Adjuvant treatment of premenopausal women with endocrine-responsive early breast cancer: design of the TEXT and SOFT trials

OBJECTIVES In 2003 the International Breast Cancer Study Group (IBCSG) initiated the TEXT and SOFT randomized phase III trials to answer two questions concerning adjuvant treatment for premenopausal women with endocrine-responsive early breast cancer: 1-What is the role of aromatase inhibitors (AI) for women treated with ovarian function suppression (OFS)? 2-What is the role of OFS for women who remain premenopausal and are treated with tamoxifen? METHODS TEXT randomized patients to receive exemestane or tamoxifen with OFS. SOFT randomized patients to receive exemestane with OFS, tamoxifen with OFS, or tamoxifen alone. Treatment was for 5 years from randomization. RESULTS TEXT and SOFT successfully met their enrollment goals in 2011. The 5738 enrolled women had lower-risk disease and lower observed disease-free survival (DFS) event rates than anticipated. Consequently, 7 and 13 additional years of follow-up for TEXT and SOFT, respectively, were required to reach the targeted DFS events (median follow-up about 10.5 and 15 years). To provide timely answers, protocol amendments in 2011 specified analyses based on chronological time and median follow-up. To assess the AI question, exemestane + OFS versus tamoxifen + OFS, a combined analysis of TEXT and SOFT became the primary analysis (n = 4717). The OFS question became the primary analysis from SOFT, assessing the unique comparison of tamoxifen + OFS versus tamoxifen alone (n = 2045). The first reports are anticipated in mid- and late-2014. CONCLUSIONS We present the original designs of TEXT and SOFT and adaptations to ensure timely answers to two questions concerning optimal adjuvant endocrine treatment for premenopausal women with endocrine-responsive breast cancer. Trial Registration TEXT: Clinicaltrials.govNCT00066703 SOFT: Clinicaltrials.govNCT00066690.

Megillat Esther : text and traditional cantillation

by A. Perlzweig

Redox front geochemistry and weathering: theory with application to the Osamu Utsumi uranium mine, Poços de Caldas, Brazil

Numerical calculations describing weathering of the Poços de Caldas alkaline complex (Minas Gerais, Brazil) by infiltrating groundwater are carried out for time spans up to two million years in the absence of pyrite, and up to 500,000 years with pyrite present. Deposition of uranium resulting from infiltration of oxygenated, uranium bearing groundwater through the hydrothermally altered phonolitic host rock at the Osamu Utsumi uranium mine is also included in the latter calculation. The calculations are based on the quasi-stationary state approximation to mass conservation equations for pure advective transport. This approximation enables the prediction of solute concentrations, mineral abundances and porosity as functions of time and distance over geologic time spans. Mineral reactions are described by kinetic rate laws for both precipitation and dissolution. Homogeneous equilibrium is assumed to be maintained within the aqueous phase. No other constraints are imposed on the calculations other than the initial composition of the unaltered host rock and the composition of the inlet fluid, taken as rainwater modified by percolation through a soil zone. The results are in qualitative agreement with field observations at the Osamu Utsumi uranium mine. They predict a lateritic cover followed by a highly porous saprolitic zone, a zone of oxidized rock with pyrite replaced by iron-hydroxide, a sharp redox front at which uranium is deposited, and the reduced unweathered host rock. Uranium is deposited in a narrow zone located on the reduced side of the redox front in association with pyrite, in agreement with field observations. The calculations predict the formation of a broad dissolution front of primary kaolinite that penetrates deep into the host rock accompanied by the precipitation of secondary illite. Secondary kaolinite occurs in a saprolitic zone near the surface and in the vicinity of the redox front. Gibbsite forms a bi-modal distribution consisting of a maximum near the surface followed by a thin tongue extending downward into the weathered profile in agreement with field observations. The results are found to be insensitive to the kinetic rate constants used to describe mineral reactions.

SMS design and aberration theory

The SMS, Simultaneous Multiple Surfaces, design was born to Nonimaging Optics applications and is now being applied also to Imaging Optics. In this paper the wave aberration function of a selected SMS design is studied. It has been found the SMS aberrations can be analyzed with a little set of parameters, sometimes two. The connection of this model with the conventional aberration expansion is also presented. To verify these mathematical model two SMS design systems were raytraced and the data were analyzed with a classical statistical methods: the plot of discrepancies and the quadratic average error. Both the tests show very good agreement with the model for our systems.

Boundary elements in potential and elasticity theory

A general theory that describes the B.I.E. linear approximation in potential and elasticity problems, is developed. A method to tread the Dirichlet condition in sharp vertex is presented. Though the study is developed for linear elements, its extension to higher order interpolation is straightforward. A new direct assembling procedure of the global of equations to be solved, is finally showed.

Design and analysis of ripple-based controls based on the discrete modeling and Floquet theory

Ripple-based controls can strongly reduce the required output capacitance in PowerSoC converter thanks to a very fast dynamic response. Unfortunately, these controls are prone to sub-harmonic oscillations and several parameters affect the stability of these systems. This paper derives and validates a simulation-based modeling and stability analysis of a closed-loop V 2Ic control applied to a 5 MHz Buck converter using discrete modeling and Floquet theory to predict stability. This allows the derivation of sensitivity analysis to design robust systems. The work is extended to different V 2 architectures using the same methodology.

Combining Text and Graphics for Interactive Exploration of Behavior Datasets

Modern sensor technologies and simulators applied to large and complex dynamic systems (such as road traffic networks, sets of river channels, etc.) produce large amounts of behavior data that are difficult for users to interpret and analyze. Software tools that generate presentations combining text and graphics can help users understand this data. In this paper we describe the results of our research on automatic multimedia presentation generation (including text, graphics, maps, images, etc.) for interactive exploration of behavior datasets. We designed a novel user interface that combines automatically generated text and graphical resources. We describe the general knowledge-based design of our presentation generation tool. We also present applications that we developed to validate the method, and a comparison with related work.

Human Immunodeficiency Virus Reverse Transcriptase and Protease Sequence Database: an expanded data model integrating natural language text and sequence analysis programs

The HIV Reverse Transcriptase and Protease Sequence Database is an on-line relational database that catalogs evolutionary and drug-related sequence variation in the human immunodeficiency virus (HIV) reverse transcriptase (RT) and protease enzymes, the molecular targets of anti-HIV therapy (http://hivdb.stanford.edu). The database contains a compilation of nearly all published HIV RT and protease sequences, including submissions from International Collaboration databases and sequences published in journal articles. Sequences are linked to data about the source of the sequence sample and the antiretroviral drug treatment history of the individual from whom the isolate was obtained. During the past year 3500 sequences have been added and the data model has been expanded to include drug susceptibility data on sequenced isolates. Database content has also been integrated with didactic text and the output of two sequence analysis programs.

Expertise in Ultra-Endurance Triathletes Early Sport Involvement, Training Structure, and the Theory of Deliberate Practice

The theory of deliberate practice (Ericsson, Krampe, & Tesch-Römer, 1993) is predicated on the concept that the engagement in specific forms of practice is necessary for the attainment of expertise. The purpose of this paper was to examine the quantity and type of training performed by expert UE triathletes. Twenty-eight UE triathletes were stratified into expert, middle of the pack, and back of the pack groups based on previous finishing times. All participants provided detailed information regarding their involvement in sports in general and the three triathlon sports in particular. Results illustrated that experts performed more training than non-experts but that the relationship between training and performance was not monotonic as suggested by Ericsson et al. Further, experts' training was designed so periods of high training stress were followed by periods of low stress. However, early specialization was not a requirement for expertise. This work indicates that the theory of deliberate practice does not fully explain expertise development in UE triathlon.