PORTUGAL: Having called tenders in March last year for an €18·5m upgrading of the 11 km between Elvas and the Spanish border as part of the first phase of the proposed South International Corridor, infrastructure manager Infraestruturas de Portugal provided further details of the work programme in early January at a community meeting in Santiago do Cacém, east of Sines.The SIC programme is intended to provide a more direct route for freight traffic between the port of Sines and the Spanish network at Caia, west of Badajoz. This forms part of the pan-European Atlantic Corridor and the EU’s TEN-T network. The initial phase of work worth €54m involves resignalling and level crossing closures on IP’s Sines – Lisboa – Évora line to permit operation of 750 m long freight trains; the railway through Santiago do Cacém is to be grade separated. Subsequent phases of SIC are covered under IP’s Ferrovia 2020 investment plan and would see the rehabilitation and electrification of the 79 km between Évora and the Spanish border crossing at Elvas/Caia at a projected cost of €626m, of which €369m would come from EU funding. The Sines – Elvas/Caia route would be fitted with dual-gauge sleepers to permit future adoption of 1 435 mm gauge once connecting routes are completed in Spain.The upgrading is intended to allow the operation of up to 51 750 m long freight trains per day from Sines, an increase on the present maximum of 36 trains of 400 m in length.
Atletico Madrid, on the other hand, are planning to retain Rodri, which is why they are willing to offer him a new deal to increase his wages and also his buyout clause.The midfielder has a €70m release clause in his contract at Wanda Metropolitano, meaning the Premier League winners don’t have to negotiate with Diego Simeone’s side and must only convince the 22-year-old of the transfer.Monday’s edition of AS once again relays the domestic treble winners have submitted an offer to the former Villarreal man and only his signature is missing for the deal to take shape.Embed from Getty ImagesUnfortunately for Pep Guardiola’s side, the player has not made a decision on his future, despite studying various options for the last 15 days.It’s almost certain that Rodri will decide this week as to where he will play next season.The newspaper is of the belief that since this has dragged on for the last 15 days, the Spaniard could decide to continue with Los Rojiblancos.AS state Rodri is now more close to staying with Atletico than packing his bags for City in the summer.Rodri, on the other hand, also wants to make a decision on his future soon so that his employer can then plan for the future.For Simeone, it is paramount the midfielder continues at the club, which has already been communicated to Rodri.by Taboolaby TaboolaSponsored LinksSponsored LinksPromoted LinksPromoted LinksTrending TodayForge of Empires – Free Online GameIf You Like to Play, this Game is a Must-HaveForge of Empires – Free Online GameUndoDating.comFind out where single guys are hanging out in Tung ChungDating.comUndo熱門話題小心會長過頭…網友推爆:「真的長得超誇張!」熱門話題UndoRaid: Shadow Legends | Free DownloadEven Non-Gamers Are Obsessed With This RPG Game (It’s Worth Installing!)Raid: Shadow Legends | Free DownloadUndoMisterStocksThese Hilarious Photos Were Captured On The SubwayMisterStocksUndoPerfect-Dating.comThousands of successful men are looking for women in Tung ChungPerfect-Dating.comUndoKeto减肥1個簡單的妙招一夜「融化」腹部贅肉（今晚試試）Keto减肥UndoSmart Tech TrendOver 55? You Have to Try Those Revolutionary Glasses!Smart Tech TrendUndoLoans | Search AdsNeed a loan? Search hereLoans | Search AdsUndo Last month, reports from Spain suggested that Manchester City have submitted an offer for Rodri and was close to joining them.
Related posts:Libertarian candidate Otto Guevara could become Costa Rica’s next president How they vote on Cocos Island, a Costa Rican territory where only 28 people live Evangelical editorial constituted ‘threat’ to free elections, says Costa Rica’s Supreme Elections Tribunal Supreme Elections Tribunal denies that presidential election runoff ballots were stolen Political campaign messages disappeared from mass media at midnight Wednesday, the official start of an electoral campaign ban ordered by Costa Rica’s Electoral Code.The law stipulates that all paid messages must be suspended three days before Election Day and during Sunday’s vote.The ban includes airing or printing of paid propaganda in newspapers, radio, television and on the Web.However, during the 2010 elections the Supreme Elections Tribunal (TSE) ruled that in the case of Internet messages, the restriction only applies to the online publication of paid ads or banners, meaning candidates are allowed to post messages in free platforms such as social networks.The ban also prohibits the publication of electoral opinion polls. Costa Rica’s Electoral Code also does not allow publication of survey results, even in social media.The rule applies “to all citizens, not only political parties or polling companies,” TSE President Luis Antonio Sobrado said recently.Survey results will be allowed again on Sunday night, after the official session in which the TSE announces its first reports from voting centers.Last Monday was the final day for political parties to convene meetings or rallies in public places.If none of the candidates reaches the required 40 percent of the vote to win the election, the TSE will open a new election season for a runoff vote that will be held on April 6 with the top two candidates. Those candidates would be allowed to air media campaigns and to participate in political debates.The TSE officially opened election season on Oct. 2, allowing candidates to pursue the votes of more than 3 million registered voters, both in Costa Rica and in 42 countries where Ticos abroad will vote for the first time. Facebook Comments
Source:https://unclineberger.org/news/prostate-cancer-care-for-older-men Reviewed by James Ives, M.Psych. (Editor)Sep 14 2018Researchers from the University of North Carolina Lineberger Comprehensive Cancer Center estimate that screening for and treating prostate cancer in men aged 70 years or older, which is not recommended by national guidelines, cost Medicare more than $1.2 billion over a three year period for each group of men diagnosed in the United States each year.Published in the journal JAMA Oncology, the study examined the costs associated with screening for prostate cancer, including treatment, for three years after diagnosis. They estimated that for men diagnosed in each of 2004, 2005, 2006, and 2007, the total cost for treating and screening for each group would be $1.2 billion for three years after diagnosis. The study also showed that of the total, $451 million was spent on men who were diagnosed with prostate cancer that is graded with a Gleason score of 6, which is considered to be low-grade disease and best managed using active surveillance rather than aggressive treatment.”The tough discussions that happen in health economics are often cases where care is beneficial, but costly. That’s a hard trade-off, but this one is actually easier than that,” said UNC Lineberger’s Justin Trogdon, PhD, associate professor of health policy management in the UNC Gillings School of Global Public Health, and the study’s first author. “This is a scenario where care is probably not beneficial and also costly, and we are putting a dollar figure on just how costly this is.”The researchers said there is a wide recognition that screening for prostate cancer should stop in men at age 70. The U.S. Preventive Services Task Force recommends against prostate cancer screening in men above age 70, citing, among other reasons, that the harms from screening are “at least moderate” or greater for men in that age group because of risk of false-positives, harms from biopsy, and harms from treatment, which can include sexual dysfunction and urinary incontinence.”For patients who are diagnosed with prostate cancer at an older age, because the cancer is often slow-growing, it is unlikely to be the cause of their mortality,” said UNC Lineberger’s Ronald C. Chen, MD, MPH, associate professor in the UNC School of Medicine Department of Radiation Oncology and the study’s corresponding author. “So, we are not only spending U.S. health care dollars diagnosing an issue that probably isn’t going to be a problem for patients, but when we treat these patients who don’t need treatment, they suffer unnecessary side effects like urinary incontinence or sexual dysfunction.”Related StoriesSugary drinks linked to cancer finds studyUsing machine learning algorithm to accurately diagnose breast cancerTrends in colonoscopy rates not aligned with increase in early onset colorectal cancerFor the retrospective study, researchers used the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER)-Medicare linked claims database to analyze costs related to diagnosis and work-up, treatment, follow-up, and side-effect management for nearly 50,000 men 70 years of age or older who were diagnosed with prostate cancer between 2004 and 2007. They estimated the cost of diagnosing and treating men for three years after diagnosis because that’s a typical time frame for patients to receive treatment in.They found that for men diagnosed in each year, the total three-year cost was $1.2 billion. For men diagnosed in 2004, for example, their estimated cost to Medicare would be $1.2 billion across three years. The median per-patient cost within three years after prostate cancer diagnosis was $14,453, with treatment costs accounting for 73 percent of that total. The researchers estimated a cost savings of $320 million per year for Medicare if patients who have a Gleason score of 6 choose active surveillance.”Studies indicate that we are testing for prostate cancer in people for whom the potential harms outweigh the potential benefits, and then we are treating – actually over treating – people for a cancer that may have little to no impact on their life expectancy,” Chen said. “Not following guidelines could be putting people’s health at risk, and it is costing the U.S. health care system a lot of money. It would make more sense to put these resources into other areas that could do more good for patients.”Researchers write in the study that foregoing aggressive treatment of low-risk prostate cancer in older patients, especially those with other health issues, could prevent harm due to treatment-related side effects, while also providing a savings to Medicare. They suggest that screening men with at least a 10-year life expectancy, and selectively treating those with more aggressive cancer may be one approach to eliminate unnecessary spending while maximizing patient outcomes.