Chemotherapy and radiotherapy in nasopharyngeal carcinoma: an update of the MAC-NPC meta-analysis.

BACKGROUND: A previous individual patient data meta-analysis by the Meta-Analysis of Chemotherapy in Nasopharynx Carcinoma (MAC-NPC) collaborative group to assess the addition of chemotherapy to radiotherapy showed that it improves overall survival in nasopharyngeal carcinoma. This benefit was restricted to patients receiving concomitant chemotherapy and radiotherapy. The aim of this study was to update the meta-analysis, include recent trials, and to analyse separately the benefit of concomitant plus adjuvant chemotherapy. METHODS: We searched PubMed, Web of Science, Cochrane Controlled Trials meta-register, ClinicalTrials.gov, and meeting proceedings to identify published or unpublished randomised trials assessing radiotherapy with or without chemotherapy in patients with non-metastatic nasopharyngeal carcinoma and obtained updated data for previously analysed studies. The primary endpoint of interest was overall survival. All trial results were combined and analysed using a fixed-effects model. The statistical analysis plan was pre-specified in a protocol. All data were analysed on an intention-to-treat basis. FINDINGS: We analysed data from 19 trials and 4806 patients. Median follow-up was 7·7 years (IQR 6·2-11·9). We found that the addition of chemotherapy to radiotherapy significantly improved overall survival (hazard ratio [HR] 0·79, 95% CI 0·73-0·86, p<0·0001; absolute benefit at 5 years 6·3%, 95% CI 3·5-9·1). The interaction between treatment effect (benefit of chemotherapy) on overall survival and the timing of chemotherapy was significant (p=0·01) in favour of concomitant plus adjuvant chemotherapy (HR 0·65, 0·56-0·76) and concomitant without adjuvant chemotherapy (0·80, 0·70-0·93) but not adjuvant chemotherapy alone (0·87, 0·68-1·12) or induction chemotherapy alone (0·96, 0·80-1·16). The benefit of the addition of chemotherapy was consistent for all endpoints analysed (all p<0·0001): progression-free survival (HR 0·75, 95% CI 0·69-0·81), locoregional control (0·73, 0·64-0·83), distant control (0·67, 0·59-0·75), and cancer mortality (0·76, 0·69-0·84). INTERPRETATION: Our results confirm that the addition of concomitant chemotherapy to radiotherapy significantly improves survival in patients with locoregionally advanced nasopharyngeal carcinoma. To our knowledge, this is the first analysis that examines the effect of concomitant chemotherapy with and without adjuvant chemotherapy as distinct groups. Further studies on the specific benefits of adjuvant chemotherapy after concomitant chemoradiotherapy are needed. FUNDING: French Ministry of Health (Programme d'actions intégrées de recherche VADS), Ligue Nationale Contre le Cancer, and Sanofi-Aventis.

La colección Marca Hispanica, un ambicioso proyecto de traducción de José Agustín Goytisolo

In May 1985 José Agustín Goytisolo launched an ambitious project to translate into Spanish works originally written in Catalan. To this end, with a small group of collaborators he founded the Marca Hispanica collection. Its aim was to spread Catalan literature beyond its borders to reach millions of readers of Spanish through schools, teachers and language academies around the world. The initial idea was to make available in bilingual editions a hundred representative works of Catalan literature but, in the event, only twenty-two volumes were ever published. Based on access to unpublished documents, in this article we defend this endeavour, report on its progress and relate the circumstances, beyond the control of the participants, that led to its demise.

Subclinical Hypothyroidism and the Risk of Stroke Events and Fatal Stroke: An Individual Participant Data Analysis.

OBJECTIVE: The objective was to determine the risk of stroke associated with subclinical hypothyroidism. DATA SOURCES AND STUDY SELECTION: Published prospective cohort studies were identified through a systematic search through November 2013 without restrictions in several databases. Unpublished studies were identified through the Thyroid Studies Collaboration. We collected individual participant data on thyroid function and stroke outcome. Euthyroidism was defined as TSH levels of 0.45-4.49 mIU/L, and subclinical hypothyroidism was defined as TSH levels of 4.5-19.9 mIU/L with normal T4 levels. DATA EXTRACTION AND SYNTHESIS: We collected individual participant data on 47 573 adults (3451 subclinical hypothyroidism) from 17 cohorts and followed up from 1972-2014 (489 192 person-years). Age- and sex-adjusted pooled hazard ratios (HRs) for participants with subclinical hypothyroidism compared to euthyroidism were 1.05 (95% confidence interval [CI], 0.91-1.21) for stroke events (combined fatal and nonfatal stroke) and 1.07 (95% CI, 0.80-1.42) for fatal stroke. Stratified by age, the HR for stroke events was 3.32 (95% CI, 1.25-8.80) for individuals aged 18-49 years. There was an increased risk of fatal stroke in the age groups 18-49 and 50-64 years, with a HR of 4.22 (95% CI, 1.08-16.55) and 2.86 (95% CI, 1.31-6.26), respectively (p trend 0.04). We found no increased risk for those 65-79 years old (HR, 1.00; 95% CI, 0.86-1.18) or ≥ 80 years old (HR, 1.31; 95% CI, 0.79-2.18). There was a pattern of increased risk of fatal stroke with higher TSH concentrations. CONCLUSIONS: Although no overall effect of subclinical hypothyroidism on stroke could be demonstrated, an increased risk in subjects younger than 65 years and those with higher TSH concentrations was observed.

Cardan Gear Mechanism versus Slider-Crank Mechanism in Pumps and Engines

In machine design we always want to save space, save energy and produce as much power as possible. We can often reduce accelerations, inertial loads and energy consumption by changing construction. In this study the old cardan gear mechanism (hypocycloid mechanism) has been compared with the conventional slider-crank mechanism in air pumps and four-stroke engines. Comprehensive Newtonian dynamics has been derived for the both mechanisms. First the slidercrank and the cardan gear machines have been studied as lossless systems. Then the friction losses have been added to the calculations. The calculation results show that the cardan gear machines can be more efficient than the slider-crank machines. The smooth running, low mass inertia, high pressures and small frictional power losses make the cardan gear machines clearly better than the slider-crank machines. The dynamic tooth loads of the original cardan gear construction do not rise very high when the tooth clearances are kept tight. On the other hand the half-size crank length causes high bearing forces in the cardan gear machines. The friction losses of the cardan gear machines are generally quite small. The mechanical efficiencies are much higher in the cardan gear machines than in the slider-crank machines in normal use. Crankshaft torques and power needs are smaller in the cardan gear air pumps than in the equal slider-crank air pumps. The mean crankshaft torque and the mean output power are higher in the cardan gear four-stroke engines than in the slider-crank four-stroke engines in normal use. The cardan gear mechanism is at its best, when we want to build a pump or an engine with a long connecting rod (≈ 5⋅crank length) and a thin piston (≈ 1.5⋅crank length) rotating at high angular velocity and intermittently high angular acceleration. The cardan gear machines can be designed also as slide constructions without gears. Suitable applications of the cardan gear machines are three-cylinder half-radial engines for motorcycles, sixcylinder radial engines for airplanes and six-cylinder double half-radial engines for sport cars. The applied equations of Newtonian dynamics, comparative calculations, calculation results (tables, curves and surface plots) and recommendations presented in this study hold novelty value and are unpublished before. They have been made and written by the author first time in this study.

Comprendre les Humanités numériques. Enjeux, outils, réseaux. L'exemple de l'histoire

Comment mener une recherche historique dans un monde mis en données?

Temporalités des commémorations du Centenaire sur Twitter

Du 1er avril 2014 au 1er avril 2015, plus d'un million de tweets ont été émis sur les commémorations du centenaire de la Première Guerre mondiale. Ces tweets, qui ont été collectés par l'auteur de cette proposition sur la base de hashtags liés au centenaire, contiennent de nombreuses traces de temporalités : le flux (twitter), le tweet (date de publication), mais aussi les nombreuses références aux temporalités propres aux utilisateurs de twitter, au Centenaire et à la Première Guerre mondiale. L'historien ne peut alors que se poser la question suivante : de quelle manière ces temporalités sont-elles reliées entre elles ? Comment s'imbriquent ces différentes strates de temps ?

Farmer-Managed Natural Regeneration Enhances Rural Livelihoods in Dryland West Africa

Declining agricultural productivity, land clearance and climate change are compounding the vulnerability of already marginal rural populations in West Africa. 'Farmer-Managed Natural Regeneration' (FMNR) is an approach to arable land restoration and reforestation that seeks to reconcile sustained food production, conservation of soils and protection of biodiversity. It involves selecting and protecting the most vigorous stems regrowing from live stumps of felled trees, pruning off all other stems, and pollarding the chosen stems to grow into straight trunks. Despite widespread enthusiasm and application of FMNR by environmental management and development projects, to date, no research has provided a measure of the aggregate livelihood impact of community adoption of FMNR. This paper places FMNR in the context of other agroforestry initiatives, then seeks to quantify the value of livelihood outcomes of FMNR. We review published and unpublished evidence about the impacts of FMNR, and present a new case study that addresses gaps in the evidence base. The case study focuses on a FMNR project in the district of Talensi in the semi-arid Upper East Region in Ghana. The case study employs a Social Return on Investment (SROI) analysis, which identifies proxy financial values for non-economic as well as economic benefits. The results demonstrate income and agricultural benefits, but also show that asset creation, increased consumption of wild resources, health improvements and psycho-social benefits created more value in FMNR-adopting households during the period of the study than increases in income and agricultural yields.

Aproximació a la biografia i el pensament educatiu de Maria Teresa Codina: Educant entre la utopia i la realitat

Maria Teresa Codina i Mir és una mestra i pedagoga que ha tingut especial rellevància en la pedagogia del segle XX a Catalunya. Durant la seva trajectòria personal i professional ha estat compromesa en l’educació dels sectors socials més desfavorits i en la renovació pedagògica de Catalunya. Aquesta tasca tan important que ha dut a terme de manera silenciosa, no pot ser ignorada. Amb aquest treball pretenem analitzar-la i donar-la a conèixer. És per aquest motiu que hem fet una aproximació biogràfica de la vida i idees pedagògiques de Maria Teresa Codina a partir de la veu de persones que l’han coneguda i que han estat significatives en la seva vida. A través de successives entrevistes i l’anàlisi de documents personals i inèdits de Codina, volem aprofundir en la seva trajectòria personal i professional i conèixer les seves idees educatives des d’una visió més propera, viva i humana.

Voting advice applications : impact on voting decisions in the 2011 Swiss national elections

In most democracies voting Advice Applications (VAAs) advising citizens which candidate or party they should vote for become more and more popular. It is therefore crucial to know more about the functioning and the effects of such tools. After some general remarks about the spread of these tools and their possible effects gathered so far in various studies, this paper presents the latest results from a research conducted in the course of the 2011 Swiss national elections. They confirm that VAAs can lead to better informed voters and are likely to have a positive impact on electoral turnout. Additionally it can be shown that the Swiss VAA smartvote made voters change their voting intention and that they voted for a different party. This was particularly advantageous for the Green Liberal Party. At the moment, only a minority of voters rely on the voting recommendation by smartvote. This might change dramatically with the introduction of e-voting. Once people can vote electronically, there are hardly any possibilities to prevent voters from transferring their selection of candidates based on the recommendation given by a VAA into the official electronic ballot paper. If this is possible, e-voting will become more popular than postal voting.

Facebook et l'Histoire

À l'ère des données massives, comment l'historien.ne voit-il facebook? Facebook pourra-t-il servir de source primaire, sous quelles conditions?

Échos du centenaire sur le web et sur Twitter : partage de liens et Grande Guerre

Depuis avril 2014, plus de deux millions de tweets ont été publiés, touchant aux commémorations du Centenaire de la Grande Guerre, principalement en Anglais et en Français. Cette communication s'intéresse à une pratique précise lié aux modalités d'usage de Twitter: le partage de liens. En s'intéressant notamment aux liens pointant vers des pages web francophones partagés le 11 novembre 2015, l'auteur a constitué un corpus d'environ 1000 pages web et en analyse le contenu. Il s'interroge notamment sur l'émergence en tant que lieu de mémoire du site « Mémoire des Hommes » et plus particulièrement de la base de données des morts pour la France.

The uncertain relationship between transparency and accountability revisited through four Swiss cases

Accountability and transparency are of growing importance in contemporary governance. The academic literature have broadly studied the two concepts separately, defining and redefining them, and including them into various framework, sometimes mistakenly using them as synonyms. The relationship between the two concepts has, curiously, only been studied by a few scholars with preliminary approaches. This theoretical paper will focus on both concepts, trying first to describe them taking into account the various evolutions in the literature and the recent evolutions as well as the first attempts to link the two concepts. In order to show a new approach linking the concepts, four cases from the Swiss context will be portrayed and will demonstrate the necessity to reconsider the relationship between transparency and accountability. Consequently, a new framework, based on Fox's framework (2007) will be presented and theoretically delimited.