scholarly journals How Anesthetic, Analgesic and Other Non-Surgical Techniques During Cancer Surgery Might Affect Postoperative Oncologic Outcomes: A Summary of Current State of Evidence

Cancers ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 592 ◽  
Author(s):  
Patrice Forget ◽  
Jose A. Aguirre ◽  
Ivanka Bencic ◽  
Alain Borgeat ◽  
Allessandro Cama ◽  
...  
Keyword(s):  
Randomized Clinical Trials ◽  
Surgical Techniques ◽  
Oncologic Outcomes ◽  
The European Union ◽  
European Network ◽  
Surgical Interventions ◽  
Cancer Resection ◽  
The Past ◽  
Current State

The question of whether anesthetic, analgesic or other perioperative intervention during cancer resection surgery might influence long-term oncologic outcomes has generated much attention over the past 13 years. A wealth of experimental and observational clinical data have been published, but the results of prospective, randomized clinical trials are awaited. The European Union supports a pan-European network of researchers, clinicians and industry partners engaged in this question (COST Action 15204: Euro-Periscope). In this narrative review, members of the Euro-Periscope network briefly summarize the current state of evidence pertaining to the potential effects of the most commonly deployed anesthetic and analgesic techniques and other non-surgical interventions during cancer resection surgery on tumor recurrence or metastasis.

scholarly journals Combined Replacement of Aortic Valve and Ascending Aorta—A 70-Year Evolution of Surgical Techniques

Aorta ◽  
2021 ◽  
Author(s):  
Igor Vendramin ◽  
Uberto Bortolotti ◽  
Davide Nunzio De Manna ◽  
Andrea Lechiancole ◽  
Sandro Sponga ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Elderly Patients ◽  
Aortic Valve Disease ◽  
Surgical Techniques ◽  
Ascending Aorta ◽  
Valve Disease ◽  
Long Term Results ◽  
The Past ◽  
Technical Advances

AbstractSimultaneous replacement of the ascending aorta and aortic valve has always been a challenging procedure. Introduction of composite conduits, through various ingenious procedures and their modifications, has changed the outlook of patients with aortic valve disease and ascending aorta pathology. In the past 70 years, progress of surgical techniques and prosthetic materials has allowed such patients to undergo radical procedures providing excellent early and long-term results in both young and elderly patients. This article aims to review the most important technical advances in the treatment of aortic valve disease and ascending aorta aneurysms recognizing the important contributions in this field.

scholarly journals Air quality trends in Europe over the past decade: a first multi-model assessment

2011 ◽  
Vol 11 (7) ◽  
pp. 19029-19087 ◽  
Author(s):  
A. Colette ◽  
C. Granier ◽  
Ø. Hodnebrog ◽  
H. Jakobs ◽  
A. Maurizi ◽  
...  
Keyword(s):  
Air Quality ◽  
Management Strategies ◽  
Anthropogenic Emissions ◽  
Model Assessment ◽  
Transport Models ◽  
The Past ◽  
Current State ◽  
Primary Compounds ◽  
Long Term Trend

Abstract. We discuss the capability of current state-of-the-art chemistry and transport models to reproduce air quality trends and inter annual variability. Documenting these strengths and weaknesses on the basis of historical simulations is essential before the models are used to investigate future air quality projections. To achieve this, a coordinated modelling exercise was performed in the framework of the CityZEN European Project. It involved six regional and global chemistry-transport models (Bolchem, Chimere, Emep, Eurad, OsloCTM2 and Mozart) simulating air quality over the past decade in the Western European anthropogenic emissions hotspots. Comparisons between models and observations allow assessing the skills of the models to capture the trends in basic atmospheric constituents (NO2, O3, and PM10). We find that the trends of primary constituents are well reproduced (except in some countries – owing to their sensitivity to the emission inventory) although capturing the more moderate trends of secondary species such as O3 is more challenging. Apart from the long term trend, the modelled monthly variability is consistent with the observations but the year-to-year variability is generally underestimated. A comparison of simulations where anthropogenic emissions are kept constant is also investigated. We find that the magnitude of the emission-driven trend exceeds the natural variability for primary compounds. We can thus conclude that emission management strategies have had a significant impact over the past 10 yr, hence supporting further emission reductions strategies.

scholarly journals Recent Patents and Designs on Hip Replacement Prostheses

2015 ◽  
Vol 9 (1) ◽  
pp. 92-102 ◽  
Author(s):  
H Derar ◽  
M Shahinpoor
Keyword(s):  
Robotic Surgery ◽  
Smart Materials ◽  
Hip Replacement ◽  
Surgical Techniques ◽  
Hip Prostheses ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
The Past ◽  
Made In

Hip replacement surgery has gone through tremendous evolution since the first procedure in 1840. In the past five decades the advances that have been made in technology, advanced and smart materials innovations, surgical techniques, robotic surgery and methods of fixations and sterilization, facilitated hip implants that undergo multiple design revolutions seeking the least problematic implants and a longer survivorship. Hip surgery has become a solution for many in need of hip joint remedy and replacement across the globe. Nevertheless, there are still long-term problems that are essential to search and resolve to find the optimum implant. This paper reviews several recent patents on hip replacement surgery. The patents present various designs of prostheses, different materials as well as methods of fixation. Each of the patents presents a new design as a solution to different issues ranging from the longevity of the hip prostheses to discomfort and inconvenience experienced by patients in the long-term.

Europa 2020

2021 ◽  
Author(s):  
Winfried Böttcher
Keyword(s):  
European Union ◽  
Political Agenda ◽  
The Political ◽  
Refugee Crisis ◽  
The European Union ◽  
Political Issue ◽  
The Past ◽  
Current State

In retrospect, the decade from 2010 to 2020 has provoked a crisis in human progress. In this book, the author proves this thesis using six occurrences, while also paying particular atten-tion to Europe’s role in relation to them: the refugee crisis the conflict in Ukraine Brexit the environment as a political issue nationalism the new coronavirus These six examples, which have had a staggering influence on the past decade, will also de-termine the political agenda in the coming decade. In view of this, the European Union has no future in its current state and thus needs to be reconceived.

Clinical research in surgical oncology: An analysis of clinicaltrials.gov.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 591-591 ◽  
Author(s):  
Amber S Menezes ◽  
Alison Barnes ◽  
Adena S Scheer ◽  
Husein Moloo ◽  
Robin P Boushey ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Surgical Techniques ◽  
Surgical Oncology ◽  
The United States ◽  
Diagnostic Methods ◽  
Phase Iii ◽  
Medical Specialties ◽  
Surgical Interventions ◽  
Adjuvant Therapies

591 Background: The conduction of randomized clinical trials has expanded in medical specialties, but to a far lesser degree in surgery. This is due to design challenges with standardization of treatment, blinding and lack of surgeon equipoise. The objective of this study was to assess the current landscape of clinical trials in surgical oncology registered at clinicaltrials.gov. Methods: Data was extracted from clinicaltrials.gov using the following search engine criteria: ‘Cancer’ as Condition, ‘Surgery OR Operation OR Resection’ as Intervention, and Non-Industry sponsored. The search was limited to Canada and the United States and included trials registered from January 1, 2001 to January 1, 2011. The search was performed on March 23, 2011 by three investigators in parallel. The total number of oncology trials was also obtained. Results: Of 9990 oncology trials, 1049 (10.5%) included any type of surgical intervention. Of these trials, 125 (11.9%; 1.3% of all oncology trials) manipulated a surgical variable, 773 (73.7%) assessed adjuvant/neoadjuvant therapies, and 151 (14.4%) were observational studies. Trials assessing adjuvant therapies focused on systemic treatment (362 trials, 46.8%) and multimodal therapy (129 trials, 16.7%). Of the 125 trials where surgery was the manipulated variable, 59 trials (47.2%) focused on surgical techniques (including minimally invasive) or devices, 45 trials (36.0%) studied invasive diagnostic methods, and 21 trials (16.8%) evaluated surgery vs. no surgery. The majority of the 125 trials were non- randomized (72, 57.6%), and Phase III trials accounted for less than one-quarter (29, 23.2%). Conclusions: The number of registered surgical oncology trials is small in comparison to oncology trials as a whole. Clinical trials specifically designed to assess surgical interventions are vastly outnumbered by trials focusing on adjuvant therapies, and are frequently non-randomized. Randomized surgical oncology trials account for <1% of all registered cancer trials. Barriers to the design and implementation of randomized trials in surgical oncology need to be clarified to facilitate higher-level evidence in surgical decision making.

Evolution of pancreatic cancer survival over the past two decades.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15722-e15722
Author(s):  
Veronica Mariotti ◽  
Ricardo Daniel Parrondo ◽  
Miguel Gonzalez Velez ◽  
Narjust Duma ◽  
Lori Ann Leslie ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Cancer Survival ◽  
Single Agent ◽  
Surgical Techniques ◽  
Pancreatic Head ◽  
Age At Diagnosis ◽  
Cancer Center ◽  
The Past ◽  
Significant Difference

e15722 Background: Pancreatic cancer (PaCa) is a highly lethal disease, with a 5-year overall survival (OS) rate of approximately 6%, and a median OS of only 3–6 months (m). Despite recent improvements in surgical techniques and increased use of combination chemotherapy (CT), OS remains poor. This study aims to examine the factors that led to increased OS in PaCa patients (pts) over the past two decades in a single academic institution. Methods: All medical records of pts diagnosed with PaCa at the John Theurer Cancer Center from 1990 to 2012 were reviewed, and 916 PaCa pts were included in this analysis. We compared one group of pts diagnosed from 1990 to 2003 (G1, n = 482), with a group of pts diagnosed from 2004 to 2012 (G2, n = 434) in terms of OS, demographics, tumor features and treatment (tx). Results: Median age at diagnosis was 70.5 years (range 26-96). There was no significant difference between G1 and G2 in terms of age at diagnosis, stage of disease and number of pts who received surgery. A significantly higher percentage of pts received CT in G2 compared to G1 (66.5% vs 51.0%, p = .00). Tumors of the pancreatic head were more common in G1 compared to G2 (51.8% vs 44.4% p = .02). More pts in G2 received two or more CT agents compared to G1 (49.0% vs 34.1%, p = .00). Median OS was significantly longer in G2 compared to G1 (9m vs 5m, p = .00), in pts who received CT compared to pts who did not (3m vs 9m, p = .00) and in pts who received surgery compared to pts who did not (5m vs 19m, p = .00). Pancreatic head location was associated with improved OS compared to other locations (9m vs 5m, p = .00). No OS difference was found between pts who received combination with two or more agents vs single agent CT. Conclusions: In line with multiple studies, analysis of PaCa data from our institution showed an increase OS in pts diagnosed with PaCa in more recent years, and in those who received surgery and CT. CT was administered in a larger number of pts in G2, which might account for the better OS in this group. Pts diagnosed with tumors of the pancreatic head had better survival, which could be explained by earlier presentation leading to earlier diagnosis and tx. Further research in PaCa therapeutics is needed, as long-term OS in PaCa pts remains poor despite recent advances.

scholarly journals Rural Poverty and Land Degradation: A Review of the Current State of Knowledge

1998 ◽  
Vol 37 (4II) ◽  
pp. 1053-1070 ◽  
Author(s):  
Sohail Jehangir Malik ◽  
Hina Nazli
Keyword(s):  
World Bank ◽  
Land Degradation ◽  
Rural Poverty ◽  
The Past ◽  
Current State ◽  
The World Bank ◽  
Resource Degradation ◽  
The World ◽  
Short And Long Term

By highlighting the lack of rigorous evidence and calling for a greater understanding of the interaction of the two processes, a recent study [Nelson et al. (1997)] has called into question the strong perception that poverty is both a consequence as well as a cause of resource degradation.1 This perception which is widely held is strongly evident in the writings of the multilateral development agencies such as the World Bank (1990) and IFAD (1992) and exists despite extensive reviews which indicate that the short- and long-term implications of land degradation are not very clear [see Scherr and Yadav (1995)]. Similarly, while knowledge about poverty is expanding rapidly, thanks in large parts to the massive international focus and resources brought to bear on its understanding in the past ten.........................

scholarly journals MAIN TRENDS AND PROSPECTS FOR THE DEVELOPMENT OF TRANSPORT BIOFUELS MARKET IN THE EU AND UKRAINE

2020 ◽  
Vol 42 (1) ◽  
pp. 69-76
Author(s):  
G.G. Geletukha ◽  
T.A. Zheliezna ◽  
S.V. Drahniev ◽  
A.I. Bashtovyi
Keyword(s):  
European Union ◽  
Renewable Energy ◽  
Transport Sector ◽  
The European Union ◽  
Second Generation Biofuels ◽  
The Past ◽  
Current State ◽  
Total Capacity ◽  
Stagnation Period ◽  
The Eu

Purpose of the work is to analyze the perspective directions for the development of transport biofuels sector in Ukraine. Current state and prospects for the production and utilization of transport biofuels in the EU are presented. It is shown that the consumption of transport biofuels in the European Union increased quite dynamically during 2004-2012, experienced a stagnation period for the next four years and started to rise again from 2017. Directive (EU) 2018/2001 (RED II) sets the mandatory target of achieving 14% of renewable energy in the EU transport sector by 2030, with a mandatory share of second generation biofuels. Analysis of the situation in Ukraine shows that the production of bioethanol and biodiesel, unfortunately, has not reached wide development. Over the past twenty years, several relevant programs were developed and approved in the country, but their implementation was not successful in terms of achieving the goals. Today, there are about 20 bioethanol producers in Ukraine with a total capacity of more than 300 kt/yr, but only 8 enterprises with a total capacity of 128 kt/yr are operating. It is known that 14 biodiesel plants with a total capacity of 300 kt/yr have been built in Ukraine, but at present they are actually idle. In addition, there are about 50 smaller enterprises capable of producing up to 25 kt of biodiesel per year, but no reliable information on the actual activity of these enterprises is available. It is obvious that the sector of transport biofuels is currently in a state of stagnation in Ukraine. To improve the situation, it is necessary to implement the consistent state policy and appropriate incentive instruments.

Banking in Africa

2019 ◽  
pp. 1075-1112
Author(s):  
Thorsten Beck ◽  
Robert Cull ◽  
Patricio Valenzuela
Keyword(s):  
Developing Countries ◽  
Financial Services ◽  
Sub Saharan Africa ◽  
Banking Systems ◽  
Financial Innovations ◽  
The Past ◽  
Current State ◽  
Recent Developments ◽  
Sub Saharan

This chapter takes stock of the current state of banking systems across Sub-Saharan Africa and discusses recent developments, including innovations that might help Africa leapfrog more traditional banking models. Using an array of different data, the chapter documents that African banking systems are shallow but stable. African banks are well capitalized and over-liquid, but lend less to the private sector than banks in non-African developing countries. African enterprises and households are less likely to use financial services than their peers in other developing countries, although there has been significant progress over the past decade. The chapter also describes a number of financial innovations across the continent that can help overcome different barriers to financial inclusion and have helped to expand the bankable and the banked population. The chapter ends with discussing current challenges for policymakers and academics, including the lack of (data on) long-term finance and the supervisory challenges stemming from increasing cross-border banking in the region.

Publication Trends and Global Collaborations on Esophageal Atresia Research: A Bibliometric Study

2020 ◽  
Author(s):  
Xiaoyan Feng ◽  
Illya Martynov ◽  
Anne Suttkus ◽  
Martin Lacher ◽  
Steffi Mayer
Keyword(s):  
Esophageal Atresia ◽  
Pediatric Surgery ◽  
Perioperative Complications ◽  
Citation Rate ◽  
Surgical Techniques ◽  
Global Network ◽  
Term Outcome ◽  
Long Term Outcome ◽  
The Past

Abstract Introduction Research on esophageal atresia (EA) has been heavily published over the past decades. Herein, we aimed to study the quantity and quality as well as key topics in EA research with regards to global collaborations among countries and authors. Material and Methods Publications on EA from 1945 to 2018 were extracted from the Web of Science core collection database. Productivity (quantity) was assessed by the number of publications. Quality was estimated from the number of citations, citation rate per item and year, h-index, and impact index. Collaborative networks were evaluated using VOSviewer. All measures were analyzed for countries, authors, and journals. The 10 most cited original articles between 1969 and 2018 in 5-year intervals (n = 100) were manually screened to assess the key points of EA research. Results A total of 2,170 publications from 85 countries published in 388 journals were identified yielding 26,755 citations, both significantly increasing over time (p < 0.001). The most productive countries and authors also accounted for high-quality publications and benefited from an active global network. The most productive journals derived from the field of pediatric surgery but accounted only for one-third of EA papers. The best cited journals were unspecific for pediatric surgery. Long-term outcome remained the most important topic in EA research, followed by surgical techniques, epidemiology, associated anomalies, perioperative complications, and postnatal management. In contrast, basic science was underrepresented. Conclusion Over the past seven decades, EA publications increased tremendously. Productiveness and quality benefited from global networking. Long-term outcome remains the key interest of EA research.

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