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for different indications.

Previous studies have reported lower colorectal cancer (CRC) survival in patients with low compared to high educational levels. We investigated the impact of education on CRC survival by using both individual and area-based information on education.

Patients diagnosed with CRC in Finland in 2007-2016 were followed up for death until the end of 2016. Age-standardized relative survival and relative excess risk of death (RER) were estimated by sex using period approach. RERs were adjusted for age, stage at diagnosis, cancer site, urbanity, hospital district and municipality by using Bayesian piecewise constant excess hazard models. Analyses were conducted including individual (basic, secondary, high) and area-based (quartiles Q1-Q4 based on the proportion of population with basic education) education separately as well as both measures in one model.

We analysed in all 24 462 CRC patients. There was a clear gradient in 5-year relative survival across education groups (men basic 62 %, secondary 64 %, high 69 %; women basic 61 %, secondary 67 %, high 71 %). Compared to the basic education group, RER in the high education group was significantly lower. This association was still present after including area-based education in the models (men RER 0.72, 95 % Confidence interval (CI) 0.64-0.81; women RER 0.76, 95 % CI 0.59-0.96). Area-based education revealed smaller effect estimates than individual education in CRC survival and no association for men.

Individual education information should be preferred over area-based when survival differences are studied by education. Educational differences in CRC survival are still present in Finland.

Individual education information should be preferred over area-based when survival differences are studied by education. Educational differences in CRC survival are still present in Finland.

The purpose of this study was to assess the relationship between the low anterior resection syndrome (LARS) and quality of life (QOL). selleck kinase inhibitor Furthermore, in patients with major LARS, therapeutic management options were explored.

A cohort of surviving patients, who underwent a low anterior resection for rectal cancer after long course of radiochemotherapy, were identified. These patients were treated in Ghent University Hospital between 2006 and 2016. QOL was assessed using the European Organization for Research and Treatment of Cancer Quality Of Life questionnaire-C30 and the bowel function using the LARS-score. The relationship between LARS and QOL was analysed. Patients with major LARS (≥30 points) were contacted to explore their therapeutic management of LARS.

69% of the participants had major LARS. QOL was closely associated with LARS. Significant differences were found between those with and without LARS in the global health status (p≤0.001) and in the following functional scales physical (p≤0.001), role (p≤0.001), cognitive (p=0.04) and social (p≤0.001). Patients with major LARS experienced more diarrhea (p≤0.001), fatigue (p=0.002), insomnia (p≤0.001) and pain (p=0.02), compared to patient with no/minor LARS. Most patients tried dietary regimens (71%), medication (71%) and incontinence material (63.8%) in an attempt to manage their LARS and found some of them useful. The level of the anastomosis (low) was a significant risk factor for major LARS (p=0.03).

More than half of the patients in this cohort still suffered from major LARS. Patients confronted with major LARS had a lower QOL than patients with no/minor LARS. Currently, there is no gold standard for the management of LARS. Patients manage it through trial and error.

More than half of the patients in this cohort still suffered from major LARS. Patients confronted with major LARS had a lower QOL than patients with no/minor LARS. Currently, there is no gold standard for the management of LARS. Patients manage it through trial and error.

Effective symptom management and provider-patient communication are critical components of quality palliative cancer care. Studies suggest nurse-telephone-interventions are feasible, acceptable and may improve the provision and satisfaction with care. However, little is known about what specific elements of nurse-telephone-interventions are most beneficial. The study’s purpose was to describe the nature and key elements of therapeutic calls made by nurses to advanced cancer patients to understand what may have previously contributed to improvement in patients who received the intervention.

As part of a larger study on methylphenidate and/or a nurse-telephone-intervention for fatigue in advanced cancer patients from a tertiary hospital, nurse calls were made to 95 patients. This qualitative descriptive study used thematic analysis of transcribed telephone calls between nurses and advanced cancer patients.

The overarching theme of these calls was supporting patients with empathy. Empathy in these conversaThe growing evidence base underscoring the numerous benefits of medical empathy may serve as a basis for adopting simple, feasible and accessible approaches such as empathic nurse-telephone-interventions in both research and clinical practice.

The aim of this study was to obtain greater insight into the environmental and genetic factors affecting the oral microbiome.

To this end, we investigated the oral microbiome composition in Han and Zang populations living at different altitudes. The saliva microbiome in 115 individuals from Zang and Han populations living at different altitudes was analyzed using the 16 s rRNA gene sequencing method on the Illumina MiSeq platform. The dominant species in the oral microbiome were verified by quantitative real-time polymerase chain reaction (qPCR) analysis.

The Han population, living at an altitude of 500 m, had higher microbiome diversity than the Zang population living at altitudes of 3000-4000 m. People living at 3000 m had a higher relative abundance of Leptothrix genus, but people living at 500 m had a higher relative abundance of Capnocytophaga genus according to Lefse difference analysis (P < 0.05). Compared to the Zang population, the Han population had higher relative abundances of Porphyromonas and Treponema genus organisms, especially Porphyromonas (P < 0.001). qPCR analysis confirmed that people living at high altitudes had the highest relative abundance of Porphyromonas gingivalis (P < 0.01).

This study showed that both genetics and the environment had significant influences on the oral microbiome composition. The study proposed a meaningful research direction to explore the relationship between different ethnic and altitude groups and oral diseases, such as periodontal diseases.

This study showed that both genetics and the environment had significant influences on the oral microbiome composition. The study proposed a meaningful research direction to explore the relationship between different ethnic and altitude groups and oral diseases, such as periodontal diseases.A wide range of species, including marine mammals, seabirds, birds of prey, fish and bivalves, were investigated for potential population health risks resulting from contemporary (post 2000) mercury (Hg) exposure, using novel risk thresholds based on literature and de novo contamination data. The main geographic focus is on the Baltic Sea, while data from the same species in adjacent waters, such as the Greater North Sea and North Atlantic, were included for comparative purposes. For marine mammals, 23% of the groups, each composing individuals of a specific sex and maturity from the same species in a specific study region, showed Hg-concentrations within the High Risk Category (HRC) and Severe Risk Category (SRC). The corresponding percentages for seabirds, fish and bivalves were 2.7%, 25% and 8.0%, respectively, although fish and bivalves were not represented in the SRC. link2 Juveniles from all species showed to be at no or low risk. In comparison to the same species in the adjacent waters, i.e. the Greater North Sea and the North Atlantic, the estimated risk for Baltic populations is not considerably higher. These findings suggest that over the past few decades the Baltic Sea has improved considerably with respect to presenting Hg exposure to its local species, while it does still carry a legacy of elevated Hg levels resulting from high neighbouring industrial and agricultural activity and slow water turnover regime.Non-Methane Volatile Organic Compounds (NMVOCs) from domestic aerosol sprays are emerging pollutants and have substantial negative effects on human health and the environment. This study, for the first time, carried out quantification of the NMVOC emissions from off-the-shelf domestic aerosol sprays, at “source” in the UK. These aerosol sprays contain harmful organic compounds as propellants and products. The results showed that the cosmetic category (i.e. body sprays) have higher concentrations of NMVOCs with 93.7 wt% per can compared to households (i.e. air fresheners) with 62 wt%. Also, water-based products showed less NMVOCs in all analyses compared to solvent-based formulations. Direct replacement of Liquefied Petroleum Gas (LPG) propellants from conventional products with ‘clean air’ (i.e. nitrogen) showed the potential emission reduction of 50%. Hair spray products, however, have the highest ozone forming potential with about 105.1 g of Ozone per litre of the product compared to other domestic aerosol sprays. The level of global warming contribution of the selected aerosol sprays in the UK was measured to be 129.8 ktCO2e in 2018 and globally, this can be projected to be 3154.6 ktCO2e in 2020. Furthermore, NMVOC emissions contribution from the domestic aerosol sprays in the UK was measured as 61.2 kt in 2018 based on annual consumption of 520 million cans. Globally this can equate to 1437.6 kt based on the projected usage of 17.5 billion cans. Therefore, it is vital to expedite replacing LPG propellant with nitrogen in a drive for a ‘near-zero’ emission in aerosol industry. link3 The results presented in this study can also be used to steer policy makers to the potentially brewing danger from an otherwise passive emission source.In Brazil, there have been few leptospires isolated from cattle, especially in the Amazon, implying that the epidemiology of the disease in this region is still largely unclear. In a previous study, 52 Leptospira isolates were obtained from urine of cattle raised in the Brazilian Amazon and, to achieve a greater understanding of Leptospira infection in cattle of this region, the present study aimed to serologically and molecularly characterizes all these isolates. The laboratory assays used were the microscopic agglutination test (MAT) adopting a panel of polyclonal antisera against Leptospira spp. for serogrouping the isolates, DNA sequencing (secY) and multiple locus variable number tandem repeat analysis (MLVA). The isolates belonged to five species 20/52 were identified as L. borgpetersenii (38.5 %); 18/52 as L. kirschneri (34.6 %); 9/52 as L. santarosai (17.3 %); 3/52 as L. noguchii (5.8 %) and 2/52 as L. interrogans (3.8 %). With serogrouping, nine different serogroups were detected, with a high frequency of the Sejroe serogroup. MLVA showed that all L. borgpetersenii isolates had a profile compatible with serovar Hardjo; moreover, the other isolates demonstrated a diversity of patterns, and some of them may represent strains not yet characterized. In the Brazilian Amazon, the leptospires circulating in cattle revealed the unique aspects of infections in this area which, in addition to a variety of strains, were characterized by a high frequency of the Sejroe serogroup, highlighting the serovar Hardjo, which has not been reported in other regions of Brazil.