Modeling circular economy innovation and performance indicators in European Union countries.

The concept of circular economy (CE) is increasingly prominent in European Union (EU) countries, considering the demand for incorporating renewable resources into end products. Similar to sustainable development dimensions, CE indicators can be classified within economic, social, and environmental protection categories, depending on their measuring scope, and within micro-, meso-, and macro-level, depending on the level of observation. The aim of the research is to determine the impact of CE innovation on CE performance in EU countries by modeling the Eurostat indicators via SmartPLS software. Relying on the relevant literature review, the paper first presents the concept of CE and the composite indicators used for evaluating its specific performances, as well as previous global and European experiences. Further, the study focuses on the modeling options for CE performance composite indicators demonstrating the relationship between the accomplishments of CE and the use of innovative measures at the level of products, services, or processes. Based on the data from EU27 countries for the period 2018-2021, the paper explores the relationship between variable and model composite indicators using SmartPLS software. SmartPLS output results support four assumption paths between CE indicator groups which are also confirmed with convergent and discriminant validity and heterotrait-monotrait ratio (HTMT) values. CE path modeling structure confirms the positive connection between CE innovations and CE performance emphasizing the need for providing a supportive environment and funds for innovations.

Occupational injuries in underground coal mining in Serbia: A case study.

BACKGROUND: Mining, especially underground coal mining, has always been a hazardous occupation. Injuries, including those that are fatal, are a major occupational risk that all miners have to face. OBJECTIVE: Despite the fact that all workers are aware of the risks, efforts must be made to increase their safety through the implementation of preventive measures. METHODS: This retrospective study includes injury data from all nine Serbian coal mines over a 16-year period, from 2000 to 2016. All injury data were collected from employee safety and health records. RESULTS: In the analyzed period, a total of 9,273 occupational injuries were recorded at Resavica. The highest number of occupational injuries (over 600) were recorded in 2008 (669), 2004 (651), and 2005 (603). The data shows that almost one fifth of the total number of occupational injuries, or 20.74%, occurred during the said three years. On average, 493.06 minor, 51.12 severe, and 1.29 fatal injuries occurred each year. Every day there were 1.29 minor occupational injuries and every seven days there was one severe injury. CONCLUSIONS: Despite indications that there is a connection between some of the variables and the number of injuries, the general conclusion is that injuries are accidental and unpredictable. The high percentages of injuries are due to the organization of work and the age or qualification structure of the staff and, of course, are the consequence of likelihood -the greater the number of workers, the greater the likelihood of injury. However, the present study showed that some measures can be taken to increase occupational safety and reduce the number of injuries.

Birth seasonality of childhood central nervous system tumors: Analysis of primary data from 16 Southern-Eastern European population-based registries.

Season of birth, a surrogate of seasonal variation of environmental exposures, has been associated with increased risk of several cancers. In the context of a Southern-Eastern Europe (SEE) consortium, we explored the potential association of birth seasonality with childhood (0-14 years) central nervous system (CNS) tumors. Primary CNS tumor cases (n = 6,014) were retrieved from 16 population-based SEE registries (1983-2015). Poisson regression and meta-analyses on birth season were performed in nine countries with available live birth data (n = 4,987). Subanalyses by birth month, age, gender and principal histology were also conducted. Children born during winter were at a slightly increased risk of developing a CNS tumor overall [incidence rate ratio (IRR): 1.06, 95% confidence intervals (CI): 0.99-1.14], and of embryonal histology specifically (IRR: 1.13, 95% CI: 1.01-1.27). The winter peak of embryonal tumors was higher among boys (IRR: 1.24, 95% CI: 1.05-1.46), especially during the first 4 years of life (IRR: 1.33, 95% CI: 1.03-1.71). In contrast, boys <5 years born during summer seemed to be at a lower risk of embryonal tumors (IRR: 0.73, 95% CI: 0.54-0.99). A clustering of astrocytomas was also found among girls (0-14 years) born during spring (IRR: 1.23, 95% CI: 1.03-1.46). Although the present exploratory results are by no means definitive, they provide some indications for age-, gender- and histology-related seasonal variations of CNS tumors. Expansion of registration and linkage with cytogenetic reports could refine if birth seasonality is causally associated with CNS tumors and shed light into the complex pathophysiology of this lethal disease.

Integrated system of occupational safety and health and fire protection of the fire rescue brigades members.

The objective of the conducted research is the identification and determination of requirements of members of fire rescue brigades during operations in the conditions of high risk in order to minimize the possibilities for injury incidence during the intervention. The research is focused on examination, determination and identification of factors affecting the increasing number of occupational injuries of members of fire rescue brigades during interventions. Hypothetical framework of the research problem consists of general hypothesis and six special hypotheses. Results suggest that almost all respondents believe that their skills and abilities are applicable in the intervention phase, but less than a half believe that their skills are applicable in prevention phase. Two-thirds of respondents stated that in their organization they have support for further education and upgrading while a half of respondents stated that they need education concerning identification, assessment and management of risks that can lead to emergency situations.

Environmental impacts the of production and use of biodiesel.

Biodiesel as renewable, environmental friendly, less toxic, and biodegradable is an attractive alternative to fossil fuels and is produced mainly from vegetable oils and animal fats. It is expected, globally, that the use of renewable biofuels, in general, will increase rapidly in the near future. The growing biodiesel production and usage have encouraged assessment of its impact on the environment. The present paper reviews various aspects of biodiesel production using commercial processing technology and biodiesel use through evaluation and analysis of the studies concerning environmental impacts of biodiesel. As a general conclusion, it can be said that biodiesel has the potential to offer a series of perceived benefits such as political, economical, and agricultural, as well as environmental (due to its biodegradability, less toxicity, renewability) and health (greenhouse gas-saving, less harmful exhaust emissions).

Mortality and survival patterns of childhood lymphomas: geographic and age-specific patterns in Southern-Eastern European and SEER/US registration data.

Childhood (0-14 years) lymphomas, nowadays, present a highly curable malignancy compared with other types of cancer. We used readily available cancer registration data to assess mortality and survival disparities among children residing in Southern-Eastern European (SEE) countries and those in the United States. Average age-standardized mortality rates and time trends of Hodgkin (HL) and non-Hodgkin (NHL; including Burkitt [BL]) lymphomas in 14 SEE cancer registries (1990-2014) and the Surveillance, Epidemiology, and End Results Program (SEER, United States; 1990-2012) were calculated. Survival patterns in a total of 8918 cases distinguishing also BL were assessed through Kaplan-Meier curves and multivariate Cox regression models. Variable, rather decreasing, mortality trends were noted among SEE. Rates were overall higher than that in SEER (1.02/106 ), which presented a sizeable (-4.8%, P = .0001) annual change. Additionally, remarkable survival improvements were manifested in SEER (10 years: 96%, 86%, and 90% for HL, NHL, and BL, respectively), whereas diverse, still lower, rates were noted in SEE. Non-HL was associated with a poorer outcome and an amphi-directional age-specific pattern; specifically, prognosis was inferior in children younger than 5 years than in those who are 10 to 14 years old from SEE (hazard ratio 1.58, 95% confidence interval 1.28-1.96) and superior in children who are 5 to 9 years old from SEER/United States (hazard ratio 0.63, 95% confidence interval 0.46-0.88) than in those who are 10 to 14 years old. In conclusion, higher SEE lymphoma mortality rates than those in SEER, but overall decreasing trends, were found. Despite significant survival gains among developed countries, there are still substantial geographic, disease subtype-specific, and age-specific outcome disparities pointing to persisting gaps in the implementation of new treatment modalities and indicating further research needs.

Incidence and time trends of childhood lymphomas: findings from 14 Southern and Eastern European cancer registries and the Surveillance, Epidemiology and End Results, USA.

PURPOSE: To describe epidemiologic patterns of childhood (0-14 years) lymphomas in the Southern and Eastern European (SEE) region in comparison with the Surveillance, Epidemiology and End Results (SEER), USA, and explore tentative discrepancies. METHODS: Childhood lymphomas were retrieved from 14 SEE registries (n = 4,702) and SEER (n = 4,416), diagnosed during 1990-2014; incidence rates were estimated and time trends were evaluated. RESULTS: Overall age-adjusted incidence rate was higher in SEE (16.9/106) compared to SEER (13.6/106), because of a higher incidence of Hodgkin (HL, 7.5/106 vs. 5.1/106) and Burkitt lymphoma (BL, 3.1 vs. 2.3/106), whereas the incidence of non-Hodgkin lymphoma (NHL) was overall identical (5.9/106 vs. 5.8/106), albeit variable among SEE. Incidence increased with age, except for BL which peaked at 4 years; HL in SEE also showed an early male-specific peak at 4 years. The male preponderance was more pronounced for BL and attenuated with increasing age for HL. Increasing trends were noted in SEER for total lymphomas and NHL, and was marginal for HL, as contrasted to the decreasing HL and NHL trends generally observed in SEE registries, with the exception of increasing HL incidence in Portugal; of note, BL incidence trend followed a male-specific increasing trend in SEE. CONCLUSIONS: Registry-based data reveal variable patterns and time trends of childhood lymphomas in SEE and SEER during the last decades, possibly reflecting diverse levels of socioeconomic development of the populations in the respective areas; optimization of registration process may allow further exploration of molecular characteristics of disease subtypes.

Survival trends in childhood chronic myeloid leukaemia in Southern-Eastern Europe and the United States of America.

AIM: To assess trends in survival and geographic disparities among children (0-14 years) with chronic myeloid leukaemia (CML) before and after the introduction of molecular therapy, namely tyrosine kinase inhibitors (TKIs) in Southern-Eastern European (SEE) countries and the USA. METHODS: We calculated survival among children with CML, acute lymphoblastic (ALL) and acute myeloid leukaemia (AML) in 14 SEE (1990-2014) cancer registries and the U.S. Surveillance, Epidemiology and End Results Program (SEER, 1990-2012). We used Kaplan-Meier curves and multivariate Cox regression models to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). RESULTS: Among 369 CML cases, substantial improvements were noted in 2-year survival during the post-TKI (range: 81-89%) compared to pre-TKI period (49-66%; HR: 0.37, 95% CI: 0.23-0.60). Risk of death was three times higher for <5-year-old children versus those aged 10-14 years (HR: 3.03, 95% CI: 1.85-4.94) and 56% higher for those living in SEE versus SEER (HR: 1.56, 95% CI: 1.01-2.42). Regardless of geographic area and period of TKI administration, however, age seems to be a significant determinant of CML prognosis (pre-TKI period, HR0-4y: 2.71, 95% CI: 1.53-4.79; post-TKI period, HR0-4y: 3.38, 95% CI: 1.29-8.85). Noticeably, post-TKI survival in CML overall approximates that for ALL, whereas therapeutic advancements for AML remain modest. CONCLUSION: Registry data show that introduction of molecular therapies coincides with revolutionised therapeutic outcomes in childhood CML entailing dramatically improved survival which is now similar to that in ALL. Given that age disparities in survival remain substantial, offering optimal therapy to entire populations is an urgent priority.

Lip, oral cavity and pharyngeal cancers in the population of the city of Belgrade in the period 1999-2010.

BACKGROUND/AIM: Cancers of the lip, oral cavity and pharynx (LOCP) are frequently grouped together mainly because they have similar risk factors. The incidence rate of these cancers varies worldwide depending on the geographic location. The aim of this study was to determine trends in age-standardized incidence rates of LOCP cancers in the Belgrade population during a 12-year period, from 1999 to 2010. METHODS: From The Serbian Cancer Registry (The Registry), we extracted all cases of LOCP cancers registered in Belgrade from January 1, 1999 to December 31, 2010. Joinpoint regression analysis was used to define trends and annual percentage change (APC). RESULTS: A total number of 2,025 (1,509 in men and 516 in women) LOCP cancers were reported to the Registry during the study period. The age standardized rate (ASR) for the entire period and for all LOCP cancers, was 6.24 per 100,000 persons (10.35 for men and 2.86 for women). ASR for lip cancers decreased (p < 0.001) during the study period with APC of -8.4%. The ASR for oral cavity and pharyngeal cancers increased (p < 0.05). CONCLUSION: Our results show a significantly decreasing trend of the incidence rate for lip cancers in the population of the city of Belgrade between 1999 and 2010. On the contrary, the incidence of oral cavity and pharyngeal cancers increased for both men and women.

Disparities in melanoma incidence and mortality in South-Eastern Europe: Increasing incidence and divergent mortality patterns. Is progress around the corner?

INTRODUCTION: Most countries in South-Eastern Europe (SEE) have lower incidence, but higher mortality rates of malignant melanoma (MM) of the skin compared to North-Western Europe (NWE). We explored trends in MM incidence and mortality in SEE countries by sex and age and compared them with the trends in NWE. METHODS: We obtained data on incident cases and deaths from MM (ICD-10 code C43) from 11 population-based cancer registries in Bosnia and Herzegovina, Bulgaria, Croatia, Cyprus, Czech Republic, Malta, Romania, Serbia, Slovakia, Slovenia and Turkey. We calculated age-specific rates for 25-49 ('young'), 50-69 ('middle aged') and 70+ years ('older') and estimated the average annual percent of change in incidence and mortality trends 2000-2010 according to age group and sex, using joinpoint regression analysis. FINDINGS: The incidence rates of MM across the region were uniformly increasing. Significant increases in mortality rates were observed in middle aged men in Serbia and Bulgaria, middle aged women in Slovenia, older men in the Czech Republic, Serbia and Turkey, and older women in Slovenia and Serbia. INTERPRETATION: While MM incidence rates were still increasing across SEE, mortality trends diverged and were less favourable than in NWE. Empowering cancer registration and improving the quality of incidence and mortality data will be essential for monitoring progress in MM control. In the context of prevention of melanoma, disparities in early detection appear to be widening the gap between SEE and NWE, while the provision of care to patients with advanced disease is likely to prove a challenge for regional healthcare budgets.

Childhood central nervous system tumour mortality and survival in Southern and Eastern Europe (1983-2014): Gaps persist across 14 cancer registries.

AIM: Childhood central nervous system (CNS) tumour registration and control programs in Southern and Eastern Europe remain thin, despite the lethal nature of the disease. Mortality/survival data were assembled to estimate the burden of malignant CNS tumours, as well as the potential role of sociodemographic survival determinants across 14 cancer registries of this region. METHODS: Average age-adjusted mortality rates were calculated, whereas time trends were quantified through Poisson and Joinpoint regressions. Kaplan-Meier curves were derived for the maximum and the more recent (10 and 5 year) registration periods. Multivariate Cox regression models were used to assess demographic and disease-related determinants. RESULTS: Variations in mortality (8-16 per million) and survival (5-year: 35-69%) were substantial among the participating registries; in most registries mortality trend was stable, whereas Bulgaria, having the highest starting rate, experienced decreasing annual mortality (-2.4%, p=0.001). A steep decrease in survival rates was evident before the second year of follow-up. After controlling for diagnostic subgroup, age, gender and diagnostic year, Greece seemed to present higher survival compared with the other contributing registries, although the follow-up period was short. Irrespective of country, however, rural residence was found to impose substantial adverse repercussions on survival (hazard ratio (HR): 1.2, 95% confidence interval (CI): 1.1-1.4). CONCLUSION: Cross-country mortality and survival variations possibly reflect suboptimal levels of health care delivery and cancer control in some regions of Southern and Eastern Europe, notwithstanding questionable death certification patterns or follow-up procedures. Continuous childhood cancer registration and linkage with clinical data are prerequisite for the reduction of survival inequalities across Europe.

Nonmelanoma Skin Cancer in the Population of the City of Belgrade in the Period 1999-2011.

INTRODUCTION: Nonmelanoma skin cancers in the literature are mainly related to basal cell and squamous cell skin carcinoma. OBJECTIVE: The aim of the study was to determine the trend in the incidence of histological types of nonmelanoma skin cancers in the population of the city of Belgrade from 1999 to 2011. METHODS: From the Serbian National Cancer Registry we extracted all recorded cases of skin cancer in Belgrade from January 1st 1999 to December 31st 2011. Incidence rates were standardized by the method of direct standardization with the world population as the standard population. Trends and annual percentage change (APC) of incidence rate were calculated by performing joinpoint regression analyses. RESULTS: Incidence rate of nonmelanoma skin cancer showed significantly increasing trend between 1999 and 2006 with APC of 8.6% (95% Cl: 5.6-11.7), basal cell carcinoma increased with APC of 8.4% (95% Cl: 5.2-11.6) and squamous cell skin carcinoma with APC of 9.33% (95% Cl: 5.7-13.1). The incidence increased with age for both men and women, especially after the age of 60. CONCLUSION: Our results showed a continuously increasing incidence trend of both basal cell and squamous cell skin carcinomas in the population of the city of Belgrade between 1999 and 2011. Adequate primary and secondary prevention would certainly be successful in reducing this type of cancer in the future.

Childhood central nervous system tumours: Incidence and time trends in 13 Southern and Eastern European cancer registries.

AIM: Following completion of the first 5-year nationwide childhood (0-14 years) registration in Greece, central nervous system (CNS) tumour incidence rates are compared with those of 12 registries operating in 10 Southern-Eastern European countries. METHODS: All CNS tumours, as defined by the International Classification of Childhood Cancer (ICCC-3) and registered in any period between 1983 and 2014 were collected from the collaborating cancer registries. Data were evaluated using standard International Agency for Research on Cancer (IARC) criteria. Crude and age-adjusted incidence rates (AIR) by age/gender/diagnostic subgroup were calculated, whereas time trends were assessed through Poisson and Joinpoint regression models. RESULTS: 6062 CNS tumours were retrieved with non-malignant CNS tumours recorded in eight registries; therefore, the analyses were performed on 5191 malignant tumours. Proportion of death certificate only cases was low and morphologic verification overall high; yet five registries presented >10% unspecified neoplasms. The male/female ratio was 1.3 and incidence decreased gradually with age, apart from Turkey and Ukraine. Overall AIR for malignant tumours was 23/10(6) children, with the highest rates noted in Croatia and Serbia. A statistically significant AIR increase was noted in Bulgaria, whereas significant decreases were noted in Belarus, Croatia, Cyprus and Serbia. Although astrocytomas were overall the most common subgroup (30%) followed by embryonal tumours (26%), the latter was the predominant subgroup in six registries. CONCLUSION: Childhood cancer registration is expanding in Southern-Eastern Europe. The heterogeneity in registration practices and incidence patterns of CNS tumours necessitates further investigation aiming to provide clues in aetiology and direct investments into surveillance and early tumour detection.

Mortality from cervical cancer in Serbia in the period 1991-2011.

PURPOSE: The aim of this study was to analyze trends of death rates for cervical cancer (CC) on territory of The Republic of Serbia in the period 1991-2011. METHODS: In this descriptive epidemiological study, unpublished data of the Statistical Office of the Republic of Serbia were used for the analysis of mortality due to CC among women in Serbia, from 1991 to 2011. Three different types of rates were calculated: crude, age-specific and age-adjusted rates. The age-standardized rates were calculated by the direct method of standardization using the World Standard Population as standard. The trends were assessed by joinpoint linear regression analysis. An average annual percentage change (AAPC) and the corresponding 95% confidence intervals (CI) were computed for trends. RESULTS: The average age-standardized CC mortality rate (ASCCMR) was 7.03 per 100,000. The lowest value of the ASCCMR was at the beginning of the observed period (6.05 per 100,000) and the highest was 8.17 per 100,000 in 2008. The age-adjusted CC mortality rates have been continuously and significantly increasing (AAPC=+0.7, 95% CI=0.3- 1.1, p<0.05). In all age groups we found increasing trends, except in the age group of 65-74 years. CONCLUSION: Since ASCCMR has been steadily increasing during the period observed, reducing these rates is highly warranted. To achieve this target, an organized CC screening program is essential.

Influence of professional drivers' personality traits on road traffic safety: case study.

The purpose of this paper is to present basic elements of the research directed at identifying and determining the personality traits of professional drivers that affect safe, secure and enjoyable ride on public roads. A quantitative method has been used here, whereas data were acquired from a questionnaire based on a sample of 59 professional drivers. Determining personality traits of professional drivers that are in correlation with a safe and pleasant ride on the roads has been enabled by applying the five-factor model of personality ('Big Five') and the Personality Inventory NEO-PI. From these results it was concluded that safe operation of the vehicle in traffic involves the successful 'conduct' of oneself, which recognises the importance of certain personality traits of professional drivers for traffic safety and the need for appropriate professional selection in the case of employment of professional drivers. Research results implicate development of educational programmes aimed at achieving harmony of psychological, physical and sensory health, that is, programmes for permanent informing, educating and training professional drivers for defensive driving. The research opens the way for new research tasks that should help in creating a specific structure of curricula that can be used in a variety of transportation companies and enterprises to improve general and public safety.

Cancer mortality in central Serbia.

PURPOSE: Cancer is the one of the leading cause of death worldwide. The aim of this study was to examine cancer mortality trends in the population of central Serbia in the period from 2002 to 2011. METHODS: The descriptive epidemiological method was used. The mortality from all malignant tumors (code C00-C96 of the International Disease Classification) was registered. The source of mortality data was the published material of the Cancer Registry of Serbia. The source of population data was the census of 2002 and 2011 and the estimates for inter-census years. Non-standardized, age-adjusted and age-specific mortality rates were calculated. Age adjustment of mortality rates was performed by the direct method of standardization. Trend lines were estimated using linear regression. RESULTS: During 2002-2011, cancer caused about 20% of all deaths each year in central Serbia. More men (56.9%) than women (43.1%) died of cancer. The average mortality rate for men was 1.3 times higher compared to women. A significant trend of increase of the age-adjusted mortality rates was recorded both for males (p<0.001) and for females (p=0.02). Except gastric cancer, the age-adjusted mortality rates in men were significantly increased for lung cancer (p=0.02), colorectal cancer (p<0.05), prostate cancer (p=0.01) and pancreatic cancer (p=0.01). Age-adjusted mortality rates for breast cancer in females were remarkably increased (p=0.01), especially after 2007. CONCLUSIONS: In central Serbia during the period from 2002 to 2011, there was an increasing trend in mortality rates due to cancers in both sexes. Cancer mortality in males was 1.3-fold higher compared to females.

Cancer incidence and mortality in Serbia 1999-2009.

BACKGROUND: Despite the increase in cancer incidence in the last years in Serbia, no nation-wide, population-based cancer epidemiology data have been reported. In this study cancer incidence and mortality rates for Serbia are presented using nation-wide data from two population-based cancer registries. These rates are additionally compared to European and global cancer epidemiology estimates. Finally, predictions on Serbian cancer incidence and mortality rates are provided. METHODS: Cancer incidence and mortality was collected from the cancer registries of Central Serbia and Vojvodina from 1999 to 2009. Using age-specific regression models, we estimated time trends and predictions for cancer incidence and mortality for the following five years (2010-2014). The comparison of Serbian with European and global cancer incidence/mortality rates, adjusted to the world population (ASR-W) was performed using Serbian population-based data and estimates from GLOBOCAN 2008. RESULTS: Increasing trends in both overall cancer incidence and mortality rates were identified for Serbia. In men, lung cancer showed the highest incidence (ASR-W 2009: 70.8/100,000), followed by colorectal (ASR-W 2009: 39.9/100,000), prostate (ASR-W 2009: 29.1/100,000) and bladder cancer (ASR-W 2009: 16.2/100,000). Breast cancer was the most common form of cancer in women (ASR-W 2009: 70.8/100,000) followed by cervical (ASR-W 2009: 25.5/100,000), colorectal (ASR-W 2009: 21.1/100,000) and lung cancer (ASR-W 2009: 19.4/100,000). Prostate and colorectal cancers have been significantly increasing over the last years in men, while this was also observed for breast cancer incidence and lung cancer mortality in women. In 2008 Serbia had the highest mortality rate from breast cancer (ASR-W 2008: 22.7/100,000), among all European countries while incidence and mortality of cervical, lung and colorectal cancer were well above European estimates. CONCLUSION: Cancer incidence and mortality in Serbia has been generally increasing over the past years. For a number of cancer sites, incidence and mortality is alarmingly higher than in the majority of European regions. For this increasing trend to be controlled, the management of risk factors that are present among the Serbian population is necessary. Additionally, prevention and early diagnosis are areas where significant improvements could still be made.

Cancer incidence and mortality patterns in South Eastern Europe in the last decade: gaps persist compared with the rest of Europe.

INTRODUCTION: Cancer registration coverage and cancer control programmes in South Eastern (SE) Europe, embracing about six new EU member states, remain thin, despite a relatively high incidence and mortality burden from avoidable cancers, particularly in males. We assembled the most recent cancer registry data to estimate the burden of the 17 most common cancers in the region, from Slovenia to Cyprus and Malta. METHODS: Data were made available for analysis from Bulgaria, Croatia, Cyprus, Malta, Romania (Cluj County), Serbia, Slovenia and Turkey (Antalya and Izmir provinces). We analysed incidence and mortality of the 17 most common cancers (counts and age-standardised rates, for the most recent year available and for the period 1999-2008). We used Joinpoint regression to quantify recent trends. FINDINGS: For much of SE Europe, there were no marked declines in overall cancer mortality rates during 1999-2008. In men, lung cancer incidence and mortality rates were high compared to other European countries (age-standardised rates (ASRW) of incidence being 50-60/100,000 in most of the countries), and still increasing in Bulgaria, Serbia and Turkey. Prostate cancer incidence rapidly increased throughout the region by 3-12% annually, largely without any clear declines in mortality. Colorectal cancer incidence increased throughout the region, as did mortality especially in Croatia, Serbia and Bulgaria (average annual percentage change (AAPC) 1.5-2%). In women, breast cancer mortality significantly declined in Slovenia, Croatia and Malta (Average Annual Percentage of Change [AAPC] -2%, -1% and -5%, respectively), but not elsewhere. Cervical cancer incidence rates remained very high in Romania, Serbia and Bulgaria (ASRW>20/100,000). INTERPRETATION: Our data confirmed the North West to South East Europe gradient of increasing incidence and mortality rates of tobacco-related cancers, as well as increasing mortality rates of screen-detectable cancers. The lack of decline in overall cancer mortality also indicates suboptimal levels of cancer control in the region.

[Clinical-epidemiologic characteristics of large, invasive basal cell carcinomas of the scalp].

We studied a large, invasive basal cell carcinoma of the scalp in 42 operated patients (53 tumors) of which 26 patients with recurrent and 16 with no recurrence. This is a rare clinical form of this tumor that invades the skin in addition to some or all of the following structure: soft tissue scalp, skull, brain and brain membranes. The literature is known as the Giant basal cell carcinoma according to TNM classification of BCC in pT4 stage. Caused by aggressive subtypes of BCC. Treatment is surgical and involves only large, mutilate surgery and extensive reconstruction. Relapse often occurs. The aim was to analyze clinical and epidemiological characteristics of large, invasive basal cell carcinoma of the scalp, finding the causes of relapse and proposal timely diagnosis. We have concluded that the appearance of tumors in the frontal and pariental region of the scalp is related to the presence of known risk factors, that tumors often penetrate bones and brains resulting in more frequent recurrence in this localization. All tumors were caused by aggressive forms of BCC. Patients in the group with recurrent, previously responded to treatment and had more surgery than patients without recurrence. Treatment-related adverse events occurred in most patients (recurrence and/or death).

Changes in the chondrocyte and extracellular matrix proteome during post-natal mouse cartilage development.

Skeletal growth by endochondral ossification involves tightly coordinated chondrocyte differentiation that creates reserve, proliferating, prehypertrophic, and hypertrophic cartilage zones in the growth plate. Many human skeletal disorders result from mutations in cartilage extracellular matrix (ECM) components that compromise both ECM architecture and chondrocyte function. Understanding normal cartilage development, composition, and structure is therefore vital to unravel these disease mechanisms. To study this intricate process in vivo by proteomics, we analyzed mouse femoral head cartilage at developmental stages enriched in either immature chondrocytes or maturing/hypertrophic chondrocytes (post-natal days 3 and 21, respectively). Using LTQ-Orbitrap tandem mass spectrometry, we identified 703 cartilage proteins. Differentially abundant proteins (q < 0.01) included prototypic markers for both early and late chondrocyte differentiation (epiphycan and collagen X, respectively) and novel ECM and cell adhesion proteins with no previously described roles in cartilage development (tenascin X, vitrin, Urb, emilin-1, and the sushi repeat-containing proteins SRPX and SRPX2). Meta-analysis of cartilage development in vivo and an in vitro chondrocyte culture model (Wilson, R., Diseberg, A. F., Gordon, L., Zivkovic, S., Tatarczuch, L., Mackie, E. J., Gorman, J. J., and Bateman, J. F. (2010) Comprehensive profiling of cartilage extracellular matrix formation and maturation using sequential extraction and label-free quantitative proteomics. Mol. Cell. Proteomics 9, 1296-1313) identified components involved in both systems, such as Urb, and components with specific roles in vivo, including vitrin and CILP-2 (cartilage intermediate layer protein-2). Immunolocalization of Urb, vitrin, and CILP-2 indicated specific roles at different maturation stages. In addition to ECM-related changes, we provide the first biochemical evidence of changing endoplasmic reticulum function during cartilage development. Although the multifunctional chaperone BiP was not differentially expressed, enzymes and chaperones required specifically for collagen biosynthesis, such as the prolyl 3-hydroxylase 1, cartilage-associated protein, and peptidyl prolyl cis-trans isomerase B complex, were down-regulated during maturation. Conversely, the lumenal proteins calumenin, reticulocalbin-1, and reticulocalbin-2 were significantly increased, signifying a shift toward calcium binding functions. This first proteomic analysis of cartilage development in vivo reveals the breadth of protein expression changes during chondrocyte maturation and ECM remodeling in the mouse femoral head.