Final results of the SAKK 16/00 trial: a randomized phase III trial comparing neoadjuvant chemoradiation to chemotherapy alone in stage IIIA/N2 non-small cell lung cancer (NSCLC).

Aim: One standard option in the treatment of stage IIIA/N2 NSCLC is neoadjuvant chemotherapy followed by surgery. We investigated in a randomized trial whether the addition of neoadjuvant radiotherapy would improve the outcome. Here we present the final results of this study. Methods: Patients (pts.) with pathologically proven, resectable stage IIIA/N2 NSCLC, performance status 0-1, and adequate organ function were randomized 1:1 to chemoradiation (CRT) with 3 cycles of neoadjuvant chemotherapy (cisplatin 100 mg/m2 and docetaxel 85 mg/m2 d1, q3weeks) followed by accelerated concomitant boost radiotherapy (RT) with 44 Gy in 22 fractions in 3 weeks, or neoadjuvant chemotherapy alone (CT), with subsequent surgery for all pts. The primary endpoint was event-free survival (EFS). Results: 232 pts. were randomized in 23 centers, the median follow-up was 53 months. Two thirds were men, median age was 60 years (range 37-76). Histology was squamous cell in 33%, adenocarcinoma in 43%. Response rate to CRT was 61% vs. 44% with CT. 85% of all pts. underwent surgery, 30-day postoperative mortality was 1%. The rate of complete resection was 91% (CRT) vs. 81% (CT) and the pathological complete remission (pCR) rate was 16% vs. 12%. The median EFS was 13.1 months (95% CI 9.9 - 23.5) for the CRT group vs. 11.8 months (95% CI 8.4 - 15.2) in the CT arm (p 0.665). The median overall survival (OS) with CRT was 37.1 months (95% CI 22.6 -50), with CT 26.1 months ( 95% CI 26.1 - 52.1, p 0.938). The local failure rate was 23% in both arms. In the CT arm 12 pts. were given postoperative radiotherapy (PORT) for R1 resection, 6 pts. received PORT in violation of the protocol. Pts. with a pCR, mediastinal downstaging to ypN0/1 and complete resection had a better outcome. Toxicity of chemotherapy was substantial, especially febrile neutropenia was common, whereas RT was well tolerated. Conclusions: This is the first completed phase III trial to evaluate the role of induction chemoradiotherapy and surgery, in comparison to neoadjuvant CT alone followed by surgery. RT was active, it increased response, complete resection and pCR rates. However, this failed to translate into an improvement of local control, EFS or OS. Notably, surgery after induction treatment was safe, including pneumonectomy. The overall survival rates of our neoadjuvant regimen are very encouraging, especially for a multicenter setting. Disclosure: M. Pless: Advisory Board for Sanofi; R. Cathomas: Advisory Board Sanofi D.C. Betticher: Advisory Board Sanofi. All other authors have declared no conflicts of interest.

Adjuvant Fluorouracil, Leucovorin, and Oxaliplatin in Stage II to III Colon Cancer: Updated 10-Year Survival and Outcomes According to BRAF Mutation and Mismatch Repair Status of the MOSAIC Study.

PURPOSE: The MOSAIC (Multicenter International Study of Oxaliplatin/Fluorouracil/Leucovorin in the Adjuvant Treatment of Colon Cancer) study has demonstrated 3-year disease-free survival (DFS) and 6-year overall survival (OS) benefit of adjuvant oxaliplatin in stage II to III resected colon cancer. This update presents 10-year OS and OS and DFS by mismatch repair (MMR) status and BRAF mutation. METHODS: Survival actualization after 10-year follow-up was performed in 2,246 patients with resected stage II to III colon cancer. We assessed MMR status and BRAF mutation in 1,008 formalin-fixed paraffin-embedded specimens. RESULTS: After a median follow-up of 9.5 years, 10-year OS rates in the bolus/infusional fluorouracil plus leucovorin (LV5FU2) and LV5FU2 plus oxaliplatin (FOLFOX4) arms were 67.1% versus 71.7% (hazard ratio [HR], 0.85; P = .043) in the whole population, 79.5% versus 78.4% for stage II (HR, 1.00; P = .980), and 59.0% versus 67.1% for stage III (HR, 0.80; P = .016) disease. Ninety-five patients (9.4%) had MMR-deficient (dMMR) tumors, and 94 (10.4%) had BRAF mutation. BRAF mutation was not prognostic for OS (P = .965), but dMMR was an independent prognostic factor (HR, 2.02; 95% CI, 1.15 to 3.55; P = .014). HRs for DFS and OS benefit in the FOLFOX4 arm were 0.48 (95% CI, 0.20 to 1.12) and 0.41 (95% CI, 0.16 to 1.07), respectively, in patients with stage II to III dMMR and 0.50 (95% CI, 0.25 to 1.00) and 0.66 (95% CI, 0.31 to 1.42), respectively, in those with BRAF mutation. CONCLUSION: The OS benefit of oxaliplatin-based adjuvant chemotherapy, increasing over time and with the disease severity, was confirmed at 10 years in patients with stage II to III colon cancer. These updated results support the use of FOLFOX in patients with stage III disease, including those with dMMR or BRAF mutation.

DNA Topoisomerase I Gene Copy Number and mRNA Expression Assessed as Predictive Biomarkers for Adjuvant Irinotecan in Stage II/III Colon Cancer.

PURPOSE: Prospective-retrospective assessment of theTOP1gene copy number andTOP1mRNA expression as predictive biomarkers for adjuvant irinotecan in stage II/III colon cancer. EXPERIMENTAL DESIGN: Formalin-fixed, paraffin-embedded tissue microarrays were obtained from an adjuvant colon cancer trial (PETACC3) where patients were randomized to 5-fluorouracil/folinic acid with or without additional irinotecan.TOP1copy number status was analyzed by fluorescencein situhybridization (FISH) using aTOP1/CEN20 dual-probe combination.TOP1mRNA data were available from previous analyses. RESULTS: TOP1FISH and follow-up data were obtained from 534 patients.TOP1gain was identified in 27% using a single-probe enumeration strategy (≥4TOP1signals per cell) and in 31% when defined by aTOP1/CEN20 ratio ≥ 1.5. The effect of additional irinotecan was not dependent onTOP1FISH status.TOP1mRNA data were available from 580 patients with stage III disease. Benefit of irinotecan was restricted to patients characterized byTOP1mRNA expression ≥ third quartile (RFS: HRadjusted, 0.59;P= 0.09; OS: HRadjusted, 0.44;P= 0.03). The treatment byTOP1mRNA interaction was not statistically significant, but in exploratory multivariable fractional polynomial interaction analysis, increasingTOP1mRNA values appeared to be associated with increasing benefit of irinotecan. CONCLUSIONS: In contrast to theTOP1copy number, a trend was demonstrated for a predictive property ofTOP1mRNA expression. On the basis ofTOP1mRNA, it might be possible to identify a subgroup of patients where an irinotecan doublet is a clinically relevant option in the adjuvant setting of colon cancer.Clin Cancer Res; 22(7); 1621-31. ©2015 AACR.

Некоторые наблюдения по поводу построения компьютерного морфологического анализатора марийского языка. [Problems in writing a two-level model of Mari morphology]

The article describes some concrete problems that were encountered when writing a two-level model of Mari morphology. Mari is an agglutinative Finno-Ugric language spoken in Russia by about 600 000 people. The work was begun in the 1980s on the basis of K. Koskenniemi’s Two-Level Morphology (1983), but in the latest stage R. Beesley’s and L. Karttunen’s Finite State Morphology (2003) was used. Many of the problems described in the article concern the inexplicitness of the rules in Mari grammars and the lack of information about the exact distribution of some suffixes, e.g. enclitics. The Mari grammars usually give complete paradigms for a few unproblematic verb stems, whereas the difficult or unclear forms of certain verbs are only superficially discussed. Another example of phenomena that are poorly described in grammars is the way suffixes with an initial sibilant combine to stems ending in a sibilant. The help of informants and searches from electronic corpora were used to overcome such difficulties in the development of the two-level model of Mari. The variation of the order of plural markers, case suffixes and possessive suffixes is a typical feature of Mari. The morphotactic rules constructed for Mari declensional forms tend to be recursive and their productivity must be limited by some technical device, such as filters. In the present model, certain plural markers were treated like nouns. The positional and functional versatility of the possessive suffixes can be regarded as the most challenging phenomenon in attempts to formalize the Mari morphology. Cyrillic orthography, which was used in the model, also caused problems. For instance, a Cyrillic letter may represent a sequence of two sounds, the first being part of the word stem while the other belongs to a suffix. In some cases, letters for voiced consonants are also generalized to represent voiceless consonants. Such orthographical conventions distance a morphological model based on orthography from the actual (morpho)phonological processes in the language.

Estimation of age- and stage-specific Catalan breast cancer survival functions using US and Catalan survival data

During the last part of the 1990s the chance of surviving breast cancer increased. Changes in survival functions reflect a mixture of effects. Both, the introduction of adjuvant treatments and early screening with mammography played a role in the decline in mortality. Evaluating the contribution of these interventions using mathematical models requires survival functions before and after their introduction. Furthermore, required survival functions may be different by age groups and are related to disease stage at diagnosis. Sometimes detailed information is not available, as was the case for the region of Catalonia (Spain). Then one may derive the functions using information from other geographical areas. This work presents the methodology used to estimate age- and stage-specific Catalan breast cancer survival functions from scarce Catalan survival data by adapting the age- and stage-specific US functions. Methods: Cubic splines were used to smooth data and obtain continuous hazard rate functions. After, we fitted a Poisson model to derive hazard ratios. The model included time as a covariate. Then the hazard ratios were applied to US survival functions detailed by age and stage to obtain Catalan estimations. Results: We started estimating the hazard ratios for Catalonia versus the USA before and after the introduction of screening. The hazard ratios were then multiplied by the age- and stage-specific breast cancer hazard rates from the USA to obtain the Catalan hazard rates. We also compared breast cancer survival in Catalonia and the USA in two time periods, before cancer control interventions (USA 1975–79, Catalonia 1980–89) and after (USA and Catalonia 1990–2001). Survival in Catalonia in the 1980–89 period was worse than in the USA during 1975–79, but the differences disappeared in 1990–2001. Conclusion: Our results suggest that access to better treatments and quality of care contributed to large improvements in survival in Catalonia. On the other hand, we obtained detailed breast cancer survival functions that will be used for modeling the effect of screening and adjuvant treatments in Catalonia

DC Boost Stage in Photovoltaic Systems

The performance of Grid connected Photovoltaic System working with DCBoost stage is investigated. The DC-Boost Converter topology is deduced from three phase half controlled bridge and controlled by Sliding Mode Control. Due to the fact that Grid connected Photovoltaic System includes Solar cells as a DC source and inverter for grid connection, those are under the scope of this research as well. The advantages of using MPPT are analyzed. The system is simulated in Matlab-Simulink™ environment.

Performance Improvement of Centrifugal Compressor Stage with Pinched Geometry or Vaned Diffuser

Centrifugal compressors are widely used for example in refrigeration processes, the oil and gas industry, superchargers, and waste water treatment. In this work, five different vaneless diffusers and six different vaned diffusers are investigated numerically. The vaneless diffusers vary only by their diffuser width, so that four of the geometries have pinch implemented to them. Pinch means a decrease in the diffuser width. Four of the vaned diffusers have the same vane turning angle and a different number of vanes, and two have different vane turning angles. The flow solver used to solve the flow fields is Finflo, which is a Navier-Stokes solver. All the cases are modeled with the Chien's k – έ- turbulence model, and selected cases are modeled also with the k – ώ-SST turbulence model. All five vaneless diffusers and three vaned diffusers are investigated also experimentally. For each construction, the compressor operating map is measured according to relevant standards. In addition to this, the flow fields before and after the diffuser are measured with static and total pressure, flow angle and total temperature measurements. When comparing the computational results to the measured results, it is evident that the k – ώ-SST turbulence model predicts the flow fields better. The simulation results indicate that it is possible to improve the efficiency with the pinch, and according to the numerical results, the two best geometries are the ones with most pinch at the shroud. These geometries have approximately 4 percentage points higher efficiency than the unpinched vaneless diffusers. The hub pinch does not seem to have any major benefits. In general, the pinches make the flow fields before and after the diffuser more uniform. The pinch also seems to improve the impeller efficiency. This is down to two reasons. The major reason is that the pinch decreases the size of slow flow and possible backflow region located near the shroud after the impeller. Secondly, the pinches decrease the flow velocity in the tip clearance, leading to a smaller tip leakage flow and therefore slightly better impeller efficiency. Also some of the vaned diffusers improve the efficiency, the increment being 1...3 percentage points, when compared to the vaneless unpinched geometry. The measurement results confirm that the pinch is beneficial to the performance of the compressor. The flow fields are more uniform with the pinched cases, and the slow flow regions are smaller. The peak efficiency is approximately 2 percentage points and the design point efficiency approximately 4 percentage points higher with the pinched geometries than with the un- pinched geometry. According to the measurements, the two best geometries are the ones with the most pinch at the shroud, the case with the pinch only at the shroud being slightly better of the two. The vaned diffusers also have better efficiency than the vaneless unpinched geometries. However, the pinched cases have even better efficiencies. The vaned diffusers narrow the operating range considerably, whilst the pinch has no significant effect on the operating range.

La adquisición de la interrogación: las interrogativas parciales en catalán y castellano = The acquisition of interrogatives:Wh-questions in Catalan and Spanish

En este trabajo se describe la naturaleza y secuencia de adquisición de las preguntas interrogativas parcialesen niños de habla catalana y/o castellana dentro de un marco de análisis según el cual la adquisición de lasestructuras lingüísticas se construye gradualmente desde estructuras concretas hasta estructuras más abstractas.La muestra utilizada se compone de 10 niños y niñas procedentes de corpus longitudinales cuyas edades van delos 17 meses a los 3 años. El análisis se ha realizado atendiendo a la estructura sintáctica de la oración, loserrores, los pronombres y adverbios interrogativos, y la tipología verbal. Los resultados muestran que la secuenciade adquisición pasa por un momento inicial caracterizado por producciones estereotipadas o fórmulas,durante el cual sólo aparecen algunas partículas interrogativas en estructuras muy concretas. Posteriormente lainterrogación aparece con otros pronombres y adverbios y se diversifica a otros verbos, además, no se observanerrores en la construcción sintáctica. Estos resultados suponen un hecho diferencial respecto de estudios previos enlengua inglesa

Final chlorine dioxide stage at near-neutral pH for bleaching eucalypt pulp

It is well known that pH is an important parameter for controlling the eucalyptus pulp bleaching when using the final chlorine dioxide stage, since it affects the effectiveness of the process. Recommendations found in the literature for operating are in the 3.5 to 4.0 range. However, in this paper it was shown that final chlorine dioxide has better performance, with significant brightness gain while also preserving pulp quality, when it is operated at near neutral pH. This result can be explained by the generation of sodium bicarbonate in situ upon adding carbon dioxide at this stage.

Defining the location factors of new manufacturing site in chemical industry

The objective of this thesis is to examine the factors that have an impact on the location decision of new manufacturing site and to create the relative order of importance of these factors by analytic hierarchy process (AHP). The decision making process especially related to the location selection and the measurement of the location factors are also examined. In theoretical part the character of decision making process and the relevant methods are introduced. Based on the previous studies of other researchers, the location factors are examined and the main research method, analytic hierarchy process, is also introduced. The empirical part of the study mainly follows the phases of decision making process and is emphasized on the main stages of analytic hierarchy process; building the hierarchy, defining the priorities and analyzing the results. The hierarchy is constructed from seven main criteria which all have several sub criteria. The evaluation of the hierarchy is implemented at the group decision making –laboratory and there can be seen significant differences between the importance of criteria. The final stage in the study is to create the appropriate measurement scales to the chosen criteria.

Innovatiivisuus ja yhteistoiminnallinen oppiminen liike-elämässä ja opetuksessa

Innovativity and cooperative learning in business life and teaching The study comprises four articles and a summary, which analyse the concepts of innovation and innovativity and the cooperative learning connected to the innovation processes of companies. Th e study comments on what is innovativity. Another point of inspection is how the cooperative learning theory constructed on the basis of educational science lends it self to inspecting business innovations. At the end, we ponder upon how the concepts of innovativity can be used to inspect teachers’ activities. The studied business innovations were chosen on after considering expert statements. The key personnel in the innovation process were interviewed. The concept of innovation is inspected especially with the aid of concept analysis. The pedagogical innovativity study based on the view of education specialists in quantitative and the data was collected with a questionnaire created on the basis of previous research and literature. Different research methods were used in the studies, thus mixed methods were used for the whole of the doctoral thesis. The starting point for the whole, grounded theory, has to be understood here as a research strategy as well as a research method and data analysis method. The results show that innovativity is creativity that demands versatile learning and has positive eff ects on the process or event in practice. The results also show that in successful innovation businesses cooperative learning is something that has been found instead of searched. Cooperative learning can be seen as characteristic for innovation businesses. The five stage division of cooperative learning creates a useful method of analysing learning in innovation businesses. Innovativity connected to cooperative learning seems to make the creation of innovations possible. In addition to this, the results also show that a teacher’s innovativity is connected to reforms and an attitude that embraces them. Versatile learning in the individual and community is a prerequisite for innovativity. It is important that the teacher has a continuous will to renew teaching methods and combine work and teaching methods. The basic requirements are pedagogical vocational profi ciency and resourcefulness in everyday work.

Lärande som text : en dramapedagogiskt förankrad läsning av det kroppsliga, rumsliga och retoriska i kunskapsbildande processer

My presupposition, that learning at some level deals with life praxis, is expressed in four metaphors: space, time, fable and figure. Relations between learning,knowledge building and meaning making are linked to the concept of personal knowledge. I present a two part study of learning as text in a drama pedagogical rooted reading where learning is framed as the ongoing event, and knowledge, as the product of previous processes, is framed as culturally formed utterances. A frame analysis model is constructed as a topological guide for relations between the two concepts learning and knowledge. It visualises an aesthetic understanding, rooted in drama pedagogical comprehension. Insight and perception are linked in an inner relationship that is neither external nor identical. This understanding expresses the movement "in between" connecting asymmetrical and nonlinear features of human endeavour and societal issues. The performability of bodily and oral participation in the learning event in a socio-cultural setting is analysed as a dialogised text. In an ethnographical case study I have gathered material with an interest for the particular. The empirical material is based on three problem based learning situations in a Polytechnic setting. The act of transformation in the polyphony of the event is considered as a turning point in the narrative employment. Negotiation and figuration in the situation form patterns of the space for improvisation (flow) and tensions at the boundaries (thresholds) which imply the logical structure of transformation. Learning as a dialogised text of "yes" and "no", of structure and play for the improvised, interrelate in that movement. It is related to both the syntagmic and the paradigmatic forms of thinking. In the philosophical study, forms of understanding are linked to the logical structure of transformation as a cultural issue. The classical rhetorical concepts of Logos, Pathos, Ethos and Mythos are connected to the multidimensional rationality of the human being. In the Aristotelian form of knowledge, phronesis,a logic structure of inquiry is recognised. The shifting of perspectives between approaches, the construction of knowledge as context and the human project of meaning making as a subtext, illuminates multiple layers of the learning text. In an argumentation that post-modern apprehension of knowledge, emphasising contextual and situational values, has an empowering impact on learning, I find pedagogical benefits. The dialogical perspective has opened lenses that manage to hold in aesthetic doubling the individual action of inquiry and the stage with its cultural tools in a three dimensional reading.

The role of arbuscular mycorrhizal fungi on the early-stage restoration of seasonally dry tropical forest in Chamela, Mexico

It was evaluated the effect of two different sources of local inocula from two contrasting sites (mature forest, pasture) of arbuscular mycorrhizae fungi (AMF) and a non-mycorrhizal control on the plant growth of six woody species differing in functional characteristics (slow-, intermediate- and fast-growth), when introduced in a seasonally tropical dry forest (STDF) converted into abandoned pasture. Six plots (12 X 12m) were set as AMF inoculum source. Six replicates of six different species arranged in a Latin Square design were set in each plot. Plant height, cover area and the number of leaves produced by individual plant was measured monthly during the first growing season in each treatment. Species differed in their ability to benefit from AMF and the largest responsiveness in plant height and leaf production was exhibited by the slow-growing species Swietenia humilis, Hintonia latiflora and Cordia alliodora. At the end of the growing season (November), the plant height of the fast growing species Tabebuia donnel-smithii, Ceiba pentandra and Guazuma ulmifolia were not influenced by AMF. However, inocula of AMF increased leaf production of all plant species regardless the functional characteristics of the species, suggesting a better exploitation of above-ground space and generating a light limited environment under the canopy, which contributed to pasture suppression. Inoculation of seedlings planted in abandoned pasture areas is recommended for ecological restoration due to the high responsiveness of seedling growth in most of species. Use of forest inoculum with its higher diversity of AMF could accelerate the ecological restoration of the above and below-ground comunities.

Comparison of maps of spatial variability of soil resistance to penetration constructed with and without covariables using a spatial linear model

A study about the spatial variability of data of soil resistance to penetration (RSP) was conducted at layers 0.0-0.1 m, 0.1-0.2 m and 0.2-0.3 m depth, using the statistical methods in univariate forms, i.e., using traditional geostatistics, forming thematic maps by ordinary kriging for each layer of the study. It was analyzed the RSP in layer 0.2-0.3 m depth through a spatial linear model (SLM), which considered the layers 0.0-0.1 m and 0.1-0.2 m in depth as covariable, obtaining an estimation model and a thematic map by universal kriging. The thematic maps of the RSP at layer 0.2-0.3 m depth, constructed by both methods, were compared using measures of accuracy obtained from the construction of the matrix of errors and confusion matrix. There are similarities between the thematic maps. All maps showed that the RSP is higher in the north region.

Removal of nitrogen, phosphorus, copper and zinc from swine breeding waste water by bermudagrass and cattail in constructed wetland systems

This work aimed to study the agronomic performance and capacity of nutrient removal by bermudagrass (Cynodon spp.) and cattail (Typha sp.) when grown in constructed wetlands systems (CWSs) of vertical and horizontal flow, respectively, used in the post-treatment of swine breeding wastewater (ARS). The average yield of dry matter (DM) of bermudagrass in sections of 60-day interval ranged from 14 to 43 t ha-1, while the cultivated cattail produced in a single cut after 200 days of cultivation between 45 and 67 t ha-1 of DM. Bermudagrass extracted up to 17.65 kg ha-1 d-1 of nitrogen, 1.76 kg ha-1 d-1 of phosphorus, 6.67 g ha-1 d-1 of copper and 54.75 g ha-1 d-1 of zinc. Cattail extracted up to 5.10 kg ha-1 d-1 of nitrogen, 1.07 kg ha-1 d-1 of phosphorus, 1.41 g ha-1 d-1 of copper and 16.04 g ha-1 d-1 of zinc. Cattail and bermudagrass were able to remove, respectively, 5.0 and 4.6% of the nitrogen and 11.2 and 5.4% of the phosphorus applied via ARS, being less efficient in extracting N and P when the initial intake of these nutrients is evaluated.