Analysing the attributes of Comprehensive Cancer Centres and Cancer Centres across Europe to identify key hallmarks

There is a persistent variation in cancer outcomes among and within European countries suggesting (among other causes) inequalities in access to or delivery of high‐quality cancer care. European policy (EU Cancer Mission and Europe’s Beating Cancer Plan) is currently moving towards a mission‐oriented approach addressing these inequalities. In this study, we used the quantitative and qualitative data of the Organisation of European Cancer Institutes’ Accreditation and Designation Programme, relating to 40 large European cancer centres, to describe their current compliance with quality standards, to identify the hallmarks common to all centres and to show the distinctive features of Comprehensive Cancer Centres. All Comprehensive Cancer Centres and Cancer Centres accredited by the Organisation of European Cancer Institutes show good compliance with quality standards related to care, multidisciplinarity and patient centredness. However, Comprehensive Cancer Centres on average showed significantly better scores on indicators related to the volume, quality and integration of translational research, such as high‐impact publications, clinical trial activity (especially in phase I and phase IIa trials) and filing more patents as early indicators of innovation. However, irrespective of their size, centres show significant variability regarding effective governance when functioning as entities within larger hospitals.     

Why you need to look where you step for precise foot placement: The effects of gaze eccentricity on stepping errors

Previous research has shown that accurate stepping involves the fixation of gaze on the intended step location. One possible explanation for this visual strategy is that the fixation of locations that are eccentric relative to the step target, results in systematic localization errors, as has previously been demonstrated in pointing. To test this idea, we assessed the possible role of gaze stabilization in the spatial planning of accurate steps, and determined whether the direction of mediolateral stepping errors depended on the direction of gaze. Final foot position was recorded from ten healthy participants when making steps towards prints of their own foot, in light and in darkness, and fixating their gaze on (i) the stepping target or (ii) locations 30 cm to the left or right of the target. The results showed that accuracy and precision of foot placement were reduced when stepping in darkness or when fixating eccentric gaze targets, demonstrating that visual feedback on the target and/or foot facilitates spatial control of the foot, and that foveal information is superior to perifoveal information in this respect. Crucially, the direction of the mediolateral stepping errors depended on the direction of gaze: on average participants overstepped 12 mm contralateral to the direction of gaze when fixating eccentric locations, indicating that the fixation of locations eccentric to the stepping target results in inaccuracies in foot placement. These results provide new insights into the contributions of foveal vision to the spatial planning of precise steps, and explain why it is important to look where you step when accurate foot placement is required.     

In Vitro Fermentation of caprine milk oligosaccharides by bifidobacteria isolated from breast-fed infants

This study was conducted to investigate the catabolism and fermentation of caprine milk oligosaccharides (CMO) by selected bifidobacteria isolated from 4 breast-fed infants. Seventeen bifidobacterial isolates consisting of 3 different species (Bifidobacterium breve, Bifidobacterium longum subsp. longum and Bifidobacterium bifidum) were investigated. A CMO-enriched fraction (CMOF) (50% oligosaccharides, 10% galacto-oligosaccharides (GOS), 20% lactose, 10% glucose and 10% galactose) from caprine cheese whey was added to a growth medium as a sole source of fermentable carbohydrate. The inclusion of the CMOF was associated with increased bifidobacterial growth for all strains compared to glucose, lactose, GOS, inulin, oligofructose, 3''-sialyl-lactose and 6''-sialyl-lactose. Only one B. bifidum strain (AGR2166) was able to utilize the sialyl-CMO, 3''-sialyl-lactose and 6''-sialyl-lactose, as carbohydrate sources. The inclusion of CMOF increased the production of acetic and lactic acid (P < 0.001) after 36 h of anaerobic fermentation at 37°C, when compared to other fermentable substrates. Two B. bifidum strains (AGR2166 and AGR2168) utilised CMO, contained in the CMOF, to a greater extent than B. breve or B. longum subsp longum isolates, and this increased CMO utilization was associated with enhanced sialidase activity. CMOF stimulated bifidobacterial growth when compared to other tested fermentable carbohydrates and also increased the consumption of mono- and disaccharides, such as galactose and lactose present in the CMOF. These findings indicate that the dietary consumption of CMO may stimulate the growth and metabolism of intestinal Bifidobacteria spp. including B. bifidum typically found in the large intestine of breast-fed infants.     

Distribution of tumors in the retina in hereditary retinoblastoma patients

We have compared the location of the ocular tumors in hereditary retinoblastoma in relation to the age of the patients at time of diagnosis. Eighty fundus drawings were analyzed from 59 hereditary patients containing 159 tumors. At the time of diagnosis, indirect ophthalmoscopy was performed under general anaesthesia in all patients and standard drawings of the retina were made depicting the number and relative location of all tumors. The distance between the center of the tumor and the center of the macula was measured and plotted against the age of the patients at time of diagnosis. The results show that the distance between the center of the tumor and the center of the macula at time of diagnosis increases with age during the first seven months after birth.     

Mercury Accumulation in Millipedes (Narceus spp.) Living Adjacent to a Southern Appalachian Mountain Stream (USA)

Bulletin of Environmental Contamination and Toxicology - Millipedes are among the most important processors of leaf litter in temperate forests. Through consumption of leaf litter, millipedes may...     

The Role of Sexual Dimorphism and Tissue Selection in Ecotoxicological Studies Using the Riparian Spider Tetragnatha elongata

Bulletin of Environmental Contamination and Toxicology - Tetragnathid spiders (Tetragnatha spp.) found in riparian habitats have recently been used as bioindicators of sediment contamination and...     

Matrix depletion of young and old human articular cartilage by cultured autologous synovium fragments: a chondrocyte-independent effect

Summary Human articular cartilage of different ages was cultured for 8 days and proteoglycan (PG) release into the medium was measured. Retinol and synovial co-culture increased the PG release of cartilage of all ages. The effect of retinol was dose-dependent. Synovium increased also the PG release of dead cartilage, whereas retinol did not. The increased PG release by synovial co-culture is therefore mainly the result of synovial enzymes acting directly on the matrix rather than of a factor inducing chondrocyte-mediated breakdown.     

Bradycardia despite hyperthyroidism

Hyperthyroidism is usually associated with tachycardia, hypothyroidism with bradycardia. After observing clinically inapparent hyperthyroidism in patients requiring pacemaker implantation, we studied the occurrence of hyperthyroidism in patients receiving a first permanent pacemaker. Of 237 patients (age 71.4 +/- 8.9 years; 54.9% females), 16 (6.75%) had subclinical (TSH < 0.1 mE/l and fT3 < or = 9.0 pmol/l) and 4 (1.69%) overt hyperthyroidism (TSH < 0.1 mE/l and fT3 > 9.0 pmol/l). Prevalence of hyperthyroidism was similar to that in the general population. Compared to euthyroid patients, in the patients with subclinical or overt hyperthyroidism there were significantly more females (n = 16) than males (n = 4; p = 0.018). Hyperthyroid patients were older (75.0 +/- 9.6 vs. 70.7 +/- 8.9 years; p = 0.015). At follow-up, all patients had a relevant proportion of pacemacer-induced beats. Clinical signs of hyperthyroidism or cardiac symptoms were not different between groups. In conclusion, bradycardia does not exclude the presence of hyperthyroidism. Temporary pacing is recommended in thyreotoxicosis with bradycardia. In contrast, primary implantation of a permanent pacemaker appears to be adequate in patients with bradycardia, cardiovascular disease and an additional diagnosis of hyperthyroidism.     

Biologic agents used to treat rheumatoid arthritis and their relevance to podiatrists: a practice update

This review considers the pharmacological management of rheumatoid arthritis including the role of anti-tumour necrosis factor alpha (TNFalpha) agents, as a precursor to highlighting some of the issues for podiatrists involved in the care of patients on this particular medication.