Whole brain radiotherapy with a conformational external beam radiation boost for lung cancer patients with 1-3 brain metastasis: a multi institutional study.

BACKGROUND: To determine the outcome of patients with brain metastasis (BM) from lung cancer treated with an external beam radiotherapy boost (RTB) after whole brain radiotherapy (WBRT). METHODS: A total of 53 BM patients with lung cancer were treated sequentially with WBRT and RTB between 1996 and 2008 according to our institutional protocol. Mean age was 58.8 years. The median KPS was 90. Median recursive partitioning analysis (RPA) and graded prognostic assessment (GPA) grouping were 2 and 2.5, respectively. Surgery was performed on 38 (71%) patients. The median number of BM was 1 (range, 1-3). Median WBRT and RTB combined dose was 39 Gy (range, 37.5-54). Median follow-up was 12.0 months. RESULTS: During the period of follow-up, 37 (70%) patients died. The median overall survival (OS) was 14.5 months. Only 13 patients failed in the brain. The majority of patients (n = 29) failed distantly. The 1-year OS, -local control, extracranial failure rates were 61.2%, 75.2% and 60.8%, respectively. On univariate analysis, improved OS was found to be significantly associated with total dose (< or = 39 Gy vs. > 39 Gy; p < 0.01), age < 65 (p < 0.01), absence of extracranial metastasis (p < 0.01), GPA > or = 2.5 (p = 0.01), KPS > or = 90 (p = 0.01), and RPA < 2 (p = 0.04). On multivariate analysis, total dose (p < 0.01) and the absence of extracranial metastasis (p = 0.03) retained statistical significance. CONCLUSIONS: The majority of lung cancer patients treated with WBRT and RTB progressed extracranially. There might be a subgroup of younger patients with good performance status and no extracranial disease who may benefit from dose escalation after WBRT to the metastatic site.

A multi-center study: intra-scan and inter-scan variability of diffusion spectrum imaging.

The objective of this study was to investigate whether it is possible to pool together diffusion spectrum imaging data from four different scanners, located at three different sites. Two of the scanners had identical configuration whereas two did not. To measure the variability, we extracted three scalar maps (ADC, FA and GFA) from the DSI and utilized a region and a tract-based analysis. Additionally, a phantom study was performed to rule out some potential factors arising from the scanner performance in case some systematic bias occurred in the subject study. This work was split into three experiments: intra-scanner reproducibility, reproducibility with twin-scanner settings and reproducibility with other configurations. Overall for the intra-scanner and twin-scanner experiments, the region-based analysis coefficient of variation (CV) was in a range of 1%-4.2% and below 3% for almost every bundle for the tract-based analysis. The uncinate fasciculus showed the worst reproducibility, especially for FA and GFA values (CV 3.7-6%). For the GFA and FA maps, an ICC value of 0.7 and above is observed in almost all the regions/tracts. Looking at the last experiment, it was found that there is a very high similarity of the outcomes from the two scanners with identical setting. However, this was not the case for the two other imagers. Given the fact that the overall variation in our study is low for the imagers with identical settings, our findings support the feasibility of cross-site pooling of DSI data from identical scanners.

Association between smoking and total energy expenditure in a multi-country study.

BACKGROUND: The association between smoking and total energy expenditure (TEE) is still controversial. We examined this association in a multi-country study where TEE was measured in a subset of participants by the doubly labeled water (DLW) method, the gold standard for this measurement. METHODS: This study includes 236 participants from five different African origin populations who underwent DLW measurements and had complete data on the main covariates of interest. Self-reported smoking status was categorized as either light (<7 cig/day) or high (≥7 cig/day). Lean body mass was assessed by deuterium dilution and physical activity (PA) by accelerometry. RESULTS: The prevalence of smoking was 55% in men and 16% in women with a median of 6.5 cigarettes/day. There was a trend toward lower BMI in smokers than non-smokers (not statistically significant). TEE was strongly correlated with fat-free mass (men: 0.70; women: 0.79) and with body weight (0.59 in both sexes). Using linear regression and adjusting for body weight, study site, age, PA, alcohol intake and occupation, TEE was larger in high smokers than in never smokers among men (difference of 298 kcal/day, p = 0.045) but not among women (162 kcal/day, p = 0.170). The association became slightly weaker in men (254 kcal/day, p = 0.058) and disappeared in women (-76 kcal/day, p = 0.380) when adjusting for fat-free mass instead of body weight. CONCLUSION: There was an association between smoking and TEE among men. However, the lack of an association among women, which may be partly related to the small number of smoking women, also suggests a role of unaccounted confounding factors.

Deep GMRT radio observations and a multi-wavelength study of the region around HESS J1858+020

Context. There are a number of very high energy sources in the Galaxy that remain unidentified. Multi-wavelength and variability studies, and catalogue searches, are powerful tools to identify the physical counterpart, given the uncertainty in the source location and extension. Aims. This work carries out a thorough multi-wavelength study of the unidentified, very high energy source HESS J1858+020 and its environs. Methods. We have performed Giant Metrewave Radio Telescope observations at 610 MHz and 1.4 GHz to obtain a deep, low-frequency radio image of the region surrounding HESS J1858+020. We analysed archival radio, infrared, and X-ray data as well. This observational information, combined with molecular data, catalogue sources, and a nearby Fermi gamma-ray detection of unidentified origin, are combined to explore possible counterparts to the very high energy source. Results. We provide with a deep radio image of a supernova remnant that might be related to the GeV and TeV emission in the region. We confirm the presence of an H ii region next to the supernova remnant and coincident with molecular emission. A potential region of star formation is also identified. We identify several radio and X-ray sources in the surroundings. Some of these sources are known planetary nebulae, whereas others may be non-thermal extended emitters and embedded young stellar objects. Three old, background Galactic pulsars also neighbour HESS J1858+020 along the line of sight. Conclusions. The region surrounding HESS J1858+020 is rich in molecular structures and non-thermal objects that may potentially be linked to this unidentified very high energy source. In particular, a supernova remnant interacting with nearby molecular clouds may be a good candidate, but a star forming region, or a non-thermal radio source of yet unclear nature, may also be behind the gamma-ray source. The neighbouring pulsars, despite being old and distant, cannot be discarded as candidates. Further observational studies are needed, however, to narrow the search for a counterpart to the HESS source.

Innovation in a Non-Formal Adult Education Organisation – Multi-Case Study in Four Adult Education Centres

More than ever, education organisations are experiencing the need to develop new services and processes to satisfy expanding and changing customer needs and to adapt to the environmental changes and continually tightening economic situation. Innovation has been found in many studies to have a crucial role in the success of an organisation, both in the private and public sectors, in formal education and in manufacturing and services alike. However, studies concerning innovation in non-formal adult education organisations, such as adult education centres (AECs) in Finland, are still lacking. This study investigates innovation in the non-formal adult education organisation context from the perspective of organisational culture types and social networks. The objective is to determine the significant characteristics of an innovative non-formal adult education organisation. The analysis is based on data from interviews with the principals and fulltime staff of four case AECs. Before the case study, a pre-study phase is accomplished in order to obtain a preliminary understanding of innovation at AECs. The research found strong support for the need of innovation in AECs. Innovation is basically needed to accomplish the AEC system’s primary mission mentioned in the ACT on Liberal Adult Education. In addition, innovation is regarded vital to institutes and may prevent their decline. It helps the institutes to be more attractive, to enter new market, to increase customer satisfaction and to be on the cutting edge. Innovation is also seen as a solution to the shortage of resources. Innovative AECs search actively for additional resources for development work through project funding and subsidies, cooperation networks and creating a conversational and joyful atmosphere in the institute. The findings also suggest that the culture type that supports innovation at AECs is multidimensional, with an emphasis on the clan and adhocratic culture types and such values as: dynamism, future orientation, acquiring new resources, mistake tolerance, openness, flexibility, customer orientation, a risk-taking attitude, and community spirit. Active and creative internal and external cooperation also promote innovation at AECs. This study also suggests that the behaviour of a principal is crucial. The way he or she shows appreciation the staff, encouragement and support to the staff and his or her approachability and concrete participation in innovation activities have a strong effect on innovation attitudes and activities in AECs.

Growing through Connections – A Multi-Case Study of Two Alternative Food Networks in Cluj-Napoca, Romania

In a context of urgent global socio-ecological challenges, the aim of this paper has been to explore the potential of localised and socially connected food systems. More specifically, through a multi-case study of two alternative food networks in the city of Cluj-Napoca, Romania, their contribution to a sustainable food paradigm has been explored. An important synergy within the networks is how good food is equated with peasant produce, but issues regarding quantity, delivery arrangement, power relations and inclusiveness constitute potential conflicts. Although challenged by unfavourable trends on national and EU levels, the networks are becoming more embedded horizontally, through an intrinsic focus on community in one case and through quality food stimulating good relations in the other case. The networks contribute to a sustainable food paradigm by promoting agroecology, by reclaiming socio-cultural factors of food provisioning and by being part of a (re)-peasantisation process. Exploring how these kinds of initiatives can emerge, be sustained and be developed is of relevance, especially considering their potential for improving the prospects of environmentally sustainable and socially just futures in Romania and beyond.

Climatic impacts of fresh water hosing under Last Glacial Maximum conditions: a multi-model study

Fresh water hosing simulations, in which a fresh water flux is imposed in the North Atlantic to force fluctuations of the Atlantic Meridional Overturning Circulation, have been routinely performed, first to study the climatic signature of different states of this circulation, then, under present or future conditions, to investigate the potential impact of a partial melting of the Greenland ice sheet. The most compelling examples of climatic changes potentially related to AMOC abrupt variations, however, are found in high resolution palaeo-records from around the globe for the last glacial period. To study those more specifically, more and more fresh water hosing experiments have been performed under glacial conditions in the recent years. Here we compare an ensemble constituted by 11 such simulations run with 6 different climate models. All simulations follow a slightly different design, but are sufficiently close in their design to be compared. They all study the impact of a fresh water hosing imposed in the extra-tropical North Atlantic. Common features in the model responses to hosing are the cooling over the North Atlantic, extending along the sub-tropical gyre in the tropical North Atlantic, the southward shift of the Atlantic ITCZ and the weakening of the African and Indian monsoons. On the other hand, the expression of the bipolar see-saw, i.e., warming in the Southern Hemisphere, differs from model to model, with some restricting it to the South Atlantic and specific regions of the southern ocean while others simulate a widespread southern ocean warming. The relationships between the features common to most models, i.e., climate changes over the north and tropical Atlantic, African and Asian monsoon regions, are further quantified. These suggest a tight correlation between the temperature and precipitation changes over the extra-tropical North Atlantic, but different pathways for the teleconnections between the AMOC/North Atlantic region and the African and Indian monsoon regions.

Fast and slow precipitation responses to individual climate forcers: a PDRMIP multi-model study

Precipitation is expected to respond differently to various drivers of anthropogenic climate change. We present the first results from the Precipitation Driver and Response Model Intercomparison Project (PDRMIP), where nine global climate models have perturbed CO2, CH4, black carbon, sulfate, and solar insolation. We divide the resulting changes to global mean and regional precipitation into fast responses that scale with changes in atmospheric absorption and slow responses scaling with surface temperature change. While the overall features are broadly similar between models, we find significant regional intermodel variability, especially over land. Black carbon stands out as a component that may cause significant model diversity in predicted precipitation change. Processes linked to atmospheric absorption are less consistently modeled than those linked to top-of-atmosphere radiative forcing. We identify a number of land regions where the model ensemble consistently predicts that fast precipitation responses to climate perturbations dominate over the slow, temperature-driven responses.

GALAXY EVOLUTION IN A COMPLEX ENVIRONMENT: A MULTI-WAVELENGTH STUDY OF HCG 7

The environment where galaxies are found heavily influences their evolution. Close groupings, like the ones in the cores of galaxy clusters or compact groups, evolve in ways far more dramatic than their isolated counterparts. We have conducted a multi-wavelength study of Hickson Compact Group 7 (HCG 7), consisting of four giant galaxies: three spirals and one lenticular. We use Hubble Space Telescope (HST) imaging to identify and characterize the young and old star cluster populations. We find young massive clusters (YMCs) mostly in the three spirals, while the lenticular features a large, unimodal population of globular clusters (GCs) but no detectable clusters with ages less than a few Gyr. The spatial and approximate age distributions of the similar to 300 YMCs and similar to 150 GCs thus hint at a regular star formation history in the group over a Hubble time. While at first glance the HST data show the galaxies as undisturbed, our deep ground-based, wide-field imaging that extends the HST coverage reveals faint signatures of stellar material in the intragroup medium (IGM). We do not, however, detect the IGM in H I or Chandra X-ray observations, signatures that would be expected to arise from major mergers. Despite this fact, we find that the H I gas content of the individual galaxies and the group as a whole are a third of the expected abundance. The appearance of quiescence is challenged by spectroscopy that reveals an intense ionization continuum in one galaxy nucleus, and post-burst characteristics in another. Our spectroscopic survey of dwarf galaxy members yields a single dwarf elliptical galaxy in an apparent stellar tidal feature. Based on all this information, we suggest an evolutionary scenario for HCG 7, whereby the galaxies convert most of their available gas into stars without the influence of major mergers and ultimately result in a dry merger. As the conditions governing compact groups are reminiscent of galaxies at intermediate redshift, we propose that HCGs are appropriate for studying galaxy evolution at z similar to 1-2.

Multi-method Study on Aquatic Humic Substances from the Rio Negro - Amazonas State/Brazil: Emphasis on Molecular-Size Classification of their Metal Contents

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)