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With a dramatic increase of incidence and a very poor prognosis, the treatment of pancreatic cancer remains a challenge. Pancreatic cancer can be completely cured only by means of surgery. Unfortunately, the majority of cases are diagnosed at an advanced stage, where palliative chemotherapy can be administered to alleviate the symptoms and prolong life. Although pancreatic carcinogenesis has not yet been explained, familial agregation, tobacco smoking, and hypercaloric intake are associated with pancreatic carcinogenesis. Till date, either prevention or screening programs could yet be proposed. [ABSTRACT FROM AUTHOR]

Population-based studies have shown that guaiac faecal occult blood testing followed by colonoscopy in case of positivity can reduce colorectal cancer (CRC) mortality. However, these tests have been criticized in particular for their low sensitivity. For this reason, attention has been given for alternative tests such as immunochemical faecal occult blood tests. Automated system can determine the concentration of human haemoglobin in faeces samples. It is now clear from available data that immunochemical tests outperform guaiac tests. They should be preferred for CRC screening. They will be available in France early 2015. The one-sample strategy has now been adopted in most screening programmes. Given the superior performance characteristics of immunochemical tests (they allow the detection of CRC to be doubled and a 3-4 fold increase in the detection rate of advanced adenoma as well as higher participation), it is reasonable to assume that an organized programme using this type of test would lead to a greater reduction in CRC mortality and possibly of CRC incidence. [ABSTRACT FROM AUTHOR]

A six-year-old intact female Lagotto Romagnolo was referred with a two-day history of purulent vulvar discharge associated with fever, lethargy, polyuria, polydipsia and signs of abdominal pain. Abdominal ultra-sound revealed a grass awn foreign body in the vaginal fornix. Culture swabs obtained from the vagina revealed the presence of Staphylococcus epidermidis as the preponderant organism. Ovariohysterectomy was performed, and the presence of the grass awn was confirmed. A chronic-active vaginitis was found at histological examination. The dog recovered with resolution of all clinical signs. Differential diagnoses for acute vulvar discharge in bitches should include retention of vaginal foreign bodies. To the authors' knowledge, this is the first reported case of a grass awn foreign body in the vaginal fornix of a dog. [ABSTRACT FROM AUTHOR]

Contents Contrast-enhanced ultrasound with sulphur hexafluoride microbubbles was performed in seven healthy dogs without a history of reproductive pathology and with histologically confirmed normal testes and in 42 dogs with chronic scrotal anomalies. All dogs underwent orchiectomy and histological examination. Enhancement patterns and perfusion parameters (peak intensity and regional blood flow) of testes of healthy dogs and testes with chronic lesions were compared. Fourteen non-pathologic and 60 pathologic testes were considered. Forty testes were neoplastic (24 interstitial cell tumours, 9 seminomas, 7 Sertoli cell tumours), 20 were non-neoplastic (16 testicular degenerations, 2 chronic orchitis, 1 testicular atrophy, 1 interstitial cell hyperplasia). In healthy dogs, the contrast medium flow had a rapid homogeneous wash-in and wash-out, with a short peak phase. With contrast ultrasound, testes that were inhomogeneous with a hyperenhancing pattern were associated with neoplasia (sensitivity: 87.5%, specificity: 100%). Lesions with persistent inner vessels and a hypo-to-isoechoic background were significantly associated with seminomas (sensitivity: 77.8%, specificity: 100%). Testes with non-neoplastic lesions were characterized by a scant/moderate homogeneous enhancement. Perfusion parameters were higher in neoplastic lesions. Contrast ultrasound was a feasible diagnostic tool in the assessment of testicular lesions, with hyperenhancement being an important feature in the diagnosis of malignancy. [ABSTRACT FROM AUTHOR]

In this study the authors present the 'fictitiously starred optimised balancing' (FSOB), a novel algorithm for load balancing in a content delivery network (CDN) scenario. FSOB exploits the multiple redirection mechanism of the HTTP protocol to optimally redistribute clients requests among the servers which build up the CDN. Load redistribution is aimed at equalising the level of occupancy of the server queues and is achieved through the periodical exchange of information computed locally at each node. The algorithm initially makes a fictitious assumption about the local topology of the network, as it is seen by each single server node, which looks at itself as the centre (i.e. the master) of a star made up of all of its neighbours (i.e. the slaves). Load redistribution is performed by the master which, if needed, appropriately redirects incoming requests to its slaves. The authors show how FSOB outperforms most of its competitors under a number of fundamental aspects, at the price of an increased overhead owing to the adoption of the multiple redirections mechanism for the redistribution phase. Finally, they study the scalability properties of FSOB and perform a comparative evaluation of its performance with respect to the most interesting existing solutions. [ABSTRACT FROM AUTHOR]

Aim To evaluate colorectal cancer risk among patients with sporadic duodenal neoplasia using a case–control protocol. Methods Cases were 35 patients referred for the management of sporadic duodenal adenoma and who underwent colonoscopy. Colonoscopy findings among cases were compared with those from a control group matched for age and sex (two controls per case) without duodenal adenoma. Colonoscopy findings were categorized as adenoma, advanced adenoma, cancer or advanced neoplasia. The two groups were compared using the chi-squared test. Odds ratio and 95% confidence intervals were calculated. Results Colorectal adenoma was present in 31% of cases vs. 24% of controls, advanced neoplasia in 29% vs. 4%, advanced adenoma in 23% vs. 3% and adenocarcinoma in 6% vs. 1%. The relative risks of advanced colorectal adenoma and advanced colorectal neoplasia in cases were 10.1 (95% CI: 1.8–100.1, P = 0.003) and 8.9 (95% CI: 2.1–53.3, P = 0.001), respectively. Conclusions The relative risk of advanced colorectal adenoma and advanced neoplasia in cases was nine- to 10-fold that among controls. Patients with sporadic duodenal adenoma represent a high-risk group for advanced colorectal neoplasia and should therefore undergo complete colonoscopy. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to determine the incidence and patterns of failure following potentially curative surgery of colonic cancer. Methods: Data were obtained from the cancer registry of the Côte-d'Or (France). Data on 2657 patients who had resection for cure of colonic cancer between 1976 and 2000 were analysed. Local and distant failure rates were calculated using the actuarial method and multivariable analysis was performed using a Cox model. Results: The 5-year cumulative rate was 12.8 per cent for local recurrence and 25.6 per cent for distant metastases. Five-year cumulative local recurrence rates were 4.9 per cent for stage I, 11.0 per cent for stage II and 23.5 percent for stage II tumours (P < 0.001). The corresponding rates for distant metastases were 6.4, 21.4 and 48.0 per cent (P < 0.001). The 5-year cumulative rates for distant metastases were 31.7 per cent for the period 1976-1980 and 21.1 per cent for 1996-2000, and the local recurrence rates were 17.6 and 9.0 per cent respectively. The decreases in rates of local recurrence and distant metastases were significant in multivariable analysis. Cancer extension and presenting features were related to patterns of failure. Tumour location was significantly associated with risk of local recurrence, whereas age and gross features were associated with risk of distant metastasis. Conclusion: Recurrence following resection of colonic cancer remains a substantial problem. Follow-up is of particular importance in the 3 years after surgery. [ABSTRACT FROM AUTHOR]

Background: Few data are available from population-based statistics on the risk of local recurrence after surgery for rectal cancer. The aims of this study were to determine factors influencing local control and to analyse treatment and prognosis of recurrences in a well defined population. Methods: Data were obtained from the cancer registry of the Côte d'Or (France). From 1976 to 1995, 682 patients resected for cure for a rectal carcinoma were included. Recurrence rates and survival rates were calculated using actuarial methods. A relative survival analysis and Cox multivariate analysis were performed. Results: During the study 135 local recurrences were registered. The 5-year cumulative local recurrence rate was 22·7 per cent. In multivariate analysis the two variables significantly associated with local recurrence risk were stage at diagnosis and the macroscopic type of growth. There was a non-significant decrease in local recurrence rate in patients treated by preoperative radiotherapy compared with that in patients treated by surgery alone. The proportion of patients re-resected for cure was 25·2 per cent, and increased from 13·0 per cent in 1976–1985 to 37·9 per cent in 1986–1995 (P = 0·001). The 5-year relative survival rate was 13·6 per cent overall and 40·6 per cent after resection for cure (P < 0·001). Conclusion: Local recurrence of rectal cancer following resection remains a substantial problem. Improvement can be expected from better care and earlier diagnosis. [ABSTRACT FROM AUTHOR]

• We propose an advanced model to assess municipal waste management impacts. • We propose an approach to improve data reporting on generated waste amounts. • The C-footprint varies from a burden of 539 to a saving of 490 kg CO 2 -eq. t−1. • The cost of managing municipal waste in EU27 averages 162 EUR t−1. • The Full-Environmental-Cost of managing municipal waste in EU27 averages 109 EUR t−1. The Monitoring Framework proposed in the EU27 New Circular Economy Action Plan comprises two mass-based indicators, namely overall recycling rate and recycling rate for specific waste streams. Yet, to monitor and assess the impacts of circular economy, indicators cannot be limited to mass-based indicators; we argue assessments should also include environmental and economic effects. Towards this end, these impacts can be quantified by an advanced model based on life cycle thinking, entailing the use of life cycle assessment and costing (LCA/LCC). Calculating these effects for municipal waste management is challenging due to gaps in available data for estimating generated waste. We propose a methodology to estimate more finely the amounts of waste generated in the Member States, complemented with LCA/LCC. The results highlight that important inconsistencies in municipal waste data reporting exist and that recycling rates calculated from these are lower than hitherto estimated. The impacts quantification shows great performance variation across EU27, with C-footprint ranging from −490 to 539 kg CO 2 -eq. t−1. Potentials for improvement are substantial and can bring up to 103 Mt CO 2 -eq. additional annual saving, reducing costs (calculated as Full Environmental LCC) of waste management by 8.4 billion EUR and bringing 206,100 new jobs in the sector. The approach presented highlights the rationale for improved data management on waste statistics and the potential for harmonised models. It also paves the way for more sophisticated impact analyses relevant for policymaking, by bringing a richer perspective to the environmental and economic impacts of waste management on top of tracking generated, collected and recycled waste flows. [ABSTRACT FROM AUTHOR]

Multilayer networks describe well many real interconnected communication and transportation systems, ranging from computer networks to multimodal mobility infrastructures. Here, we introduce a model in which the nodes have a limited capacity of storing and processing the agents moving over a multilayer network, and their congestions trigger temporary faults which, in turn, dynamically affect the routing of agents seeking for uncongested paths. The study of the network performance under different layer velocities and node maximum capacities reveals the existence of delicate trade-offs between the number of served agents and their time to travel to destination. We provide analytical estimates of the optimal buffer size at which the travel time is minimum and of its dependence on the velocity and number of links at the different layers. Phenomena reminiscent of the slower is faster effect and of the Braess' paradox are observed in our dynamical multilayer setup. [ABSTRACT FROM AUTHOR]

Two types of bifunctional films having both electro-optical and photochromic properties have been prepared and investigated. These films are able to modulate the light transmission by means of suitable electric fields and to change their color under light irradiation. One of the films is fluid-like, being an emulsion of a liquid crystal and a photochrome in an organic monomer. It is defined as a photochromic emulsion dispersed liquid crystal (PEDLC). The other film is solid, having the structure of a polymer dispersed liquid crystal and containing a small percentage of photochrome; it is defined as a photochromic polymer dispersed liquid crystal (PPDLC). The solid films were obtained by photopolymerizing the fluid one. The electro-optical and photochromic properties of these films were investigated. To choose suitable photochromic components, the color-forming and color-bleaching kinetics of some compounds of the classes of spiro-oxazines and spiropyrans were preliminarily investigated in the components of the matrix (liquid crystals and monomers). They generally exhibited a better colorability in the matrix, as compared with organic solvents, due to decreasing of the bleaching rate. Their presence did not alter the electro-optical properties of the films with respect to those of PDLC and EDLC systems. Some significant variations in the color-forming and color-bleaching processes, observed for some of the photochromes dispersed in PDLC films, are discussed. Two of them were found to have the prerequisites of colorability, reversibility, and durability to be used in the bifunctional devices. The results are promising in view of the future involvement of these films in technology. © 2001 American Institute of Physics. [ABSTRACT FROM AUTHOR]

Objective Hormone replacement therapy (HRT) is acknowledged as the gold standard for the alleviation of climacteric vasomotor symptoms. Prothrombotic genetic variants have been suggested to increase thrombotic risk among HRT users. The aim of the study was to determine whether a positive family history may identify a genetic predisposition for thrombosis in women before prescribing HRT. Methods From January 2005 to May 2009, we consecutively enrolled 145 asymptomatic women (mean age 51.2 ±± 5.4 years) without previous episodes of venous and/or arterial thrombosis referred to our Genetics Research Unit before starting HRT. A detailed family history was reconstructed and we identified 48 women (33.1%%) with a positive family history, defined as venous thromboembolism and/or stroke or heart attack, in first-degree relatives before 60 years for men and 65 years for women. A group of 121 women (mean age 54.0 ±± 9.1 years) with an episode of venous and/or arterial thrombosis was also included. Genetic screening for factor V Leiden, prothrombin G20210A and methylenetetrahydrofolate reductase C677T polymorphisms was performed. Results The frequency of factor V Leiden or prothrombin G20210A mutations was significantly higher both in asymptomatic women with a positive family history (16.7%% vs. 2.1%%, p == 0.001) and in patients with thrombosis (12.4%% vs. 2.1%%; p == 0.005) compared with asymptomatic women without a family history. Multivariate regression analysis showed a synergic effect between the presence of one prothrombotic mutation and family history on the risk of thrombosis (odds ratio 3.7, 95%% confidence interval 1.9--7.2). Conclusions A positive family history of thrombosis is a sensitive indicator for selected genetic testing in high-risk women before starting HRT. [ABSTRACT FROM AUTHOR]

Reverse Mode Polymer Dispersed Liquid Crystal films obtained by the photo polymerization of homeotropically aligned Liquid crystal solutions, have been investigated in order to optimise their optical contrast with the aim of their application as windows able to be switched from an high transparent state into a very opaque state by an appropriate electric field. An excellent optical contrast has been obtained by varying the amounts of two different liquid crystal diacrylate monomers in the starting solutions as precursors of the final polymer matrix. Morphology of the film has been investigated to account for the electric threshold field needed to operate the film. A simple model has been proposed to describe the threshold field and the behaviours of the dynamic response times as a function of the polymer composition. A novel type of morphology which opens the field for deeper investigation, has been found, where two different segregations of the liquid crystal into the polymer matrix coexist. [ABSTRACT FROM AUTHOR]

La prise en charge de la pancréatite aiguë est maintenant assez codifiée, avec des recommandations précises élaborées par des groupes d'experts. Ces recommandations traitent notamment du bilan initial minimal, des scores de gravités reconnus, de la prise en charge médicale initiale avec l'hyperhydratation, l'anticoagulation préventive, la réalimentation précoce, des délais d'imagerie et de la gestion des complications. Nous avons essayé dans ce travail, de regrouper les différentes recommandations, articles et études traitant de ce sujet, en nous fondant plus particulièrement sur les recommandations européennes, afin de guider la prise en charge de la pancréatite aiguë en pratique courante. The management of acute pancreatitis is now fairly codified, with specific recommendations developed by expert groups. These recommendations deal in particular with the minimum initial assessment, recognized severity scores, initial medical management with hyperhydration, preventive anticoagulation, early refeeding, delays in imaging and management of complications. In this work, we have tried to bring together the various recommendations, articles and studies dealing with this subject, based more particularly on European recommendations, in order to guide the management of acute pancreatitis in current practice. [ABSTRACT FROM AUTHOR]

Background Diagnosis and management of poorly differentiated gastro-entero-pancreatic (GEP) neuroendocrine carcinomas (NECs) remain challenging. Recent studies suggest prognostic heterogeneity. We designed within the French Group of Endocrine Tumours a prospective cohort to gain insight in the prognostic stratification and treatment of GEP-NEC. Patients and methods All patients with a diagnosis of GEP-NEC between 1st January 2010 and 31st December 2013 could be included in this national cohort. Adenoneuroendocrine tumours were excluded. Results 253 patients from 49 centres were included. Median age was 66 years. Main primary locations were pancreas (21%), colorectal (27%), oesophagus-stomach (18%); primary location was unknown in 20%. Tumours were metastatic at diagnosis in 78% of cases. Performance status (PS) at diagnosis was 0–1 in 79% of patients. Among the 147 (58%) cases reviewed by an expert pathological network, 39% were classified as small cell NEC and 61% as large cell NEC. Median Ki67 index was 75% (range, 20–100). Median overall survival was 15.6 (13.6–17.0) months. Significant adverse prognostic factors in univariate analysis were PS > 1 (hazard ratio [HR] = 2.5), metastatic disease (HR = 1.6), NSE > 2 upper limit of normal [ULN]; HR = 3.2), CgA > 2 ULN (HR = 1.7) and lactate dehydrogenase >2 ULN (HR = 2.1). After first-line palliative chemotherapy (CT1) with platinum-etoposide (n = 152), objective response, progression-free survival and overall survival were 50%, 6.2 and 11.6 months; they were 24%, 2.9 and 5.9, respectively, after post-CT1 FOLFIRI regimen (n = 72). Conclusions We report a large prospective series of GEP-NEC which show the predominance of large cell type and advanced stage at diagnosis. Prognosis was found more homogeneous than previously reported, mainly impacted by PS and tumour burden. [ABSTRACT FROM AUTHOR]

Background: Cancer registries recording all cases diagnosed in a well defined population represent the only way to assess real changes in the management of colon cancer at the population level. Aims: To determine trends over a 23 year period in treatment, stage at diagnosis, and prognosis of colon cancer in the Côte-d'Or region, France. Patients: A total of 3389 patients with colon cancer diagnosed between 1976 and 1998. Methods: Time trends in clinical presentation, surgical treatment, chemotherapy treatment, stage at diagnosis, postoperative mortality, and survival were studied. A non-conditional logistic regression was performed to obtain an odds ratio for each period adjusted for the other variables. To estimate the independent effect of the period on prognosis, a relative survival analysis was performed. Results: Between 1976 and 1991, the resection rate increased from 69.3% to 91.9% and then remained stable. This increase was particularly marked in the older age group (56.4% to 90.5%). The proportion of stage III patients treated with adjuvant chemotherapy rose from 4.1% for the 1989-1990 period to 45.7% for the 1997-1998 period. Over the 23 years of the study the proportion of stage I and II patients increased from 39.6% to 56.6%, associated with a corresponding decrease in the proportion of patients with advanced stages. Postoperative mortality decreased from 19.5% to 7.3%. This led to an improvement in five year relative survival (from 33.0% for the 1976-1979 period to 55.3% for the 1992-1995 period). Conclusions: Advances in the management of colon cancer have resulted in improving the prognosis of this disease. However, progress is still possible, particularly in the older age group. [ABSTRACT FROM AUTHOR]

Background: Genetic variants of endothelial nitric oxide synthase (eNOS) could influence individual susceptibility to coronary artery disease. Objective: To assess whether GIu298 → Asp polymorphism of the eNOS gene is associated with the occurrence and severity of angiographically defined coronary artery disease in the Italian population. Methods: Polymerase chain reaction/restriction fragment length polymorphism analysis was done to detect the Glu298 → Asp variant of the eNOS gene in 201 patients with coronary artery disease and 114 controls. The severity of coronary artery disease was expressed by the number of affected vessels and by the Duke scoring system. Results: The frequencies of the eNOS Glu/Glu, Glu/Asp, and Asp/Asp genotypes in the coronary artery disease group were significantly different from those of controls (45.3%, 38.8%, and 15.9% v 42.1%, 51.8%, and 6.1%, respectively; χ² = 8.589, p = 0.0136). In comparison with subjects who had a Glu298 allele in the eNOS gene, the risk of coronary artery disease was increased among Asp/Asp carriers (odds ratio 2.9, 95% confidence interval 1.2 to 6.8, p = 0.01) and was independent of the other common risk factors (p = 0.04). There was a significant association between the eNOS Glu298→Asp variant and both the number of stenosed vessels (mean (SEM), 2.3 (0.1) for Asp/Asp v 1.9 (0.1) and 1.8 (0.1) for Glu/Glu and Glu/Asp, respectively; p = 0.01) and the Duke score (56.1 (3.1) for Asp/Asp v 46.7 (2.0) and 46.1 (1.9) for Glu/Glu and Glu/Asp respectively; p = 0.02). Conclusions: Glu298→Asp polymorphism of the eNOS gene appears to be associated with the presence, extent, and severity of angiographically assessed coronary artery disease. [ABSTRACT FROM AUTHOR]