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Objective The purpose of the present guideline is to recommend surgical or systemic treatment for metastatic testicular cancer; T3b or T4, or node-positive, and metastatic renal cell cancer (rcc); and T3, T4, or node-positive upper tract urothelial (utuc) cancer. Methods Draft recommendations were formulated based on evidence obtained through a systematic review of randomized controlled trials, comparative retrospective studies, and guideline endorsement. The draft recommendations underwent an internal review by clinical and methodology experts, and an external review by clinical practitioners. Results The primary literature search yielded eight guidelines, five systematic reviews, and twenty-seven primary studies that met the eligibility criteria. Conclusions Cytoreductive nephrectomy should no longer be considered the standard of care in patients with T3b or T4, or node-positive, and metastatic rcc. Eligible patients should be treated with systemic therapy and have their primary tumour removed only after review at a multidisciplinary case conference (mcc). Adjuvant sunitinib after surgery is not recommended. Patients with venous tumour thrombus should be considered for surgical intervention. Patients with T3, T4, or node-positive utuc should have their tumour removed without delay. Decisions concerning lymph node dissection should be done at a mcc and be based on stage, expertise, and imaging. Adjuvant systemic treatment is recommended for resected high-risk utuc. Patients with metastasis-positive testicular cancer with residual tumour after systemic treatment should be treated at specialized centres. For all complex retroperitoneal surgeries, the evidence shows that higher-volume centres are associated with lower rates of procedure-related mortality, and patients should be referred to higher-volume centres for surgical resection. [ABSTRACT FROM AUTHOR]

Background Access to cancer care is a significant concern for Canadians. Prolonged delays between cancer diagnosis and treatment have been associated with anxiety, stress, and perceived powerlessness for patients and their family members. Longer wait times can also be associated with poorer prognosis, although the evidence is inconclusive. Here, we report national wait times for radiation therapy and surgery for localized prostate cancer (pca) and the effect of wait time on patient perceptions of their care. Results Treatment wait times showed substantial interprovincial variation. The longest 90th percentile wait times for radiation therapy and surgery were, respectively, 40 days and 105 days. In all provinces, waits for radiation therapy were longer for pca patients than for patients with breast, colorectal, or lung cancer. In the focus groups and interviews conducted with 47 men treated for pca, many participants did not perceive that wait times for treatment were prolonged. Those who experienced delays between diagnosis and treatment voiced issues with a lack of communication about when they would receive treatment and a lack of support or information to make an informed decision about treatment. Minimizing treatment delays was an aspect of the cancer journey that participants would like to change because of the stress it caused. Conclusions Although wait time statistics are useful, a review of cancer control in Canada cannot be considered complete unless an effort is made to give voice to the experiences of individuals with cancer. The findings presented here are intended to provide a snapshot of national care delivery for localized pca and to identify opportunities for improvement in clinical practice. [ABSTRACT FROM AUTHOR]

Objective: To identify outcomes and prognostic variables that predict survival outcomes in adult Wilms tumour patients. Methods: We collected data on 128 patients with adult Wilms tumour treated between 1973 and 2006. Six cases from our 2 Canadian centres have not been previously reported. We collected data on the remaining 122 patients from published case reports or case series. Analyzed factors included age, sex, favourable or unfavourable histopathology, clinical stage (I, II, III or IV) and chemotherapy and radiotherapy received. The outcomes studied included overall survival (OS) and disease-specific survival (DSS). Univariate analysis with KaplanDSMeier actuarial methodology and multivariate analyses with Cox regression were used to determine outcomes and predictive clinical factors. Results: The patients' mean age was 26 (range 15DS73) years. After a mean follow-up of 54 (range 2DS240) months, the OS and DSS of the entire cohort were both 68%. Favourable histopathology predicted superior OS and DSS (both p < 0.001). Higher clinical stage predicted inferior OS and DSS (both p < 0.001). Conclusion: Adult Wilms tumour has a poorer prognosis than pediatric Wilms tumour. In adults with Wilms tumour, more aggressive patient- and tumour-specific surveillance and adjunctive therapies than those advocated by pediatric National Wilms Tumor Study guidelines may be warranted, especially in patients with an unfavourable histopathology and higher clinical stage. [ABSTRACT FROM AUTHOR]

Abstract When fed once daily with wet squid, turbot (30–50 g) accustomed to dry pellets require many days to increase intake to meet their feed requirement (≈ 10 mg dry matter g[sup -1] bw meal[sup -1]). Adaptation takes 1–2 days if several daily feedings are given. With dried squid, they ingest about 20% of the wet squid bulk because the stomach contents expand when moisturised. In contrast, turbot eat enough wet squid to fill most of the available stomach volume (≈ 7.6 mL 100 g[sup -1] bw). When presented in gelatine capsules, food water content is masked and does not affect the volume ingested. Moistening the contents shortens the delay before gastric emptying starts to one-third (0.6 h) compared with dry food (1.9 h). Daily dry-matter intake increased when dry contents were moistened but only if two or more meals were offered per day. Turbot adapt their digestion to supply water for dry diets but this may add extra metabolic costs. When offered 20 mg dry matter g bw[sup -1] day[sup -1], divided into four equal meals, turbot grew faster and more efficiently with moist than with dry squid. Protein, energy and dry-matter digestibilities were also enhanced. The increased daily protein absorption did not increase ammonia release, indicating that the extra protein was used for somatic growth. [ABSTRACT FROM AUTHOR]

Thin films of rigid poly( p-phenylene pyromellitimide) (PMDA-PDA) and semi-rigid poly( p-phenylene biphenyltetracarboximide) (BPDA-PDA), prepared by thermal imidization of the respective poly(amic acid) and poly(amic ethyl ester) precursors, were characterized with respect to their optical, thermomechanical and structural properties. Both polyimides exhibit an unusually large anisotropy between the in-plane and out-of-plane refractive indices, with Δ n ranging from 0.198 to 0.216 for PMDA-PDA and from 0.230 to 0.242 for BPDA-PDA, nearly independent of the nature of the initial polyimide precursor, film thickness, and film preparation method. PMDA-PDA films exhibit low coefficients of thermal expansion (CTE's) of 6.5 and 8.2 ppm/δC for the acid-derived and the ester-derived polyimides, respectively. In comparison, the BPDA-PDA films show CTE values of 4.3 and 18.0 for the acid-derived and ester-derived samples, respectively, despite the small differences in their optical anisotropies. Wide-angle x-ray diffraction patterns obtained in reflection and transmission for the various samples reveal a strong in-plane chain orientation for both PMDA-PDA and BPDA-PDA polyimides, with somewhat better intermolecular packing order for the ester-derived polyimide films. These effects of chemical structure and precursor on properties and structures of the polyimide films are discussed in light of recent theoretical considerations of semiflexible polymers. [ABSTRACT FROM AUTHOR]

X-ray lithography using synchrotron radiation has been applied in a multi-step process for the production of plastic moulds to be used in the fabrication of separation nozzles by electrodeposition. For characteristic dimensions of a few microns a total height of the nozzle structure of about 400 μm has been achieved. Structural details of about 0.1 μm are being reproduced across the total thickness of the polymer layer. The surface finish of metallic separation nozzles produced by electrodeposition was equivalent to the high quality of the polymer surface. The separation-nozzle systems fabricated by the described method allow an increase by a factor three of the gas pressure in separationnozzle plants as compared to the present standard. This results in considerable savings in the enrichment of U for nuclear power production. [ABSTRACT FROM AUTHOR]