Bevacizumab plus oxaliplatin-based chemotherapy as adjuvant treatment for colon cancer (AVANT): a phase 3 randomised controlled trial

Background: Bevacizumab improves the efficacy of oxaliplatin-based chemotherapy in metastatic colorectal cancer. Our aim was to assess the use of bevacizumab in combination with oxaliplatin-based chemotherapy in the adjuvant treatment of patients with resected stage III or high-risk stage II colon carcinoma. Methods: Patients from 330 centres in 34 countries were enrolled into this phase 3, open-label randomised trial. Patients with curatively resected stage III or high-risk stage II colon carcinoma were randomly assigned (1: 1: 1) to receive FOLFOX4 (oxaliplatin 85 mg/m(2), leucovorin 200 mg/m(2), and fluorouracil 400 mg/m(2) bolus plus 600 mg/m(2) 22-h continuous infusion on day 1; leucovorin 200 mg/m(2) plus fluorouracil 400 mg/m(2) bolus plus 600 mg/m(2) 22-h continuous infusion on day 2) every 2 weeks for 12 cycles; bevacizumab 5 mg/kg plus FOLFOX4 (every 2 weeks for 12 cycles) followed by bevacizumab monotherapy 7.5 mg/kg every 3 weeks (eight cycles over 24 weeks); or bevacizumab 7.5 mg/kg plus XELOX (oxaliplatin 130 mg/m(2) on day 1 every 2 weeks plus oral capecitabine 1000 mg/m(2) twice daily on days 1-15) every 3 weeks for eight cycles followed by bevacizumab monotherapy 7.5 mg/kg every 3 weeks (eight cycles over 24 weeks). Block randomisation was done with a central interactive computerised system, stratified by geographic region and disease stage. Surgery with curative intent occurred 4-8 weeks before randomisation. The primary endpoint was disease-free survival, analysed for all randomised patients with stage III disease. This study is registered with ClinicalTrials.gov, number NCT00112918. Findings: Of the total intention-to-treat population (n=3451), 2867 patients had stage III disease, of whom 955 were randomly assigned to receive FOLFOX4, 960 to receive bevacizumab-FOLFOX4, and 952 to receive bevacizumab-XELOX. After a median follow-up of 48 months (range 0-66 months), 237 patients (25%) in the FOLFOX4 group, 280 (29%) in the bevacizumab-FOLFOX4 group, and 253 (27%) in the bevacizumab-XELOX group had relapsed, developed a new colon cancer, or died. The disease-free survival hazard ratio for bevacizumab-FOLFOX4 versus FOLFOX4 was 1.17 (95% CI 0.98-1.39; p=0.07), and for bevacizumab-XELOX versus FOLFOX4 was 1.07 (0.90-1.28; p=0.44). After a minimum follow-up of 60 months, the overall survival hazard ratio for bevacizumab-FOLFOX4 versus FOLFOX4 was 1.27 (1.03-1.57; p=0.02), and for bevacizumab-XELOX versus FOLFOX4 was 1.15 (0.93-1.42; p=0.21). The 573 patients with high-risk stage II cancer were included in the safety analysis. The most common grade 3-5 adverse events were neutropenia (FOLFOX4: 477 [42%] of 1126 patients, bevacizumab-FOLFOX4: 416 [36%] of 1145 patients, and bevacizumab-XELOX: 74 [7%] of 1135 patients), diarrhoea (110 [10%], 135 [12%], and 181 [16%], respectively), and hypertension (12 [1%], 122 [11%], and 116 [10%], respectively). Serious adverse events were more common in the bevacizumab groups (bevacizumab-FOLFOX4: 297 [26%]; bevacizumab-XELOX: 284 [25%]) than in the FOLFOX4 group (226 [20%]). Treatment-related deaths were reported in one patient receiving FOLFOX4, two receiving bevacizumab-FOLFOX4, and five receiving bevacizumab-XELOX. Interpretation: Bevacizumab does not prolong disease-free survival when added to adjuvant chemotherapy in resected stage III colon cancer. Overall survival data suggest a potential detrimental effect with bevacizumab plus oxaliplatin-based adjuvant therapy in these patients. On the basis of these and other data, we do not recommend the use of bevacizumab in the adjuvant treatment of patients with curatively resected stage III colon cancer.

Female-biased sex ratios in marine pelagic copepods: Response to Hirst et al. (2013)

Hirst et al. (2013; Mar Ecol Prog Ser 489:297-298) suggest that Gusmão et al. (2013; Mar Ecol Prog Ser 482:279-298) misinterpreted the findings of Hirst et al. (2010; Limnol Oceanogr 55:2193-2206). They restate that the major factors determining sex ratio in pelagic copepods act upon the adult stage, but they place less emphasis on the idea that predation on male copepods is a likely determinant, and highlight the role of physiological longevity. Here we reconsider the data and confirm our position that at present there is limited evidence to support the theory of male-skewed predation. However, we agree that sex determination is governed by a combination of factors, with the relative emphasis being the main point of contention between the 2 parties.

Two-degree-of-freedom vortex-induced vibration of circular cylinders with very low aspect ratio and small mass ratio

The investigation of vortex-induced vibration on very short cylinders with two degrees of freedom has drawn the attention of a large number of researchers. Some investigations on such a problem are carried out in order to have a better understanding of the physics involved in vortex-induced motions of floating bodies such as offshore platforms. In this paper, experiments were carried out in a recirculating water channel over the range of Reynolds number 6000ratios (m⁎=1.00; 2.62 and 4.36) and very low aspect ratios (0.3≤L/D≤2.0) were shown and the results were discussed in depth. Conversely to what would be expected for cylinders with very low aspect ratio, the results showed large motions in the transverse direction with maximum amplitudes around 1.5 diameters for cylinders with L/D=2.0, despite being smaller when the aspect ratio is reduced. Moreover, the response amplitudes presented high values around 0.4 diameters in the in-line direction. In fact, the large transverse motions were related to a strong coupling with the in-line responses, visibly identified in the plots of nondimensional frequency, as well as by the trajectories in the XY-plane, Lissajous figures, particularly in the case of m⁎=1.00 and L/D=2.0, when 8-shape trajectories were clearly observed. The case of m⁎=1.00 deserves more attention because of its smaller amplitude compared to the cases with the same aspect ratio and a larger mass ratio. This counter-intuitive behavior seems to be related to the energy transferring process from the steady stream to the oscillatory hydroelastic system. Finally, it is noteworthy that the characteristic of the “Strouhal-like” number decreases when the aspect ratio decreases, as also observed in previous works available in the literature, most of them for stationary cylinders.

Two-degree-of-freedom vortex-induced vibration of circular cylinders with very low aspect ratio and small mass ratio

The investigation of vortex-induced vibration on very short cylinders with two degrees of freedom has drawn the attention of a large number of researchers. Some investigations on such a problem are carried out in order to have a better understanding of the physics involved in vortex-induced motions of floating bodies such as offshore platforms. In this paper, experiments were carried out in a recirculating water channel over the range of Reynolds number 6000ratios (m⁎=1.00; 2.62 and 4.36) and very low aspect ratios (0.3≤L/D≤2.0) were shown and the results were discussed in depth. Conversely to what would be expected for cylinders with very low aspect ratio, the results showed large motions in the transverse direction with maximum amplitudes around 1.5 diameters for cylinders with L/D=2.0, despite being smaller when the aspect ratio is reduced. Moreover, the response amplitudes presented high values around 0.4 diameters in the in-line direction. In fact, the large transverse motions were related to a strong coupling with the in-line responses, visibly identified in the plots of nondimensional frequency, as well as by the trajectories in the XY-plane, Lissajous figures, particularly in the case of m⁎=1.00 and L/D=2.0, when 8-shape trajectories were clearly observed. The case of m⁎=1.00 deserves more attention because of its smaller amplitude compared to the cases with the same aspect ratio and a larger mass ratio. This counter-intuitive behavior seems to be related to the energy transferring process from the steady stream to the oscillatory hydroelastic system. Finally, it is noteworthy that the characteristic of the “Strouhal-like” number decreases when the aspect ratio decreases, as also observed in previous works available in the literature, most of them for stationary cylinders.

Effect of sex ratio on growth and survival in Octopus vulgaris (Cuvier, 1797) reared in floating cages

[EN]Octopus vulgaris is a potential candidate to diversify European aquaculture for its rapid growth and high market prices (Vaz Pires et al. 2004). One factor affecting industrial development of octopus culture is sexual maturation under rearing conditions. Octopus females can lose up to 30-60% of their initial body weight during egg-laying (Iglesias et al., 2000) and die after the paralarvae hatch (Guerra,1992), while a correlation between males death and spermatic sac depletion has being recently reported by Estefanell et al. (2010b). The present experiment discusses the effect of three different sex ratios on growth, sexual maturation and survival in O. Vulgaris. Conclusions: Discarded bogue from fish farms could be used as alternative diet for the final stage of O. vulgaris ongrowing ; Male segregation would maximize biomass increment ; Under the conditions described, sex ratios close to 1:1 produced higher biomass increment than 4:1

Multiwavelenght study of cluster mergers and consequences for the radio emission properties of galaxy clusters

In the present thesis a thourough multiwavelength analysis of a number of galaxy clusters known to be experiencing a merger event is presented. The bulk of the thesis consists in the analysis of deep radio observations of six merging clusters, which host extended radio emission on the cluster scale. A composite optical and X–ray analysis is performed in order to obtain a detailed and comprehensive picture of the cluster dynamics and possibly derive hints about the properties of the ongoing merger, such as the involved mass ratio, geometry and time scale. The combination of the high quality radio, optical and X–ray data allows us to investigate the implications of the ongoing merger for the cluster radio properties, focusing on the phenomenon of cluster scale diffuse radio sources, known as radio halos and relics. A total number of six merging clusters was selected for the present study: A3562, A697, A209, A521, RXCJ 1314.4–2515 and RXCJ 2003.5–2323. All of them were known, or suspected, to possess extended radio emission on the cluster scale, in the form of a radio halo and/or a relic. High sensitivity radio observations were carried out for all clusters using the Giant Metrewave Radio Telescope (GMRT) at low frequency (i.e. ≤ 610 MHz), in order to test the presence of a diffuse radio source and/or analyse in detail the properties of the hosted extended radio emission. For three clusters, the GMRT information was combined with higher frequency data from Very Large Array (VLA) observations. A re–analysis of the optical and X–ray data available in the public archives was carried out for all sources. Propriety deep XMM–Newton and Chandra observations were used to investigate the merger dynamics in A3562. Thanks to our multiwavelength analysis, we were able to confirm the existence of a radio halo and/or a relic in all clusters, and to connect their properties and origin to the reconstructed merging scenario for most of the investigated cases. • The existence of a small size and low power radio halo in A3562 was successfully explained in the theoretical framework of the particle re–acceleration model for the origin of radio halos, which invokes the re–acceleration of pre–existing relativistic electrons in the intracluster medium by merger–driven turbulence. • A giant radio halo was found in the massive galaxy cluster A209, which has likely undergone a past major merger and is currently experiencing a new merging process in a direction roughly orthogonal to the old merger axis. A giant radio halo was also detected in A697, whose optical and X–ray properties may be suggestive of a strong merger event along the line of sight. Given the cluster mass and the kind of merger, the existence of a giant radio halo in both clusters is expected in the framework of the re–acceleration scenario. • A radio relic was detected at the outskirts of A521, a highly dynamically disturbed cluster which is accreting a number of small mass concentrations. A possible explanation for its origin requires the presence of a merger–driven shock front at the location of the source. The spectral properties of the relic may support such interpretation and require a Mach number M < ∼ 3 for the shock. • The galaxy cluster RXCJ 1314.4–2515 is exceptional and unique in hosting two peripheral relic sources, extending on the Mpc scale, and a central small size radio halo. The existence of these sources requires the presence of an ongoing energetic merger. Our combined optical and X–ray investigation suggests that a strong merging process between two or more massive subclumps may be ongoing in this cluster. Thanks to forthcoming optical and X–ray observations, we will reconstruct in detail the merger dynamics and derive its energetics, to be related to the energy necessary for the particle re–acceleration in this cluster. • Finally, RXCJ 2003.5–2323 was found to possess a giant radio halo. This source is among the largest, most powerful and most distant (z=0.317) halos imaged so far. Unlike other radio halos, it shows a very peculiar morphology with bright clumps and filaments of emission, whose origin might be related to the relatively high redshift of the hosting cluster. Although very little optical and X–ray information is available about the cluster dynamical stage, the results of our optical analysis suggest the presence of two massive substructures which may be interacting with the cluster. Forthcoming observations in the optical and X–ray bands will allow us to confirm the expected high merging activity in this cluster. Throughout the present thesis a cosmology with H0 = 70 km s−1 Mpc−1, m=0.3 and =0.7 is assumed.

A two-stage economic succession at the inception of farming in central Portugal. Preliminary examination of possible causes and consequences

[EN]Notwithstanding their scarcity and uneven distribution, zooarchaeological and stable isotope data sets on the Early and Middle Neolithic (5500–3200 cal BC) in the region of Estremadura in Central Portugal strongly suggest that two succeeding stages in subsistence strategies took place: sheep and goat itinerant pastoralism (across large areas) and/or renewed focus on wild food sources (cervid hunting, harvesting marine and freshwater food) which replaced livestock farming within smaller areas and less specialised hunting practices. This economic shift seems to have coincided with two other dramatic changes: the 5.9 kyr cal BP climate event and the onset of megalithism. Possible correlations between these past cultural and palaeoenvironmental phenomena are herein preliminarily outlined. [ES] A pesar de su escasez y distribución desigual, el conjunto de datos arqueozoológicos y de isótopos estables para el Neolítico Antiguo y Medio de la región de Estremadura en el centro de Portugal (5500-3200 a. C. cal), sugiere con claridad dos etapas sucesivas en las estrategias de subsistencia: pastoreo itinerante de ovejas y cabras (ocupando grandes territorios) y/o un renovado interés por los recursos alimenticios silvestres (caza de cérvidos, recolección de alimentos marinos y de agua dulce), que reemplazó otras formas de ganadería más confinadas en el espacio acciones con regímenes de mantenimiento reducidos y unas prácticas de caza menos especializadas. Este cambio económico parece haber ocurrido junto con otros dos cambios dramáticos, el evento climático 5.9 k BP (cal.) y el inicio del megalitismo. Aquí se esbozan de forma preliminar las posibles correlaciones entre estos fenómenos culturales y paleoambientales del pasado.

Effetto crowding e dislessia evolutiva: un confronto inter e intra-linguistico

Crowding is defined as the negative effect obtained by adding visual distractors around a central target which has to be identified. Some studies have suggested the presence of a marked crowding effect in developmental dyslexia (e.g. Atkinson, 1991; Spinelli et al., 2002). Inspired by Spinelli’s (2002) experimental design, we explored the hypothesis that the crowding effect may affect dyslexics’ response times (RTs) and accuracy in identification tasks dealing with words, pseudowords, illegal non-words and symbolstrings. Moreover, our study aimed to clarify the relationship between the crowding phenomenon and the word-reading process, in an inter-language comparison perspective. For this purpose we studied twenty-two French dyslexics and twenty-two Italian dyslexics (total forty-four dyslexics), compared to forty-four subjects matched for reading level (22 French and 22 Italians) and forty-four chronological age-matched subjects (22 French and 22 Italians). Children were all tested on reading and cognitive abilities. Results showed no differences between French and Italian participants suggesting that performances were homogenous. Dyslexic children were all significantly impaired in words and pseudowords reading compared to their normal reading controls. Regarding the identification task with which we assessed crowding effect, both accuracy and RTs showed a lexicality effect which meant that the recognition of words was more accurate and faster in words than pseudowords, non-words and symbolstrings. Moreover, compared to normal readers, dyslexics’ RTs and accuracy were impaired only for verbal materials but not for non-verbal material; these results are in line with the phonological hypothesis (Griffiths & Snowling, 2002; Snowling, 2000; 2006) . RTs revealed a general crowding effect (RTs in the crowding condition were slower than those recorded in the isolated condition) affecting all the subjects’ performances. This effect, however, emerged to be not specific for dyslexics. Data didn’t reveal a significant effect of language, allowing the generalization of the obtained results. We also analyzed the performance of two subgroups of dyslexics, categorized according to their reading abilities. The two subgroups produced different results regarding the crowding effect and type of material, suggesting that it is meaningful to take into account also the heterogeneity of the dyslexia disorder. Finally, we also analyzed the relationship of the identification task with both reading and cognitive abilities. In conclusion, this study points out the importance of comparing visual tasks performances of dyslexic participants with those of their reading level-matched controls. This approach may improve our comprehension of the potential causal link between crowding and reading (Goswami, 2003).

Plasmoscope: Automated spectroscopy of single nanoparticles

Plasmonen sind die kollektive resonante Anregung von Leitungselektronen. Vom Licht angeregternPlasmonen in subwellenlängen-grossen Nanopartikeln heissen Partikelplasmonen und sind vielversprechende Kandidaten für zukünftige Mikrosensoren wegen der starken Abhängigkeit der Resonanz an extern steuerbaren Parametern, wie die optischen Eigenschaften des umgebenden Mediums und die elektrische Ladung der Nanopartikel. Die extrem hohe Streue_zienz von Partikelplasmonen erlaubt eine einfache Beobachtung einzelner Nanopartikel in einem Mikroskop.rnDie Anforderung, schnell eine statistisch relevante Anzahl von Datenpunkten sammeln zu können,rnund die wachsende Bedeutung von plasmonischen (vor allem Gold-) Nanopartikeln für Anwendungenrnin der Medizin, hat nach der Entwicklung von automatisierten Mikroskopen gedrängt, die im bis dahin nur teilweise abgedeckten spektralen Fenster der biologischen Gewebe (biologisches Fenster) von 650 bis 900nm messen können. Ich stelle in dieser Arbeit das Plasmoscope vor, das genau unter Beobachtung der genannten Anforderungen entworfen wurde, in dem (1) ein einstellbarer Spalt in die Eingangsö_nung des Spektrometers, die mit der Bildebene des Mikroskops zusammenfällt, gesetzt wurde, und (2) einem Piezo Scantisch, der es ermöglicht, die Probe durch diesen schmalen Spalt abzurastern. Diese Verwirklichung vermeidet optische Elemente, die im nahen Infra-Rot absorbieren.rnMit dem Plasmoscope untersuche ich die plasmonische Sensitivität von Gold- und Silbernanostrnäbchen, d.h. die Plasmon-Resonanzverschiebung in Abhängigkeit mit der Änderung des umgebendenrnMediums. Die Sensitivität ist das Mass dafür, wie gut die Nanopartikeln Materialänderungenrnin ihrer Umgebung detektieren können, und damit ist es immens wichtig zu wissen, welche Parameterrndie Sensitivität beein_ussen. Ich zeige hier, dass Silbernanostäbchen eine höhere Sensitivität alsrnGoldnanostäbchen innerhalb des biologischen Fensters besitzen, und darüberhinaus, dass die Sensitivität mit der Dicke der Stäbchen wächst. Ich stelle eine theoretische Diskussion der Sensitivitätrnvor, indenti_ziere die Materialparameter, die die Sensitivität bein_ussen und leite die entsprechendenrnFormeln her. In einer weiteren Annäherung präsentiere ich experimentelle Daten, die die theoretische Erkenntnis unterstützen, dass für Sensitivitätsmessschemata, die auch die Linienbreite mitberücksichtigen, Goldnanostäbchen mit einem Aspektverhältnis von 3 bis 4 das optimalste Ergebnis liefern. Verlässliche Sensoren müssen eine robuste Wiederholbarkeit aufweisen, die ich mit Gold- und Silbernanostäbchen untersuche.rnDie Plasmonen-resonanzwellenlänge hängt von folgenden intrinsischen Materialparametern ab:rnElektrondichte, Hintergrundpolarisierbarkeit und Relaxationszeit. Basierend auf meinen experimentellen Ergebnissen zeige ich, dass Nanostäbchen aus Kupfer-Gold-Legierung im Vergleich zu ähnlich geformten Goldnanostäbchen eine rotverschobene Resonanz haben, und in welcher Weiserndie Linienbreite mit der stochimetrischen Zusammensetzung der legierten Nanopartikeln variiert.rnDie Abhängigkeit der Linienbreite von der Materialzusammensetzung wird auch anhand von silberbeschichteten und unbeschichteten Goldnanostäbchen untersucht.rnHalbleiternanopartikeln sind Kandidaten für e_ziente photovoltaische Einrichtungen. Die Energieumwandlung erfordert eine Ladungstrennung, die mit dem Plasmoscope experimentell vermessen wird, in dem ich die lichtinduzierte Wachstumsdynamik von Goldsphären auf Halbleiternanost äbchen in einer Goldionenlösung durch die Messung der gestreuten Intensität verfolge.rn

Controlled wetting on silica-based nano- and microstructured surfaces

Der Fokus dieser Doktorarbeit liegt auf der kontrollierten Benetzung von festen Oberflächen, die in vielen Bereichen, wie zum Beispiel in der Mikrofluidik, für Beschichtungen und in biologischen Studien von Zellen oder Bakterien, von großer Bedeutung ist.rnDer erste Teil dieser Arbeit widmet sich der Frage, wie Nanorauigkeit das Benetzungsverhalten, d.h. die Kontaktwinkel und die Pinningstärke, von hydrophoben und superhydrophoben Beschichtungen beeinflusst. Hierfür wird eine neue Methode entwickelt, um eine nanoraue Silika-Beschichtung über die Gasphase auf eine superhydrophobe Oberfläche, die aus rauen Polystyrol-Silika-Kern-Schale-Partikeln besteht, aufzubringen. Es wird gezeigt, dass die Topographie und Dichte der Nanorauigkeiten bestimmt, ob sich die Superhydrophobizität verringert oder erhöht, d.h. ob sich ein Flüssigkeitstropfen im Nano-Wenzel- oder Nano-Cassie-Zustand befindet. Das verstärkte Pinning im Nano-Wenzel-Zustand beruht auf dem Eindringen von Flüssigkeitsmolekülen in die Nanoporen der Beschichtung. Im Nano-Cassie-Zustand dagegen sitzt der Tropfen auf den Nanorauigkeiten, was das Pinning vermindert. Die experimentellen Ergebnisse werden mit molekulardynamischen Simulationen in Bezug gesetzt, die den Einfluss der Oberflächenbeschichtungsdichte und der Länge von fluorinierten Silanen auf die Hydrophobizität einer Oberfläche untersuchen. rnEs wurden bereits verschiedenste Techniken zur Herstellung von transparenten superhydrophoben, d.h. extrem flüssigkeitsabweisenden, Oberflächen entwickelt. Eine aktuelle Herausforderung liegt darin, Funktionalitäten einzuführen, ohne die superhydrophoben Eigenschaften einer Oberfläche zu verändern. Dies ist extrem anspruchsvoll, da funktionelle Gruppen in der Regel hydrophil sind. In dieser Arbeit wird eine innovative Methode zur Herstellung von transparenten superhydrophoben Oberflächen aus Janus-Mikrosäulen mit variierenden Dimensionen und Topographien entwickelt. Die Janus-Säulen haben hydrophobe Seitenwände und hydrophile Silika-Oberseiten, die anschließend selektiv und ohne Verlust der superhydrophoben Eigenschaften der Oberfläche funktionalisiert werden können. Diese selektive Oberflächenfunktionalisierung wird mittels konfokaler Mikroskopie und durch das chemische Anbinden von fluoreszenten Molekülen an die Säulenoberseiten sichtbar gemacht. Außerdem wird gezeigt, dass das Benetzungsverhalten durch Wechselwirkungen zwischen Flüssigkeit und Festkörper in der Nähe der Benetzungslinie bestimmt wird. Diese Beobachtung widerlegt das allgemein akzeptierte Modell von Cassie und Baxter und beinhaltet, dass hydrophile Flächen, die durch mechanischen Abrieb freigelegt werden, nicht zu einem Verlust der Superhydrophobizität führen müssen, wie allgemein angenommen.rnBenetzung kann auch durch eine räumliche Beschränkung von Flüssigkeiten kontrolliert werden, z.B. in mikrofluidischen Systemen. Hier wird eine modifizierte Stöber-Synthese verwendet, um künstliche und natürliche Faser-Template mit einer Silika-Schicht zu ummanteln. Nach der thermischen Zersetzung des organischen Templat-Materials entstehen wohldefinierte Silika-Kanäle und Kanalkreuzungen mit gleichmäßigen Durchmessern im Nano- und Mikrometerbereich. Auf Grund ihrer Transparenz, mechanischen Stabilität und des großen Länge-zu-Durchmesser-Verhältnisses sind die Kanäle sehr gut geeignet, um die Füllgeschwindigkeiten von Flüssigkeiten mit variierenden Oberflächenspannungen und Viskositäten zu untersuchen. Konfokale Mikroskopie ermöglicht es hierbei, die Füllgeschwindigkeiten über eine Länge von mehreren Millimetern, sowie direkt am Kanaleingang zu messen. Das späte Füllstadium kann sehr gut mit der Lucas-Washburn-Gleichung beschrieben werden. Die anfänglichen Füllgeschwindigkeiten sind jedoch niedriger als theoretisch vorhergesagt. Wohingegen die vorhergehenden Abschnitte dieser Arbeit sich mit der quasistatischen Benetzung beschäftigen, spielt hier die Dynamik der Benetzung eine wichtige Rolle. Tatsächlich lassen sich die beobachteten Abweichungen durch einen geschwindigkeitsabhängigen Fortschreitkontaktwinkel erklären und durch dynamische Benetzungstheorien modellieren. Somit löst diese Arbeit das seit langem diskutierte Problem der Abweichungen von der Lucas-Washburn-Gleichung bei kleinen Füllgeschwindigkeiten.

An inter-comparison between a VIS/IR and a MW satellite-based methods for cloud detection and classification

This thesis is aimed to assess similarities and mismatches between the outputs from two independent methods for the cloud cover quantification and classification based on quite different physical basis. One of them is the SAFNWC software package designed to process radiance data acquired by the SEVIRI sensor in the VIS/IR. The other is the MWCC algorithm, which uses the brightness temperatures acquired by the AMSU-B and MHS sensors in their channels centered in the MW water vapour absorption band. At a first stage their cloud detection capability has been tested, by comparing the Cloud Masks they produced. These showed a good agreement between two methods, although some critical situations stand out. The MWCC, in effect, fails to reveal clouds which according to SAFNWC are fractional, cirrus, very low and high opaque clouds. In the second stage of the inter-comparison the pixels classified as cloudy according to both softwares have been. The overall observed tendency of the MWCC method, is an overestimation of the lower cloud classes. Viceversa, the more the cloud top height grows up, the more the MWCC not reveal a certain cloud portion, rather detected by means of the SAFNWC tool. This is what also emerges from a series of tests carried out by using the cloud top height information in order to evaluate the height ranges in which each MWCC category is defined. Therefore, although the involved methods intend to provide the same kind of information, in reality they return quite different details on the same atmospheric column. The SAFNWC retrieval being very sensitive to the top temperature of a cloud, brings the actual level reached by this. The MWCC, by exploiting the capability of the microwaves, is able to give an information about the levels that are located more deeply within the atmospheric column.

Combined modality treatment improves tumor control and overall survival in patients with early stage Hodgkin's lymphoma: a systematic review

Combined modality treatment (CMT) of chemotherapy followed by localized radiotherapy is standard treatment for patients with early stage Hodgkin's lymphoma. However, the role of radiotherapy has been questioned recently and some clinical study groups advocate chemotherapy only for this indication. We thus performed a systematic review with meta-analysis of randomized controlled trials comparing chemotherapy alone with CMT in patients with early stage Hodgkin's lymphoma with respect to response rate, tumor control and overall survival (OS). We searched Medline, EMBASE and the Cochrane Library as well as conference proceedings from January 1980 to February 2009 for randomized controlled trials comparing chemotherapy alone versus the same chemotherapy regimen plus radiotherapy. Progression free survival and similar outcomes were analyzed together as tumor control. Effect measures used were hazard ratios for OS and tumor control as well as relative risks for complete response (CR). Meta-analyses were performed using RevMan5. Five randomized controlled trials involving 1,245 patients were included. The hazard ratio (HR) was 0.41 (95% confidence interval (CI) 0.25 to 0.66) for tumor control and 0.40 (95% CI 0.27 to 0.59) for OS for patients receiving CMT compared to chemotherapy alone. CR rates were similar between treatment groups. In sensitivity analyses another 6 trials were included that did not fulfill the inclusion criteria of our protocol but were considered relevant to the topic. These trials underlined the results of the main analysis. In conclusion, adding radiotherapy to chemotherapy improves tumor control and OS in patients with early stage Hodgkin's lymphoma.

Dental arch relationship in children with complete unilateral cleft lip and palate following one-stage and three-stage surgical protocols

The objective of this study is to compare dental arch relationship following one-stage and three-stage surgical protocols of unilateral cleft lip and palate. Dental casts of 61 children (mean age, 11.2 years; SD, 1.7), consecutively treated in one center with one-stage closure of the complete cleft at 9.2 months (SD, 2.0), were compared with a sample of 97 patients (mean age, 8.7 years; SD, 0.9), consecutively treated with a three-stage protocol including delayed hard palate closure in another center. The dental casts were assigned random numbers to blind their origin. Four raters graded dental arch relationship and palatal morphology using the EUROCRAN index. The strength of agreement of rating was assessed with kappa statistics. Independent t tests were run to compare the EUROCRAN scores between one-stage and three-stage samples, and Fisher's exact tests were performed to evaluate differences of distribution of the EUROCRAN grades. The intra- and inter-rater agreement was moderate to very good. Dental arch relationship in the one-stage sample was less favorable than in three-stage group (mean scores, 2.58 and 1.97 for one-stage and three-stage samples, respectively; p?

Treatment failure and mortality factors in patients receiving second-line HIV therapy in resource-limited countries

Context Long-term antiretroviral therapy (ART) use in resource-limited countries leads to increasing numbers of patients with HIV taking second-line therapy. Limited access to further therapeutic options makes essential the evaluation of second-line regimen efficacy in these settings. Objectives To investigate failure rates in patients receiving second-line therapy and factors associated with failure and death. Design, Setting, and Participants Multicohort study of 632 patients >14 years old receiving second-line therapy for more than 6 months in 27 ART programs in Africa and Asia between January 2001 and October 2008. Main Outcome Measures Clinical, immunological, virological, and immunovirological failure (first diagnosed episode of immunological or virological failure) rates, and mortality after 6 months of second-line therapy use. Sensitivity analyses were performed using alternative CD4 cell count thresholds for immunological and immunovirological definitions of failure and for cohort attrition instead of death. Results The 632 patients provided 740.7 person-years of follow-up; 119 (18.8%) met World Health Organization failure criteria after a median 11.9 months following the start of second-line therapy (interquartile range [IQR], 8.7-17.0 months), and 34 (5.4%) died after a median 15.1 months (IQR, 11.9-25.7 months). Failure rates were lower in those who changed 2 nucleoside reverse transcriptase inhibitors (NRTIs) instead of 1 (179.2 vs 251.6 per 1000 person-years; incidence rate ratio [IRR], 0.64; 95% confidence interval [CI], 0.42-0.96), and higher in those with lowest adherence index (383.5 vs 176.0 per 1000 person-years; IRR, 3.14; 95% CI, 1.67-5.90 for <80% vs ≥95% [percentage adherent, as represented by percentage of appointments attended with no delay]). Failure rates increased with lower CD4 cell counts when second-line therapy was started, from 156.3 vs 96.2 per 1000 person-years; IRR, 1.59 (95% CI, 0.78-3.25) for 100 to 199/μL to 336.8 per 1000 person-years; IRR, 3.32 (95% CI, 1.81-6.08) for less than 50/μL vs 200/μL or higher; and decreased with time using second-line therapy, from 250.0 vs 123.2 per 1000 person-years; IRR, 1.90 (95% CI, 1.19-3.02) for 6 to 11 months to 212.0 per 1000 person-years; 1.71 (95% CI, 1.01-2.88) for 12 to 17 months vs 18 or more months. Mortality for those taking second-line therapy was lower in women (32.4 vs 68.3 per 1000 person-years; hazard ratio [HR], 0.45; 95% CI, 0.23-0.91); and higher in patients with treatment failure of any type (91.9 vs 28.1 per 1000 person-years; HR, 2.83; 95% CI, 1.38-5.80). Sensitivity analyses showed similar results. Conclusions Among patients in Africa and Asia receiving second-line therapy for HIV, treatment failure was associated with low CD4 cell counts at second-line therapy start, use of suboptimal second-line regimens, and poor adherence. Mortality was associated with diagnosed treatment failure.

First-line temozolomide combined with bevacizumab in metastatic melanoma: a multicentre phase II trial (SAKK 50/07)

Oral temozolomide has shown similar efficacy to dacarbazine in phase III trials with median progression-free survival (PFS) of 2.1 months. Bevacizumab has an inhibitory effect on the proliferation of melanoma and sprouting endothelial cells. We evaluated the addition of bevacizumab to temozolomide to improve efficacy in stage IV melanoma.