Vosaroxin and vosaroxin plus low-dose Ara-C (LDAC) vs low-dose Ara-C alone in older patients with acute myeloid leukemia

The development of new treatments for older patients with acute myeloid leukemia is an active area, but has met with limited success. Vosaroxin, a quinolone-derived intercalating agent has several properties that could prove beneficial. Initial clinical studies showed it to be well-tolerated in older patients with relapsed/refractory disease. In vitro data suggested synergy with cytarabine (Ara-C). To evaluate vosaroxin, we performed 2 randomized comparisons within the "Pick a Winner" program. A total of 104 patients were randomized to vosaroxin vs low-dose Ara-C (LDAC) and 104 to vosaroxin + LDAC vs LDAC. When comparing vosaroxin with LDAC, neither response rate (complete recovery [CR]/complete recovery with incomplete count recovery [CRi], 26% vs 30%; odds ratio [OR], 1.16 (0.49-2.72); P = .7) nor 12-month survival (12% vs 31%; hazard ratio [HR], 1.94 [1.26-3.00]; P = .003) showed benefit for vosaroxin. Likewise, in the vosaroxin + LDAC vs LDAC comparison, neither response rate (CR/CRi, 38% vs 34%; OR, 0.83 [0.37-1.84]; P = .6) nor survival (33% vs 37%; HR, 1.30 [0.81-2.07]; P = .3) was improved. A major reason for this lack of benefit was excess early mortality in the vosaroxin + LDAC arm, most obviously in the second month following randomization. At its first interim analysis, the Data Monitoring and Ethics Committee recommended closure of the vosaroxin-containing trial arms because a clinically relevant benefit was unlikely.

Pharmacogenetic angiogenesis profiling for first-line Bevacizumab plus oxaliplatin-based chemotherapy in patients with metastatic colorectal cancer

PURPOSE: There is substantial germline genetic variability within angiogenesis pathway genes, thereby causing interindividual differences in angiogenic capacity and resistance to antiangiogenesis therapy. We investigated germline polymorphisms in genes involved in VEGF-dependent and -independent angiogenesis pathways to predict clinical outcome and tumor response in metastatic colorectal cancer (mCRC) patients treated with bevacizumab and oxaliplatin-based chemotherapy.

EXPERIMENTAL DESIGN: A total of 132 patients treated with first-line bevacizumab and FOLFOX or XELOX were included in this study. Genomic DNA was isolated from whole-blood samples by PCR-RFLP or direct DNA sequencing. The endpoints of the study were progression-free survival (PFS), overall survival (OS), and response rate (RR).

RESULTS: The minor alleles of EGF rs444903 A>G and IGF-1 rs6220 A>G were associated with increased OS and remained significant in multivariate Cox regression analysis (HR: 0.52; 95% CI: 0.31-0.87; adjusted P = 0.012 and HR: 0.60; 95% CI: 0.36-0.99; adjusted P = 0.046, respectively). The minor allele of HIF1α rs11549465 C>T was significantly associated with increased PFS but lost its significance in multivariate analysis. CXCR1 rs2234671 G>C, CXCR2 rs2230054 T>C, EGFR rs2227983 G>A, and VEGFR-2 rs2305948 C>T predicted tumor response, with CXCR1 rs2234671 G>C remaining significant in multiple testing (P(act) = 0.003).

CONCLUSION: In this study, we identified common germline variants in VEGF-dependent and -independent angiogenesis genes predicting clinical outcome and tumor response in patients with mCRC receiving first-line bevacizumab and oxaliplatin-based chemotherapy.

"Je ne sais plus du tout qui je suis": The Phenomenology of Cancer in Anne Cuneo’s 'Une cuillerée de bleu'

Taking as its case study Anne Cuneo’s autopathography, Une cuillerée de bleu (1979), and supported by a phenomenological reading of the subjective realities of illness, including feelings of alienation, fragmentation, and passivity, this article considers how the experience of cancer affects the patient’s perception of her body, self, and world.

Plus Ça Change: The 2014 Local Elections in Northern Ireland

The local government elections of 22 May 2014 in Northern Ireland were the first to be held under revised district boundaries, with 11 'super councils' replacing the 26-council model used since 1973. Despite the structural reform, little changed in terms of political party support. Although they suffered some losses, the Democratic Unionist Party and Sinn Féin remained firmly entrenched as the two dominant players at local government level in Northern Ireland. The Ulster Unionist Party enjoyed only a marginal increase in its vote share, while the Social Democratic and Labour Party recorded one of the worst electoral performances in its history. Elsewhere, the Traditional Unionist Voice enjoyed a 'breakthrough' election and the Alliance Party defied widely held predictions that it would suffer at the polls as a result of its role in the Union flag crisis. The campaign was overshadowed by both the concurrent European Parliament contest and several crises of power-sharing at Stormont. As a result, distinctly local government issues received scant and fleeting attention. The contest saw the lowest local election turnout in Northern Ireland's history, continuing a general trend of increasing voter apathy in the province.

Proyecto de mejoramiento de procesos administrativos y operativos de Ecuadorian Cleaner Services, Cleaner Plus S.A.

ECUADORIAN CLEANER SERVICES CLEANER PLUS S.A. Es una empresa que se ha propuesto alcanzar varios objetivos en el actual Directorio conformado por Félix Marín Rueda, Presidente Ejecutivo, y Jorge Lagla Salazar, Gerente General; a pesar de que la empresa no cuenta con una Planificación estratégica como tal, sin embargo sus fines se enmarcan en planes a corto, mediano y largo plazo, los mismos que para llevarse a cabo necesitan de forma inmediata que todos los procesos de la empresa se encuentren formalizados. Uno de los principales problemas que tiene la empresa, y en el cual se sustenta la aplicación del presente proyecto, radica en la falta de un manual de procesos específicos, ya que todas las actividades actualmente se están llevando de forma empírica, lo que dificulta el actuar empresarial de Cleaner Plus S.A. evidenciando la inexistencia de planificación, organización y coordinación interna entre todas las áreas de la empresa.

Regularity of Wiener-Hopf plus Hankel operators

In this thesis we consider Wiener-Hopf-Hankel operators with Fourier symbols in the class of almost periodic, semi-almost periodic and piecewise almost periodic functions. In the first place, we consider Wiener-Hopf-Hankel operators acting between L2 Lebesgue spaces with possibly different Fourier matrix symbols in the Wiener-Hopf and in the Hankel operators. In the second place, we consider these operators with equal Fourier symbols and acting between weighted Lebesgue spaces Lp(R;w), where 1 < p < 1 and w belongs to a subclass of Muckenhoupt weights. In addition, singular integral operators with Carleman shift and almost periodic coefficients are also object of study. The main purpose of this thesis is to obtain regularity properties characterizations of those classes of operators. By regularity properties we mean those that depend on the kernel and cokernel of the operator. The main techniques used are the equivalence relations between operators and the factorization theory. An invertibility characterization for the Wiener-Hopf-Hankel operators with symbols belonging to the Wiener subclass of almost periodic functions APW is obtained, assuming that a particular matrix function admits a numerical range bounded away from zero and based on the values of a certain mean motion. For Wiener-Hopf-Hankel operators acting between L2-spaces and with possibly different AP symbols, criteria for the semi-Fredholm property and for one-sided and both-sided invertibility are obtained and the inverses for all possible cases are exhibited. For such results, a new type of AP factorization is introduced. Singular integral operators with Carleman shift and scalar almost periodic coefficients are also studied. Considering an auxiliar and simpler operator, and using appropriate factorizations, the dimensions of the kernels and cokernels of those operators are obtained. For Wiener-Hopf-Hankel operators with (possibly different) SAP and PAP matrix symbols and acting between L2-spaces, criteria for the Fredholm property are presented as well as the sum of the Fredholm indices of the Wiener-Hopf plus Hankel and Wiener-Hopf minus Hankel operators. By studying dependencies between different matrix Fourier symbols of Wiener-Hopf plus Hankel operators acting between L2-spaces, results about the kernel and cokernel of those operators are derived. For Wiener-Hopf-Hankel operators acting between weighted Lebesgue spaces, Lp(R;w), a study is made considering equal scalar Fourier symbols in the Wiener-Hopf and in the Hankel operators and belonging to the classes of APp;w, SAPp;w and PAPp;w. It is obtained an invertibility characterization for Wiener-Hopf plus Hankel operators with APp;w symbols. In the cases for which the Fourier symbols of the operators belong to SAPp;w and PAPp;w, it is obtained semi-Fredholm criteria for Wiener-Hopf-Hankel operators as well as formulas for the Fredholm indices of those operators.