Fludarabine, Cyclophosphamide and Rituximab:an effective chemoimmunotherapy combination with high remission rates for chronic lymphocytic leukaemia

BACKGROUND: Combined Fludarabine and Cyclophosphamide is now standard first-line therapy in chronic lymphocytic leukaemia (CLL) and the addition of Rituximab improves outcome.

METHODS: We adopted a modified Fludarabine, Cyclophosphamide and Rituximab (FCR) protocol in treating 39 patients (median age 57 years) with progressive or advanced CLL. Depending on CR, treatment was given for four or six cycles.

RESULT: Twenty-six patients were treatment naïve and 13 were pre-treated. Twelve patients had progressive Binet stage A, 16 stage B and 11 stage C disease. The overall response rate (ORR) was 100%, with 75% achieving CR. Neutropenia was the major toxicity in 71/187 (38%) of the cycles. There were five deaths, two from infection and three from progressive disease. Twenty-six of 31 patients have maintained their post-treatment disease status for a median of 17 months (2-41).

CONCLUSION: We conclude that FCR is a feasible, well-tolerated and effective treatment for patients with CLL.

Perspectivar o pensamento do design

presente estudo visa contribuir para uma perspectivação do design thinking, que assume cada vez mais importância no mundo do design e em áreas externas ao design. Pretendemos acentuar a relevância da adopção do design thinking como forma de beneficiar e melhorar os processos criativos no seio das organizações. O artigo divide-se em quatro partes: a complexidade da experiência humana, o peso do valor acrescentado no pensamento do design, os cinco modos propostos pela Universidade de Stanford para o pensamento do design e, finalmente, a apologia do movimento colaborativo. Neste contexto, terá especial destaque, em vários níveis, a relevância da interdisciplinaridade na resolução de problemas.

Swiss clinical practice guidelines for skin cancer in organ transplant recipients.

Patients with a solid organ transplant have increased in numbers and in individual survival in Switzerland over the last decades. As a consequence of long-term immunosuppression, skin cancer in solid organ recipients (SOTRs) has been recognized as an important problem. Screening and education of potential SOTRs about prevention of sun damage and early recognition of skin cancer are important before transplantation. Once transplanted, SOTRs should be seen by a dermatologist yearly for repeat education as well as early diagnosis, prevention and treatment of skin cancer. Squamous cell carcinoma of the skin (SCC) is the most frequent cancer in the setting of long-term immunosuppression. Sun protection by behaviour, clothing and daily sun screen application is the most effective prevention. Cumulative sun damage results in field cancerisation with numerous in-situ SCC such as actinic keratosis and Bowen's disease which should be treated proactively. Invasive SCC is cured by complete surgical excision. Early removal is the best precaution against potential metastases of SCC. Reduction of immunosuppression and switch to mTOR inhibitors and potentially, mycophenolate, may reduce the incidence of further SCC. Chemoprevention with the retinoid acitretin reduces the recurrence rate of SCC. The dermatological follow-up of SOTRs should be integrated into the comprehensive post-transplant care.

Vitamin D levels and associated factors: a population-based study in Switzerland.

QUESTIONS UNDER STUDY: To update the prevalence of vitamin D insufficiency and to identify factors associated with vitamin D status in the Swiss adult population. METHODS: Data from the 2010-2011 Swiss Study on Salt intake, a population-based study in the Swiss population, was used. Vitamin D concentration in serum was measured by liquid chromatography- tandem mass spectrometry. Major factors that influence vitamin D levels were taken into account. Survey statistical procedures were used to estimate means and prevalences of vitamin D levels and status. Monthly-specific tertiles of vitamin D and ordinal logistic regression were used to determine the associations of covariates of interest with vitamin D status. RESULTS: The prevalences of vitamin D insufficiency (serum 25-hydroxyvitamin D: 20-29.9 ng/ml) and deficiency (<20 ng/ml) were the highest in the January-March period; 26.4% (95%CI: 21.6-31.7) and 61.6% (95%CI: 56.0-67.0), respectively. In the same period, more than 9 of ten men were vitamin D insufficient or deficient. Each unit increase of Body Mass Index was associated with an 8% decreased likelihood of being in a higher vitamin D tertiles. Oral contraceptive, altitude, urinary excretion of calcium, use of vitamin D supplement or treatment, high wine consumption, physical activity were associated with vitamin D tertiles. Compared to the French-speaking region, the Italian-speaking region was independently associated with a higher likelihood of being in higher vitamin D tertiles (OR: 1.66, 95%CI: 1.14-2.43). CONCLUSIONS: Low levels of vitamin D are common among Swiss adults, in particular during winter months and outside the Italian-speaking region.

PTX3 Polymorphisms and Invasive Mold Infections After Solid Organ Transplant.

Donor PTX3 polymorphisms were shown to influence the risk of invasive aspergillosis among hematopoietic stem cell transplant recipients. Here, we show that PTX3 polymorphisms are independent risk factors for invasive mold infections among 1101 solid organ transplant recipients, thereby strengthening their role in mold infection pathogenesis and patients' risk stratification.

The generation effect and word learning: a test of the effect of the language experience approach versus the text approach in the acquisition of new reading vocabulary

A class of twenty-two grade one children was tested to determine their reading levels using the Stanford Diagnostic Reading Achievement Test. Based on these results and teacher input the students were paired according to reading ability. The students ages ranged from six years four months to seven years four months at the commencement of the study. Eleven children were assigned to the language experience group and their partners became the text group. Each member of the language experience group generated a list of eight to be learned words. The treatment consisted of exposing the student to a given word three times per session for ten sessions, over a period of five days. The dependent variables consisted of word identification speed, word identification accuracy, and word recognition accuracy. Each member of the text group followed the same procedure using his/her partner's list of words. Upon completion of this training, the entire process was repeated with members of the text group from the first part becoming members of the language experience group and vice versa. The results suggest that generally speaking language experience words are identified faster than text words but that there is no difference in the rate at which these words are learned. Language experience words may be identified faster because the auditory-semantic information is more readily available in them than in text words. The rate of learning in both types of words, however, may be dictated by the orthography of the to be learned word.

Subjective, behavioural and electrophysiological measurements of the time-course and intensity of sleep inertia after a full night of sleep /

Several recent studies have described the period of impaired alertness and performance known as sleep inertia that occurs upon awakening from a full night of sleep. They report that sleep inertia dissipates in a saturating exponential manner, the exact time course being task dependent, but generally persisting for one to two hours. A number of factors, including sleep architecture, sleep depth and circadian variables are also thought to affect the duration and intensity. The present study sought to replicate their findings for subjective alertness and reaction time and also to examine electrophysiological changes through the use of event-related potentials (ERPs). Secondly, several sleep parameters were examined for potential effects on the initial intensity of sleep inertia. Ten participants spent two consecutive nights and subsequent mornings in the sleep lab. Sleep architecture was recorded for a fiiU nocturnal episode of sleep based on participants' habitual sleep patterns. Subjective alertness and performance was measured for a 90-minute period after awakening. Alertness was measured every five minutes using the Stanford Sleepiness Scale (SSS) and a visual analogue scale (VAS) of sleepiness. An auditory tone also served as the target stimulus for an oddball task designed to examine the NlOO and P300 components ofthe ERP waveform. The five-minute oddball task was presented at 15-minute intervals over the initial 90-minutes after awakening to obtain six measures of average RT and amplitude and latency for NlOO and P300. Standard polysomnographic recording were used to obtain digital EEG and describe the night of sleep. Power spectral analyses (FFT) were used to calculate slow wave activity (SWA) as a measure of sleep depth for the whole night, 90-minutes before awakening and five minutes before awakening.

Kings of the battle-field: comprising a series of biographical sketches of the most distinguished military leaders...

UANL

A portal for the Canadian Virtual Health Library / Bibliothèque virtuelle canadienne de la santé (CVHL/BVCS): Accomplishments and possibilities, scope and structure - a review of best practices

Introduction: Coordination through CVHL/BVCS gives Canadian health libraries access to information technology they could not offer individually, thereby enhancing the library services offered to Canadian health professionals. An example is the portal being developed. Portal best practices are of increasing interest (usability.gov; Wikipedia portals; JISC subject portal project; Stanford clinical portals) but conclusive research is not yet available. This paper will identify best practices for a portal bringing together knowledge for Canadian health professionals supported through a network of libraries. Description: The portal for Canadian health professionals will include capabilities such as: • Authentication • Question referral • Specialist “branch libraries” • Integration of commercial resources, web resources and health systems data • Cross-resource search engine • Infrastructure to enable links from EHR and decision support systems • Knowledge translation tools, such as highlighting of best evidence Best practices will be determined by studying the capabilities of existing portals, including consortia/networks and individual institutions, and through a literature review. Outcomes: Best practices in portals will be reviewed. The collaboratively developed Virtual Library, currently the heart of cvhl.ca, is a unique database collecting high quality, free web documents and sites relevant to Canadian health care. The evident strengths of the Virtual Library will be discussed in light of best practices. Discussion: Identification of best practices will support cost-benefit analysis of options and provide direction for CVHL/BVCS. Open discussion with stakeholders (libraries and professionals) informed by this review will lead to adoption of the best technical solutions supporting Canadian health libraries and their users.

Generating Compliant Motion of Objects with an Articulated Hand

The flexibility of the robot is the key to its success as a viable aid to production. Flexibility of a robot can be explained in two directions. The first is to increase the physical generality of the robot such that it can be easily reconfigured to handle a wide variety of tasks. The second direction is to increase the ability of the robot to interact with its environment such that tasks can still be successfully completed in the presence of uncertainties. The use of articulated hands are capable of adapting to a wide variety of grasp shapes, hence reducing the need for special tooling. The availability of low mass, high bandwidth points close to the manipulated object also offers significant improvements I the control of fine motions. This thesis provides a framework for using articulated hands to perform local manipulation of objects. N particular, it addresses the issues in effecting compliant motions of objects in Cartesian space. The Stanford/JPL hand is used as an example to illustrate a number of concepts. The examples provide a unified methodology for controlling articulated hands grasping with point contacts. We also present a high-level hand programming system based on the methodologies developed in this thesis. Compliant motion of grasped objects and dexterous manipulations can be easily described in the LISP-based hand programming language.

Microscale thermal engineering of electronic systems

The electronics industry is encountering thermal challenges and opportunities with lengthscales comparable to or much less than one micrometer. Examples include nanoscale phonon hotspots in transistors and the increasing temperature rise in onchip interconnects. Millimeter-scale hotspots on microprocessors, resulting from varying rates of power consumption, are being addressed using two-phase microchannel heat sinks. Nanoscale thermal data storage technology has received much attention recently. This paper provides an overview of these topics with a focus on related research at Stanford University.

Enllaços d'interès

Presentació de les webs de: Enciclopèdia Stanford de Filososofia, Sociedad Española para el estudio de la Ansiedad y el Estrés (SEAS) i Revista Electrònica de Motivació i Emoció (REME)

Proyecto de investigación : Matemáticas-76. Tercera fase.

Completar los objetivos de las fases anteriores: comportamientos de los grupos de alumnos según el profesor y la naturaleza de cada grupo. Diferencias del nivel alcanzado en BUP y en COU. Contrastar la homogeneidad o no del comportamiento global en teoría y en la práctica. Escuelas y Colegios Universitarios de Granada y Bilbao. Centros de EGB y Bachillerato de Granada, Bilbao y Málaga. Centros privados y centros de enseñanza profesional. Centros Experimentales de Bachillerato pertenecientes al ICE. Aplicaciones experimentales del análisis de interacción, de la Universidad de Stanford, ampliado mediante las técnicas de las cadenas de Markov. Análisis de la adquisición de objetivos de la taxonomía NLSMA, adaptada en BUP y COU. Pruebas realizadas por los alumnos. Observaciones sistematizadas. Matrices de Markov. Test de hipótesis para cadenas finitas. Test de estacionaridad en cadenas finitas de Markov. Análisis multivariante. Fiabilidad en el método de interacción Amidon-Flanders. Tratamiento en ordenador. Chi cuadrado. Deducen que las observaciones de Flanders estan hechas sobre clases no muy activas. Relación entre el equilibrio-iniciativa-respuesta del profesor y la conducta de iniciativa de los alumnos. Reacción del profesor cuando los alumnos dejan de intervenir. Importancia del contenido. Homogeneidad de varianza entre todos los grupos. La deducción en COU ha pasado a ser homogénea, mientras que hay diferencias en los niveles medios de expresión y aplicación como en segundo de BUP. Los factores 'interpretación' y 'automatismo' por un lado, y 'expresión' y 'aplicación' por otro, están agrupados entre sí; mientras que 'deducción' presenta en principio un carácter más aislado. Sin embargo en COU, los factores agrupados son: interpretación, aplicación, automatismos y deducción. Clasificación de las pruebas realizadas por los alumnos de acuerdo a una taxonomía.

Proyecto de investigación : Matemáticas-76. Segunda fase.

Estudio y programación de los fines de la enseñanza de la Matemática Moderna. Estudio del diseño experimental necesario, para estudiar la correlación entre los niveles abstractos de Matemáticas y los niveles mentales del alumno, y para la experimentación de cuestionarios. Estudio y experimentación del material necesario y de las pruebas objetivas. Estudio, construcción y experimentación de tests normalizados. Estudio de la orientación escolar y la formación del profesorado. Escuelas y Colegios Universitarios de Granada y Bilbao. Centros de EGB y Bachillerato de Granada, Bilbao y Málaga. Centros experimentales de Bachillerato pertenecientes al ICE. Se organizan en cuatro grupos: subgrupo de metodología, subgrupo de programación de objetivos en Matemática Moderna, subgrupo de profesorado y subgrupo de diseño de Cálculo Estadístico. Construcción y experimentación de un modelo de comportamiento de los alumnos ante la probabilidad y respecto de algunas variables 'tipo-Stanford'. Continuación de la adquisición por alumnos de BUP de los cinco factores de la taxonomía, NLSMA. Evaluación de la programación de objetivos a través de una prueba. Encuesta al profesorado seleccionador de los institutos. Diseño factorial ortogonal, para el estudio de la influencia de varios factores en la dificultad de resolución de cuestiones de probabilidad en BUP. Técnica de las variables estructurales, y en el sentido G. Stanford-Nesher. Análisis de varianza asociado a un diseño en bloques. En el grupo de geometría: los factores no influyen igualmente, es decir, hay clara influencia de algunos de ellos sobre los demás, en el resultado de los exámenes -al 99- es decir, hay un desarrollo menos armónico de la Geometría en BUP, que del análisis S. En el grupo de análisis: es aceptable que todos lo factores influyan igualmente en el resultado de la prueba -95-.

TU Graz: Course: 707.000 Web Science and Web Technology: Lecture 7: Link Analysis and Search

What are ways of searching in graphs? In this class, we will discuss basics of link analysis, including Google's PageRank algorithm as an example. Readings: The PageRank Citation Ranking: Bringing Order to the Web, L. Page and S. Brin and R. Motwani and T. Winograd (1998) Stanford Tecnical Report