease progression in multiple sclerosis
No full textThere is a need for sensitive measures of disease progression in multiple sclerosis (MS) to
monitor treatment effects and understand disease evolution. MRI measures of brain
atrophy have been proposed for this purpose. This thesis investigates a number of
measurement techniques to assess their relative ability to monitor disease progression in
clinically isolated syndromes (CIS) and early relapsing remitting MS (RRMS).
Presented, is work demonstrating that measurement techniques and MR acquisitions can
be optimised to give small but significant improvements in measurement sensitivity and
precision, which provided greater statistical power. Direct comparison of numerous
techniques demonstrated significant differences between them. Atrophy measurements
from SIENA and the BBSI (registration-based techniques) were significantly more
precise than segmentation and subtraction of brain volumes, although larger percentage
losses were observed in grey matter fraction. Ventricular enlargement (VE) gave similar
statistical power and these techniques were robust and reliable; scan-rescan measurement
error was <0.01% of brain volume for BBSI and SIENA and <0.04ml for VE.
Annual atrophy rates (using SIENA) were -0.78% in RRMS and -0.52% in CIS patients
who progressed to MS, which were significantly greater than the rate observed in controls
(-0.07%). Sample size calculations for future trials of disease-modifying treatments in
RRMS, using brain atrophy as an outcome measure, are described. For SIENA, the BBSI
and VE respectively, an estimated 123, 157 and 140 patients per treatment arm
respectively would be required to show a 30% slowing of atrophy rate over two years. In
CIS subjects brain atrophy rate was a significant prognostic factor, independent of T2
MRI lesions at baseline, for development of MS by five year follow-up. It was also the
most significant MR predictor of disability in RRMS subjects. Cognitive assessment of
RRMS patients at five year follow-up is described, and brain atrophy rate was a
significant predictor of overall cognitive performance, and more specifically, of
performance in tests of memory.
The work in this thesis has identified methods for sensitively measuring progressive brain
atrophy in MS. It has shown that brain atrophy changes in early MS are related to early
clinical evolution, providing complementary information to clinical assessment that could
be utilised to monitor disease progression
The emergence of clusters in societal transition : a coevolutionary perspective on the TCM cluster at Tonghua/China
No full textNew industries are recognized as new impetus to national wealth. At the same time, they are increasingly becoming geographically concentrated in some well defined areas. But current studies on the emergence of industrial clusters tend to analyze favorable driving factors. This dissertation takes the example of a Chinese endogenous industrial cluster, the traditional Chinese medicine (TCM) cluster at Tonghua, a small peripheral city in Northeastern China, to contribute to the theoretical understanding of the emergence of industrial cluster as a co-evolutionary process of organizations, institutions and firms, or, to put it more broadly, as economic evolution embedded in complex socio-economic contexts. The recent advance in evolutionary and co-evolutionary economics which considers the economy and economic landscape as dynamic process instead of equilibrium can be regarded as a part of broader and more intellectual turn of quest for history in social sciences. Although the principle of "history matters" is widely acknowledged, it tends to be reduced to a quite simple concept of "path dependence". However, path dependence cannot offer space for new path creation, except from an external shock. Accordingly, the role of human conscious action or Schumpeterian innovation should be added to path analysis through the concept of path creation. Furthermore, and more importantly, history should be understood as context, and historical context can be explored through the understanding of multi-paths and interaction among them over time. So path inter-dependence (co-evolution between paths) would be useful to better understand the complexity of real history. Since the industrial cluster is composed of interconnected firms and is also subject to changes in institution and technology, I will focus on the multi-way causal relationship between firm, institution and technology. The theorizing is not entirely new, but most of the theoretical and empirical discussions are at the national or industrial level, not regional or local one. A competitive cluster can be regarded as a co-evolutionary hotspot in which multiple populations actively interact and are interconnected. Co-evolution itself is a dynamic and evolutionary process. So I will adopt a dynamic and evolutionary view to examine co-evolutionary degree or co-evolutionary effects in the Tonghua pharmaceutical cluster through time. After a brief introduction which deals with the national institutional changes that are highly associated with new venture creation, entrepreneurship, and innovation, with registrations on drug and healthcare system, and with changes in market demand of China’s pharmaceutical industry and geographical distribution, I will collect evidences from three aspects based upon field survey and second hand data, i.e., the history of the enterprises, the origin of entrepreneurship, and the knowledge of evolution, linking their respective generative relationships through the genealogical method. In this volume, the evolution of the Tonghua pharmaceutical firm organization, the formation of local entrepreneurship, historical accumulation of knowledge, and particular knowledge of transfer among generations of firms will be discussed, then I will probe into co-adaption and co-evolution between local formal and informal institutions and organizations in Tonghua’s TCM industry. In addition, I will try to understand the co-evolutionary process at different geographical levels (namely, national and local). In summary, my main findings include the following several points. Firstly, in the course of the emergence of Tonghua’s pharmaceutical industry, local social networks and the traditional alliance between enterprises and government have played important roles. Secondly, the most important factor that influences the evolution of endogenous industrial clusters such as the Tonghua pharmaceutical industry in transitional countries is not the change in technology, but the change in fundamental national institutions. Thirdly, the success of the Tonghua pharmaceutical industry can be ascribed to the creation of multiple paths largely based on initial conditions, which implies that economic policy should have historical consciousness, namely, new economic innovation should make full use of both historical legacies and existing assets. Finally, it is co-adaption and co-selection of firm organization, institution, and technology that have jointly made Tonghua’s pharmaceutical industry become highly competitive, which means that whether one region can grasp new opportunities partially depends on its capabilities to coordinate a varity of development agents.Neue Industrien werden im Allgemeinen als Impuls der Entwicklung zu nationalem Wohlstand verstanden. Zugleich sind sie überwiegend an einigen geographisch genau definierten Orten konzentriert. Aktuelle Studien zur Emergenz dieser Industrie-Cluster neigen dazu, entsprechende begünstigende Faktoren zu analysieren. Mit dem Beispiel eines endogenen Clusters in China, dem Cluster der Traditionellen Chinesischen Medizin (TCM) in Tonghua, will diese Dissertation zum theoretischen Verständnis der Emergenz von Industrie-Clustern unter der Perspektive eines ko-evolutorischen Prozesses von Form der Organisation, Institutionen und Unternehmen beitragen. Oder, um es etwas breiter auszudrücken, diese Emergenz als ökonomische Evolution zu verstehen, die in einen komplexen sozio-ökonomischen Kontext eingebettet ist. Obgleich der Vorstellung, Geschichte habe eine Bedeutung („history matters“), überwiegend in der Forschung zugestimmt wird, bleibt diese oft auf das Konzept der Pfadabhängigkeit beschränkt. Das aber eröffnet keinen Raum für die Betrachtung endogener Pfad-Bildung. Dem Konzept der Pfad-Bildung entsprechend sollte jedoch die Pfadanalyse ergänzt werden um bewusste Handlungen des Menschen oder auch um Innovationen im Schumpeterschen Sinn. Wichtiger ist außerdem, dass Geschichte als ein Kontext verstanden werden sollte, in dem mehrere Pfade ko-existieren und im Zeitverlauf auch interagieren. So wäre ein Konzept der Pfad-Interdependenz (oder der Ko-Evolution von Pfaden) nützlich zum besseren Verständnis der Komplexität „wirklicher“ Geschichte. Weil das Industriecluster sich aus untereinander verflochtenen Unternehmen zusammen setzt und zugleich Gegenstand von Änderungen in den Institutionen und der Technologie ist, konzentriert sich die Dissertation auf vielseitige kausale Beziehungen von Unternehmen, Institutionen und Technologie. Ein wettbewerbsfähiges Cluster kann aus geographischer Sicht als ein „hot spot“ der Ko-evolution betrachtet werden, in dem verschiedenartige Populationen aktiv untereinander agieren und daher miteinander verflochten sind. Ko-Evolution selbst ist dann ein dynamischer und evolutorischer Prozess. Die Arbeit wählt diese Perspektive, um das Maß und die Wirkungen der Ko-Evolution im Pharma-Cluster von Tonghua im Zeitverlauf zu analysieren. Die Dissertation fußt auf empirischen Erhebungen, ergänzt um eine Dokumenten-Analyse, zur Geschichte der Unternehmen, der Herkunft der Unternehmerschaft sowie der Evolution von Wissen. Sie diskutiert die Evolution in den Organisationsformen der Pharma-Unternehmen in Tonghua, die Bildung einer lokalen Unternehmerschaft, die historische Akkumulation von Wissen und den besonderen Wissenstransfer zwischen Generationen von Unternehmen. Schließlich untersucht sie die Ko-Adaption und Ko-Evolution von lokalen formalen und informellen Institutionen und Organisationen der TCM-Industrie in Tonghua. Die folgenden Punkte betreffen die wichtigsten Ergebnisse der Dissertation: Erstens haben sehr langfristige und dichte lokale soziale Netzwerke eine erhebliche Rolle im Lauf der Emergenz der Pharma-Industrie in Tonghua gespielt. Zweitens ist der wichtigste Faktor in der Pharma-Industrie nicht im technologischen Fortschritt durch Anstrengungen bei Forschung und Entwicklung (FuE) zu sehen, sondern im institutionellen Wandel sowohl auf nationaler als auch auf lokaler Ebene. Drittens kann der Erfolg der Pharma-Industrie in Tonghua der Bildung multipler Pfade zugeschrieben werden, die auf bestimmten Anfangsbedingungen gründen. Das bedeutet, dass die neue ökonomische Entwicklungspolitik sowohl das historische Erbe als auch bestehende Aktivposten in vollem Umfang nutzen sollte. Schließlich ist festzustellen, dass Ko-Adaption und Ko-Selektion der Unternehmens-Organisation, von Institutionen und Technologie zusammen die Pharma-Industrie von Tonghua in hohem Maße wettbewerbsfähig gemacht haben. Ob eine Region neue Gelegenheiten ergreifen kann, hängt folglich teilweise von ihrer Fähigkeit ab, eine Vielfalt von Entwicklungs-Agenten zu koordinieren
New training program for the new requirements of combat of tactical athletes
No full textActual theaters of operations are complex contexts where soldiers must face different situations, such as symmetrical, asymmetrical, or close quarter combat. The requirements of the actual battlefield are different to the traditional conditioning military training. This new changing scenario produces an activation of the innate fight or flight defense mechanisms with large activations of the anaerobic metabolic pathways and the sympathetic autonomic nervous system. In these scenarios, the anaerobic, aerobic, and strength demands are so specific and the time to improve all training demands in the units is limited. We propose a new training periodization for the military population based on the latest research into the psychophysiological response of soldiers in actual theaters of operations (actual military missions) and actual civilian models of training and periodization to develop a specific, easy, and reliable periodization model for actual tactical athletes. This training intervention was developed in order to improve operational training according to the demands of actual theaters of operations, based on recent research in military and civilian populations. We tried to conduct a proposal that is easy to apply, with minimal use of material different to what could be found in a military base and that could be implemented in a short period of time
Global survival trends for brain tumors, by histology: Analysis of individual records for 67,776 children diagnosed in 61 countries during 2000-2014 (CONCORD-3).
No full textINTRODUCTION: Tumors of the central nervous system are among the leading causes of cancer-related death in children. Population-based cancer survival reflects the overall effectiveness of a health care system in managing cancer. Inequity in access to care world-wide may result in survival disparities. METHODS: We considered children (0-14 years) diagnosed with a brain tumor during 2000-2014, regardless of tumor behavior. Data underwent a rigorous, three-phase quality control as part of CONCORD-3. We implemented a revised version of the International Classification of Childhood Cancer (third edition) to control for under-registration of non-malignant astrocytic tumors. We estimated net survival using the unbiased nonparametric Pohar Perme estimator. RESULTS: The study included 67,776 children. We estimated survival for 12 histology groups, each based on relevant ICD-O-3 codes. Age-standardized 5-year net survival for low-grade astrocytoma ranged between 84% and 100% world-wide during 2000-2014. In most countries, 5-year survival was 90% or more during 2000-2004, 2005-2009, and 2010-2014. Global variation in survival for medulloblastoma was much wider, with age-standardized 5-year net survival between 47% and 86% for children diagnosed during 2010-2014. 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 in children, by histology. We devised an enhanced version of ICCC-3 to account for differences in cancer registration practices world-wide. Our findings may have public health implications, because low-grade glioma is 1 of the 6 index childhood cancers included by WHO in the Global Initiative for Childhood Cancer
Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries.
No full textBACKGROUND: In 2015, the second cycle of the CONCORD programme established global surveillance of cancer survival as a metric of the effectiveness of health systems and to inform global policy on cancer control. CONCORD-3 updates the worldwide surveillance of cancer survival to 2014. METHODS: CONCORD-3 includes individual records for 37·5 million patients diagnosed with cancer during the 15-year period 2000-14. Data were provided by 322 population-based cancer registries in 71 countries and territories, 47 of which provided data with 100% population coverage. The study includes 18 cancers or groups of cancers: oesophagus, stomach, colon, rectum, liver, pancreas, lung, breast (women), cervix, ovary, prostate, and melanoma of the skin in adults, and brain tumours, leukaemias, and lymphomas in both adults and children. Standardised quality control procedures were applied; errors were rectified by the registry concerned. We estimated 5-year net survival. Estimates were age-standardised with the International Cancer Survival Standard weights. FINDINGS: For most cancers, 5-year net survival remains among the highest in the world in the USA and Canada, in Australia and New Zealand, and in Finland, Iceland, Norway, and Sweden. For many cancers, Denmark is closing the survival gap with the other Nordic countries. Survival trends are generally increasing, even for some of the more lethal cancers: in some countries, survival has increased by up to 5% for cancers of the liver, pancreas, and lung. For women diagnosed during 2010-14, 5-year survival for breast cancer is now 89·5% in Australia and 90·2% in the USA, but international differences remain very wide, with levels as low as 66·1% in India. For gastrointestinal cancers, the highest levels of 5-year survival are seen in southeast Asia: in South Korea for cancers of the stomach (68·9%), colon (71·8%), and rectum (71·1%); in Japan for oesophageal cancer (36·0%); and in Taiwan for liver cancer (27·9%). By contrast, in the same world region, survival is generally lower than elsewhere for melanoma of the skin (59·9% in South Korea, 52·1% in Taiwan, and 49·6% in China), and for both lymphoid malignancies (52·5%, 50·5%, and 38·3%) and myeloid malignancies (45·9%, 33·4%, and 24·8%). For children diagnosed during 2010-14, 5-year survival for acute lymphoblastic leukaemia ranged from 49·8% in Ecuador to 95·2% in Finland. 5-year survival from brain tumours in children is higher than for adults but the global range is very wide (from 28·9% in Brazil to nearly 80% in Sweden and Denmark). INTERPRETATION: The CONCORD programme enables timely comparisons of the overall effectiveness of health systems in providing care for 18 cancers that collectively represent 75% of all cancers diagnosed worldwide every year. It contributes to the evidence base for global policy on cancer control. Since 2017, the Organisation for Economic Co-operation and Development has used findings from the CONCORD programme as the official benchmark of cancer survival, among their indicators of the quality of health care in 48 countries worldwide. Governments must recognise population-based cancer registries as key policy tools that can be used to evaluate both the impact of cancer prevention strategies and the effectiveness of health systems for all patients diagnosed with cancer. FUNDING: American Cancer Society; Centers for Disease Control and Prevention; Swiss Re; Swiss Cancer Research foundation; Swiss Cancer League; Institut National du Cancer; La Ligue Contre le Cancer; Rossy Family Foundation; US National Cancer Institute; and the Susan G Komen Foundation
The histology of ovarian cancer: worldwide distribution and implications for international survival comparisons (CONCORD-2)
No full textObjective Ovarian cancers comprise several histologically distinct tumour groups with widely different prognosis. We aimed to describe the worldwide distribution of ovarian cancer histology and to understand what role this may play in international variation in survival. Methods The CONCORD programme is the largest population-based study of global trends in cancer survival. Data on 681,759 women diagnosed during 1995â2009 with cancer of the ovary, fallopian tube, peritoneum and retroperitonum in 51 countries were included. We categorised ovarian tumours into six histological groups, and explored the worldwide distribution of histology. Results During 2005â2009, type II epithelial tumours were the most common. The proportion was much higher in Oceania (73.1%), North America (73.0%) and Europe (72.6%) than in Central and South America (65.7%) and Asia (56.1%). By contrast, type I epithelial tumours were more common in Asia (32.5%), compared with only 19.4% in North America. From 1995 to 2009, the proportion of type II epithelial tumours increased from 68.6% to 71.1%, while the proportion of type I epithelial tumours fell from 23.8% to 21.2%. The proportions of germ cell tumours, sex cord-stromal tumours, other specific non-epithelial tumours and tumours of non-specific morphology all remained stable over time. Conclusions The distribution of ovarian cancer histology varies widely worldwide. Type I epithelial, germ cell and sex cord-stromal tumours are generally associated with higher survival than type II tumours, so the proportion of these tumours may influence survival estimates for all ovarian cancers combined. The distribution of histological groups should be considered when comparing survival between countries and regions
Worldwide comparison of survival from childhood leukaemia for 1995-2009, by subtype, age, and sex (CONCORD-2): a population-based study of individual data for 89 828 children from 198 registries in 53 countries.
No full textBACKGROUND: Global inequalities in access to health care are reflected in differences in cancer survival. The CONCORD programme was designed to assess worldwide differences and trends in population-based cancer survival. In this population-based study, we aimed to estimate survival inequalities globally for several subtypes of childhood leukaemia. METHODS: Cancer registries participating in CONCORD were asked to submit tumour registrations for all children aged 0-14 years who were diagnosed with leukaemia between Jan 1, 1995, and Dec 31, 2009, and followed up until Dec 31, 2009. Haematological malignancies were defined by morphology codes in the International Classification of Diseases for Oncology, third revision. We excluded data from registries from which the data were judged to be less reliable, or included only lymphomas, and data from countries in which data for fewer than ten children were available for analysis. We also excluded records because of a missing date of birth, diagnosis, or last known vital status. We estimated 5-year net survival (ie, the probability of surviving at least 5 years after diagnosis, after controlling for deaths from other causes [background mortality]) for children by calendar period of diagnosis (1995-99, 2000-04, and 2005-09), sex, and age at diagnosis (<1, 1-4, 5-9, and 10-14 years, inclusive) using appropriate life tables. We estimated age-standardised net survival for international comparison of survival trends for precursor-cell acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML). FINDINGS: We analysed data from 89 828 children from 198 registries in 53 countries. During 1995-99, 5-year age-standardised net survival for all lymphoid leukaemias combined ranged from 10·6% (95% CI 3·1-18·2) in the Chinese registries to 86·8% (81·6-92·0) in Austria. International differences in 5-year survival for childhood leukaemia were still large as recently as 2005-09, when age-standardised survival for lymphoid leukaemias ranged from 52·4% (95% CI 42·8-61·9) in Cali, Colombia, to 91·6% (89·5-93·6) in the German registries, and for AML ranged from 33·3% (18·9-47·7) in Bulgaria to 78·2% (72·0-84·3) in German registries. Survival from precursor-cell ALL was very close to that of all lymphoid leukaemias combined, with similar variation. In most countries, survival from AML improved more than survival from ALL between 2000-04 and 2005-09. Survival for each type of leukaemia varied markedly with age: survival was highest for children aged 1-4 and 5-9 years, and lowest for infants (younger than 1 year). There was no systematic difference in survival between boys and girls. INTERPRETATION: Global inequalities in survival from childhood leukaemia have narrowed with time but remain very wide for both ALL and AML. These results provide useful information for health policy makers on the effectiveness of health-care systems and for cancer policy makers to reduce inequalities in childhood cancer survival. FUNDING: Canadian Partnership Against Cancer, Cancer Focus Northern Ireland, Cancer Institute New South Wales, Cancer Research UK, US Centers for Disease Control and Prevention, Swiss Re, Swiss Cancer Research foundation, Swiss Cancer League, and the University of Kentucky
Erratum to "Worldwide comparison of ovarian cancer survival: Histological group and stage at diagnosis (CONCORD-2)" [Gynecol. Oncol. 144 (2017) 396-404]
No full textObjective. Ovarian cancer comprises several histological groups with widely differing levels of survival. We
aimed to explore international variation in survival for each group to help interpret international differences in
survival from all ovarian cancers combined. We also examined differences in stage-specific survival.
Methods. The CONCORD programme is the largest population-based study of global trends in cancer survival,
including data from 60 countries for 695,932 women (aged 15–99 years) diagnosed with ovarian cancer during
1995–2009. We defined six histological groups: type I epithelial, type II epithelial, germ cell, sex cord-stromal,
other specific non-epithelial and non-specific morphology, and estimated age-standardised 5-year net survival
for each country by histological group. We also analysed data from67 cancer registries for 233,659 women diagnosed
from 2001 to 2009, for whom information on stage at diagnosis was available. We estimated agestandardised
5-year net survival by stage at diagnosis (localised or advanced).
Results. Survival fromtype I epithelial ovarian tumours for women diagnosed during 2005–09 ranged from40
to 70%. Survival from type II epithelial tumours was much lower (20–45%). Survival fromgermcell tumours was
higher than that of type II epithelial tumours, but also varied widely between countries. Survival for sex-cord
stromal tumours was higher than for the five other groups. Survival from localised tumours was much higher
than for advanced disease (80% vs. 30%).
Conclusions. There is wide variation in survival between histological groups, and stage at diagnosis remains an
important factor in ovarian cancer survival. International comparisons of ovarian cancer survival should incorporate
histology
Erratum to "The histology of ovarian cancer: Worldwide distribution and implications for international survival comparisons (CONCORD-2)" [Gynecol. Oncol. 144 (2017) 405-413]
No full textObjective. Ovarian cancers comprise several histologically distinct tumour groups with widely different prognosis.
We aimed to describe the worldwide distribution of ovarian cancer histology and to understand what role
this may play in international variation in survival.
Methods. The CONCORD programme is the largest population-based study of global trends in cancer survival.
Data on 681,759 women diagnosed during 1995–2009 with cancer of the ovary, fallopian tube, peritoneum and
retroperitonum in 51 countries were included.We categorised ovarian tumours into six histological groups, and
explored the worldwide distribution of histology.
Results. During 2005–2009, type II epithelial tumours were the most common. The proportion was much
higher in Oceania (73.1%), North America (73.0%) and Europe (72.6%) than in Central and South America
(65.7%) and Asia (56.1%). By contrast, type I epithelial tumours were more common in Asia (32.5%), compared
with only 19.4% in North America. From 1995 to 2009, the proportion of type II epithelial tumours increased
from 68.6% to 71.1%, while the proportion of type I epithelial tumours fell from 23.8% to 21.2%. The proportions
of germ cell tumours, sex cord-stromal tumours, other specific non-epithelial tumours and tumours of non-specific morphology all remained stable over time.
Conclusions. The distribution of ovarian cancer histology varieswidely worldwide. Type I epithelial, germcell
and sex cord-stromal tumours are generally associated with higher survival than type II tumours, so the proportion of these tumours may influence survival estimates for all ovarian cancers combined. The distribution of histological groups should be considered when comparing survival between countries and regions
