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Despite recent achievements in reducing the contribution of road traffic to air pollution, agreed pollutant standards are exceeded frequently in large parts of Europe. Previous studies assessed the effectiveness of traffic interventions in improving local air quality. However, little research exists on the effect of closures of short road sections over longer periods. The multi-week maintenances on the Theodor Heuss Bridge, the main connection over the river Rhine between the German cities Mainz and Wiesbaden, offered the opportunity to investigate its effect on local air pollution. We measured ambient concentrations of major air pollutants and meteorological parameters at the Theodor Heuss Bridge before, during, and after its closure on 800 m in early 2020. We carried out time-series and closure-dependent evaluations of pollutant concentrations at the bridge accounting for wind direction. Furthermore, we performed regression analyses accounting for wind speed additionally. We compared the results with data from surrounding monitoring stations. We recorded higher concentrations at the Theodor Heuss Bridge compared to outside the closure, especially for particulate matter, nitric oxide, and black carbon. Only with wind from specific directions, we could detect reductions of concentrations during the closure for many pollutants as nitrogen dioxide (− 9.8%; 95% confidence interval: − 10.8– − 8.7%), but not for particulate matter. Since we found similar meteorology-dependent pollution reductions during the closure at both the bridge and the surrounding monitoring stations, we assume that regional meteorological factors overlaid a potential closure-related effect on local air quality. These factors must be accounted for in accountability studies on interventions focusing on short roads. [ABSTRACT FROM AUTHOR]

Purpose: Multimodal therapies affect the quality of life (QoL) of patients with primary breast cancer (PBC). The objectives of this prospective study were to explore the changes in QoL from diagnosis to conclusion of adjuvant therapy and to identify predictive factors of QoL.Methods: Before surgery (t1), before onset of adjuvant treatment (t2) and after completion of adjuvant chemo- or radiotherapy (t3), patients with PBC (n = 759) completed the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire, Charlson Comorbidity Index, Patient Health Questionnaire and Perceived Involvement in Care Scales. Predictors of the course of global QoL were estimated using multinomial logistic regression. Effect estimates are odds ratios (OR) and their 95% confidence intervals (CIs).Results: Global QoL improved between t1 and t3, while physical functioning, emotional functioning and fatigue deteriorated. QoL before surgery was more often poor in patients <60 years (OR 2.2, 95% CI 1.5-3.1) and in those with comorbid mental illnesses (OR 8.6, CI 5.4-13.7). Forty-seven percentage reported good global QoL both at t1 and at t3. QoL improved in 28%, worsened in 10% and remained poor in 15%. Compared to patients with consistently good global QoL, a course of improving QoL was more often seen in patients who had received a mastectomy and in those with intense fear of treatment before surgery. A course of decreasing QoL was more often found in patients who were treated with chemotherapy. QoL stayed poor in patients with chemotherapy, mastectomy and intense fear. There was no evidence that radiotherapy, progressive disease or perceived involvement impact the course of QoL.Conclusions: Younger age and comorbid mental illnesses are associated with poor QoL pre-therapeutically. QoL is more likely to stay or become poor in patients who receive chemotherapy. [ABSTRACT FROM AUTHOR]

Background: There is no consensus on the treatment and prognosis of malignant rectal polyps. The aim of the present study was to determine the role of transanal endoscopic microsurgery (TEM) after endoscopic complete polypectomy of malignant rectal adenomas with long-term follow-up. Methods: Of 105 patients with pT1 rectal carcinoma in 32 patients TEM followed complete endoscopic polypectomy while 73 had primary TEM. Local recurrence (LR), distant metastasis, overall and cancer-specific survival were determined by the Kaplan-Meier method. Results: Median follow-up was 9.1 years. In 32 patients with TEM following complete polypectomy no residual cancer was found. LR occurred in 3/28 (11%) patients with low-risk carcinoma (pT1 G1/2/X, L0/X, R0) and in 1/4 (25%) with high-risk carcinoma (pT1 G3/4 or L1). After primary TEM with complete resection (minimal distance >1 mm) LR occurred in 6/60 (10%) with low-risk carcinoma. After incomplete TEM resection (minimal distance ≤1 mm) LR occurred in 3/8 (38%) patients with low-risk and in 1/5 (20%) patients with high-risk carcinoma. Grading was the only significant risk factor for LR after endoscopic polypectomy followed by TEM ( p = 0.002). At all outcomes did not differ between postpolypectomy TEM and primary TEM. Conclusions: Patients with malignant rectal polyps removed by endoscopic polypectomy have a substantial risk of LR even if TEM of polyp site is cancer free. Risk of LR depends on tumor characteristics. In low-risk carcinoma long-term follow-up is necessary. The high LR rate in patients with high-risk rectal carcinoma restricts the use of TEM alone. [ABSTRACT FROM AUTHOR]

Purpose: The study examines the association between exposure to current and cumulative night shift work and subclinical parameters of atherosclerosis. Methods: Participants of a population-based cohort study (the Gutenberg Health Study, N = 15,010) aged 35-64 years were examined at baseline (2007-2012). Investigations included measurements of arterial stiffness, vascular function [reactive hyperaemia (RH) index], and intima media thickness (IMT). Also, a complete job history (including up to 15 periods), occupational exposures, a variety of lifestyle, and dispositional variables were enquired. Results: Night shift work was performed by 1071 out of 8065 currently employed individuals. The strongest association after adjustment for age, sex, job complexity level, being a manager, overtime work, and noise appeared for more than 660 night shifts within the last 10 years and a significantly increased arterial stiffness of 0.33 m/s. This reflects a 4 % flow velocity increase for individuals with more than 660 night shifts compared to non-night workers. Regarding the entire professional life, night shift workers showed a significantly decreased vascular function by −0.054 RH index points by using the same adjustment. IMT values did not differ statistically from non-night workers. Lifestyle and dispositional factors showed an influence on all used subclinical atherosclerosis parameters. Conclusions: The cross-sectional results demonstrate an association between night work and detrimental changes in the atherosclerotic process. The association is more pronounced with more years in night shift and is partly explained by lifestyle and dispositional factors. Longitudinal analyses are necessary to confirm the results. [ABSTRACT FROM AUTHOR]

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Purpose: Inflammatory breast cancer (IBC) represents a rare and aggressive form of cancer with negative prognosis and high rate of recurrence. The purpose of this retrospective multi-center study was to evaluate the effect of IBC on overall and disease-free survival. Furthermore we analyzed the influence of hormone and Her2 receptor expression on inflammatory breast cancer cells on the clinical outcome of patients. Methods: This retrospective German multi-center study included 11,780 patients with primary breast cancer recruited from 1992 to 2008. In this sub-group analysis we focused on 70 patients with IBC. Results: Despite the relatively small sample size, we could confirm the aggressiveness of inflammatory breast cancer and the different clinical behavior of IBC subtypes. It could be demonstrated that the lack of expression of hormone receptors on tumor cells is associated with a more aggressive clinical course and decreased overall and disease-free survival. Higher incidence of Her2 overexpression, that is typically associated with poor prognostic outcome among women with non-IBC tumors, seems however to have no prognostic significance. Conclusions: This BRENDA sub-group analysis, on a German cohort of breast cancer patients confirmed the negative outcome of IBC and the different clinical behavior of IBC subtypes. The best management of IBC requires intensive coordination and cooperation between various clinical disciplines involved in the treatment of IBC patients. Moreover there is a need to identify IBC-specific targeted therapies to improve the curing prospects of this subtype of cancer. [ABSTRACT FROM AUTHOR]

Introduction: It is well accepted that innovation in oncology is transported through randomized clinical trials (CT), furthermore there is some evidence that patients profit from participation in CT. However, especially elderly patients aged >65 usually do not have access to clinical trials; we therefore used an unselected patient cohort to investigate the following questions: Materials and methods: This German retrospective multi-center cohort study included 4,142 patients (study participants <65 and elderly breast cancer patients 65-80) with primary breast cancer recruited from 1992 to 2008 in 17 participating breast cancer centers. Results: Applying the exclusion criteria, we included 960 (23.2 %) study participants (PA) <65 and 3,182 (76.8 %) elderly >65. Elderly non-participants (NPA) >65 demonstrate a significantly inferior RFS [RFS: HR = 1.67; p < 0.001] and OS [OS: HR = 1.98; p < 0.001] compared to PA <65. Within the elderly group, 1,868 (58.7 %) patients received guideline-adherent adjuvant treatment. When comparing guideline conform elderly >65 versus PA <65, we found no significant difference in RFS [RFS: HR = 1.17; p = 0.218] and OS [OS: HR = 1.34; p = 0.054]. In contrast, non-guideline-adherent elderly demonstrated significantly inferior survival parameters [RFS: HR = 2.06; p < 0.001] [OS: HR = 2.50; p < 0.001] compared to <65 PA. Conclusion: Guideline-adherent adjuvant treatment seems to be an equivalent option for elderly breast cancer patients. There is a strong association between guideline adherence and improved outcome parameters in elderly breast cancer patients. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to clarify whether the lymph node ratio (LNR) is superior to the updated TNM classification regarding the prognosis of stage III rectal cancer patients who have not undergone neoadjuvant therapy. The TNM system is based on the absolute number of lymph nodes involved, and the LNR takes into account involved and examined nodes. Methods: In 237 patients with stage III rectal cancer, we evaluated prognostic factors for 5-year overall survival (OS), disease-free survival (DFS), and risk of distant metastases (DM) using the Kaplan-Meier method, with patients divided based on adequate versus inadequate lymph node dissection (≥12 vs. <12 lymph nodes examined). The updated TNM divides patients into four groups (1, 2-3, 4-6, and ≥7 involved nodes), while LNR divides patients into quartiles. Multivariate Cox regression analyses were performed. Results: Among patients with adequate lymph node dissection, the distributions within the two systems were in agreement in 141/178 (79.2 %, kappa 0.721), and the predictive values for OS, DFS, and DM were similar. In patients with inadequate lymph node dissection, the classifications of both systems were concordant in only 13/59 (22 %, kappa 0.021). The pN system significantly under-staged patients, while the LNR classification was a better predictor of OS, DFS, and DM. Conclusions: In patients with adequate lymph node dissection, LNR staging does not add substantial information to the predictions of updated TNM lymph node staging. However, in patients with inadequate lymph node harvesting, the LNR compensates for the under-staging of the TNM classification and provides a better estimation of prognosis than the updated TNM system. [ABSTRACT FROM AUTHOR]

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Purpose: Breast cancer epidemiology and survival recently saw major changes resulting from improved screening and treatment modalities. This paper aims to provide an overview of changes in recent years in patient characteristics and treatment procedures. Methods: Using data from BRENDA, an unselected cohort with universal coverage of a constant catchment area over a 13-year observation period, this study provides an overview of key trends. Results: Beside steady increases in overall and disease-free survival, main trends in recent years included a gradual increase in new patients' average ages. Grading, but not T stages, improved. Node negative, endocrine responsive patient shares increased; node positive, endocrine responsive shares decreased. HER2 neu screening went from uncommon to ubiquitous. Sentinel node biopsy reduced excised numbers of lymph nodes. Second and third generation chemotherapies replaced CMF. Neoadjuvant therapy was gradually introduced. Aromatase inhibitors pushed down Tamoxifen use. 90 % of endocrine responsive patients now receive endocrine therapy. Our results suggest that improved survival only partially results from improved prognostic factors, but rather seems mainly due to improved treatment modalities. Conclusions: Treatment procedures have changed dramatically over recent years. This was associated with steady increases in favorable outcomes among patients. [ABSTRACT FROM AUTHOR]

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The objectives of this study were to assess total exposure to radiofrequency electromagnetic fields (RF-EMF) in bedrooms and the contribution of different radioservices ( FM radio, analogue TV and DVB- T, TETRA, GSM900 downlink, GSM1800 downlink, UMTS downlink, DECT, and wireless LAN and blue tooth) to the total exposure. Additional aims were to describe the proportion of measuring values above the detection limit of the dosimeters and to characterize the differences in exposure patterns associated with self-reported residential characteristics. Exposure to RF sources in bedrooms was measured using Antennessa EME Spy 120 dosimeters in 1,348 households in Germany; 280 measures were available for each frequency band per household. Mean electrical field strengths and power flux densities were calculated. Power flux densities allow the calculation of proportions of different radioservices on total exposure. Exposure was often below the detection limit (electrical field strength: 0.05 V/m) of the dosimeter. Total exposure varied, depending on residential characteristics (urban vs. rural areas and floor of a building the measurement took place). Major sources of exposure were cordless phones (DECT standard) and wireless LAN/blue tooth contributing about 82% of total exposure (20.5 μW/m). Exposure to RF-EMF is ubiquitous, but exposure levels are-if at all measurable-very low and far below the ICNIRP's exposure reference levels. [ABSTRACT FROM AUTHOR]

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Copyright of Der Onkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Occupational studies of aircrew in civil or military aviation did not receive much attention until the beginning of this decade. Since 1990, a number of epidemiological studies has been published on the cancer risk among flight personnel. Their results are equivocal: elevated cancer risks have been observed in some studies, but not in others. The exposure situation for pilots and flight attendants is unique with respect to several factors and particularly in that cosmic rays contribute substantially to their cumulative radiation dose. The average annual doses received are relatively low, however, and commonly range between 3 and 6 mSv. Results of epidemiological studies are presented as well as information on planned studies. [ABSTRACT FROM AUTHOR]

Exposure to ionizing radiation is a known risk factor for cancer. Cancer risk is highest after exposure in childhood. The computed tomography is the major contributor to the average, individual radiation exposure. Until now the association has been addressed only in statistical modeling. We present the first feasible study design on childhood cancer risk after exposure to computed tomography. [ABSTRACT FROM AUTHOR]

The authors reflect on two articles which examine the relationship between exposure to extremely low-frequency electromagnetic fields (ELF-EMF) and childhood cancer risk. They mention the pooled reanalysis of M. E. Kroll and L. Kheifets which showed that unstable results may be gained if numbers are small and if different cutoff points were used in different analysis. They say that epidemiological research cannot provide further evidence on biological mechanism for EMLF-ELF induced cancer.