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.

Nominal debt as a burden on monetary policy

We study the effects of nominal debt on the optimal sequential choice of monetary policy. When the stock of debt is nominal, the incentive to generate unanticipated inflation increases the cost of the outstanding debt even if no unanticipated inflation episodes occur in equilibrium. Without full commitment, the optimal sequential policy is to deplete the outstanding stock of debt progressively until these extra costs disappear. Nominal debt is therefore a burden on monetary policy, not only because it must be serviced, but also because it creates a time inconsistency problem that distorts interest rates. The introduction of alternative forms of taxation may lessen this burden, if there is enough commtiment to fiscal policy. If there is full commitment to an optimal fiscal policy, then the resulting monetary policy is the Friedman rule of zero nominal interest rates.

The role of phylogeny in the spatial distributions and assembly of mountain plant communities.

A major challenge in community ecology is a thorough understanding of the processes that govern the assembly and composition of communities in time and space. The growing threat of climate change to the vascular plant biodiversity of fragile ecosystems such as mountains has made it equally imperative to develop comprehensive methodologies to provide insights into how communities are assembled. In this perspective, the primary objective of this PhD thesis is to contribute to the theoretical and methodological development of community ecology, by proposing new solutions to better detect the ecological and evolutionary processes that govern community assembly. As phylogenetic trees provide by far, the most advanced tools to integrate the spatial, ecological and evolutionary dynamics of plant communities, they represent the cornerstone on which this work was based. In this thesis, I proposed new solutions to: (i) reveal trends in community assembly on phylogenies, depicted by the transition of signals at the nodes of the different species and lineages responsible for community assembly, (ii) contribute to evidence the importance of evolutionarily labile traits in the distribution of mountain plant species. More precisely, I demonstrated that phylogenetic and functional compositional turnover in plant communities was driven by climate and human land use gradients mostly influenced by evolutionarily labile traits, (iii) predict and spatially project the phylogenetic structure of communities using species distribution models, to identify the potential distribution of phylogenetic diversity, as well as areas of high evolutionary potential along elevation. The altitudinal setting of the Diablerets mountains (Switzerland) provided an appropriate model for this study. The elevation gradient served as a compression of large latitudinal variations similar to a collection of islands within a single area, and allowed investigations on a large number of plant communities. Overall, this thesis highlights that stochastic and deterministic environmental filtering processes mainly influence the phylogenetic structure of plant communities in mountainous areas. Negative density-dependent processes implied through patterns of phylogenetic overdispersion were only detected at the local scale, whereas environmental filtering implied through phylogenetic clustering was observed at both the regional and local scale. Finally, the integration of indices of phylogenetic community ecology with species distribution models revealed the prospects of providing novel and insightful explanations on the potential distribution of phylogenetic biodiversity in high mountain areas. These results generally demonstrate the usefulness of phylogenies in inferring assembly processes, and are worth considering in the theoretical and methodological development of tools to better understand phylogenetic community structure.

Adapting the Process Writing Approach to English Language Learners with Special Needs: Using Visuals

The available literature on the writing characteristics and best practices to teach writing to English Language Learners who also present some disability is scarce. In order to understand and provide some insight on the developments in this field, I propose an adaptation of the Process Writing Approach based on a literature review of the existing bibliography about the writing characteristics of English Language Learners, Special Needs Learners, and English Language Learners with Special Needs’ writing, the effects of the Process Writing Approach in teaching writing to these groups, and the use of visuals in writing instruction. The main assumptions of this study are: a) The Process Writing Approach provides an opportunity to differentiate instruction to ELLs with special needs and gives them additional opportunities to bring their funds of knowledge to the classroom, improving their writing, and b) By allowing students to rely on visuals in different phases of the writing process teachers will be addressing the needs of both visual and verbal learners, therefore allowing students more options to develop writing skills. The main pedagogical implication is that by dividing writing in recursive stages and inserting visuals as scaffolding throughout the entire writing process, teachers will provide an alternative approach to writing instruction that may be more effective to English Language Learners with Special Needs.

Pesca exploratoria y experimental con red de cerco artesanal en la Región Tumbes.2005

Se evaluó la utilización de la malla de 50 mm (2”) en redes de cerco artesanal de la Región Tumbes en una pesquería multiespecífica. Se trabajó con una red control de tamaño de malla de 38 mm (1,5”) y la red experimental de 50 mm (2,0”), con un porcentaje de embande de 0,65 y 0,77, respectivamente. Se determinó diferencia entre las curvas de profundidad de calado del cuerpo central de las redes (tc= 46,670, t*= 1,98, p= 0) la red experimental tuvo mayor profundidad de velado; entre las curvas de velocidad de caída del cuerpo central de las redes, hubo diferencia significativa (tc= 7,790, t*= 1,98, p = 0,000), debido al mayor lastre y filtrado de las mallas de la red experimental. El coeficiente abertura horizontal (μ1) de las mallas en la franja superior durante el máximo velado de la red y el gareteo fue en las mallas del cabecero o copo, parte central y ultimo cuerpo de la red, en promedio 0,71; 0,74 y 0,73 respectivamente; (valores cercanos al coeficiente de armado ideal para el escape de ciertos peces fusiformes). El promedio de μ1 obtenidos en la región de las mallas centrales en el cabecero, centro y ultimo cuerpo de la red fue 0,85; 0,85 y 0,84 respectivamente; lo que indicó una mayor abertura horizontal de las mallas por encima del valor del coeficiente de armado que no permitiría el escape de los peces. Se concluyó que por la condición de las mallas de la red de cerco experimental (tamaño de malla 50 mm) no es óptima para gran parte de la estructura de la red, esto no permitiría la selectividad por tamaños.

Single-trial topographic analysis of human EEG: A new image of event-related potentials

We present a novel approach for analyzing single-trial electroencephalography (EEG) data, using topographic information. The method allows for visualizing event-related potentials using all the electrodes of recordings overcoming the problem of previous approaches that required electrode selection and waveforms filtering. We apply this method to EEG data from an auditory object recognition experiment that we have previously analyzed at an ERP level. Temporally structured periods were statistically identified wherein a given topography predominated without any prior information about the temporal behavior. In addition to providing novel methods for EEG analysis, the data indicate that ERPs are reliably observable at a single-trial level when examined topographically.

Pretherapeutic gamma-glutamyltransferase is an independent prognostic factor for patients with renal cell carcinoma.

BACKGROUND: Gamma-glutamyltransferase (GGT) regulates apoptotic balance and promotes cancer progression and invasion. Higher pretherapeutic GGT serum levels have been associated with worse outcomes in various malignancies, but there are no data for renal cell carcinoma (RCC). METHODS: Pretherapeutic GGT serum levels and clinicopathological parameters were retrospectively evaluated in 921 consecutive RCC patients treated with nephrectomy at a single institution between 1998 and 2013. Gamma-glutamyltransferase was analysed as continuous and categorical variable. Associations with RCC-specific survival were assessed with Cox proportional hazards models. Discrimination was measured with the C-index. Decision-curve analysis was used to evaluate the clinical net benefit. The median postoperative follow-up was 45 months. RESULTS: Median pretherapeutic serum GGT level was 25 U l(-1). Gamma-glutamyltransferase levels increased with advancing T (P<0.001), N (P=0.006) and M stages (P<0.001), higher grades (P<0.001), and presence of tumour necrosis (P<0.001). An increase of GGT by 10 U l(-1) was associated with an increase in the risk of death from RCC by 4% (HR 1.04, P<0.001). Based on recursive partitioning-based survival tree analysis, we defined four prognostic categories of GGT: normal low (<17.5 U l(-1)), normal high (17.5 to <34.5 U l(-1)), elevated (34.5 to <181.5 U l(-1)), and highly elevated (⩾181.5 U l(-1)). In multivariable analyses that adjusted for the effect of standard features, both continuously and categorically coded GGT were independent prognostic factors. Adding GGT to a model that included standard features increased the discrimination by 0.9% to 1.8% and improved the clinical net benefit. CONCLUSIONS: Pretherapeutic serum GGT is a novel and independent prognostic factor for patients with RCC. Stratifying patients into prognostic subgroups according to GGT may be used for patient counselling, tailoring surveillance, individualised treatment planning, and clinical trial design.

Specialisation in Europe and asymmetric shocks: potential risks of EMU

Most optimistic views, based on Optimum Currency Areas (OCA) literature, have concluded that the probability of asymmetric shocks to occur at anational level will tend to diminish in the Economic and Monetary Union (EMU)as a result of the intensification of the integration process during the most recent years. Therefore, since Economic Geography Theories predict a higherspecialisation of regions, it is expected that asymmetric shocks will increase.Previous studies have examined to what extent asymmetric shocks have been relevant in the past using, mainly, static measures of asymmetries such as the correlation coefficients between series of shocks previously calculated from astructural VAR model (Bayoumi and Eichengreen, 1992).In this paper, we study the evolution of manufacturing specific asymmetries in Europe from a dynamic point of view (applying the modelproposed by Haldane and Hall, 1991) in order to obtain new evidence about potential risks of EMU.

Potencialidad de la modelización state-space y el filtro de Kalman para el anàlisis regional : una aplicación para el índice de actividad industrial

El déficit existente a nuestro país con respecto a la disponibilidad de indicadores cuantitativos con los que llevar a término un análisis coyuntural de la actividad industrial regional ha abierto un debate centrado en el estudio de cuál es la metodología más adecuada para elaborar indicadores de estas características. Dentro de este marco, en este trabajo se presentan las principales conclusiones obtenidas en anteriores estudios (Clar, et. al., 1997a, 1997b y 1998) sobre la idoneidad de extender las metodologías que actualmente se están aplicando a las regiones españolas para elaborar indicadores de la actividad industrial mediante métodos indirectos. Estas conclusiones llevan a plantear una estrategia distinta a las que actualmente se vienen aplicando. En concreto, se propone (siguiendo a Israilevich y Kuttner, 1993) un modelo de variables latentes para estimar el indicador de la producción industrial regional. Este tipo de modelo puede especificarse en términos de un modelo statespace y estimarse mediante el filtro de Kalman. Para validar la metodología propuesta se estiman unos indicadores de acuerdo con ella para tres de las cuatro regiones españolas que disponen d¿un Índice de Producción Industrial (IPI) elaborado mediante el método directo (Andalucía, Asturias y el País Vasco) y se comparan con los IPIs publicados (oficiales). Los resultados obtenidos muestran el buen comportamiento de l¿estrategia propuesta, abriendo así una línea de trabajo con la que subsanar el déficit al que se hacía referencia anteriormente

Phylogenetic relatedness and proboscis length contribute to structuring bumblebee communities in the extremes of abiotic and biotic gradients

Aim To improve our understanding of how biological communities assemble, we investigated changes in bumblebee communities in space along an elevation gradient. We assessed how much deterministic abiotic and biotic factors shape community assembly. We focused on proboscis length (influencing the species' dietary regime) and phylogenetic relatedness to investigate if competition and environmental filtering occur in more and less productive climates, respectively. Location Western Swiss Alps. Methods We recorded bumblebee species in 149 plots along a 1800-m wide elevation gradient. We contrasted two major clades of bumblebees, a short-tongued and a long-tongued clade. We calculated the phylogenetic and proboscis-length diversity of the bumblebee communities and compared these observed data with a random distribution to detect clustering likely to be caused by environmental filtering or overdispersion likely to be caused by competition. We compared the prevalence of clustered and overdispersed communities along the gradients of plant species richness (biotic) and temperature (abiotic). Results Under colder conditions, where plant species richness is lower and floral resources are scarcer, the clade with shorter proboscides prevails over the clade with longer proboscides, and communities are functionally and phylogenetic clustered. Under warmer conditions, we found phylogenetic but not functional overdispersion in communities. Main conclusions We show for the first time a strong correlation between phylogenetic relatedness, proboscis length and species distribution along temperature and plant richness gradients shaping bumblebee communities. The low temperatures and low levels of plant species richness limit the dispersal of the species from the long-tongued clade, which have more specialized diets, into high-elevation areas. Competition under warmer conditions may produce communities composed of less closely related species that share distinct ecological preferences. Our empirical results corroborate theoretical expectation as well as experiments on the prevalence of deterministic processes in the most severe and most productive parts of environmental gradients.

Cilengitide combined with standard treatment for patients with newly diagnosed glioblastoma with methylated MGMT promoter (CENTRIC EORTC 26071-22072 study): a multicentre, randomised, open-label, phase 3 trial.

BACKGROUND: Cilengitide is a selective αvβ3 and αvβ5 integrin inhibitor. Data from phase 2 trials suggest that it has antitumour activity as a single agent in recurrent glioblastoma and in combination with standard temozolomide chemoradiotherapy in newly diagnosed glioblastoma (particularly in tumours with methylated MGMT promoter). We aimed to assess cilengitide combined with temozolomide chemoradiotherapy in patients with newly diagnosed glioblastoma with methylated MGMT promoter. METHODS: In this multicentre, open-label, phase 3 study, we investigated the efficacy of cilengitide in patients from 146 study sites in 25 countries. Eligible patients (newly diagnosed, histologically proven supratentorial glioblastoma, methylated MGMT promoter, and age ≥18 years) were stratified for prognostic Radiation Therapy Oncology Group recursive partitioning analysis class and geographic region and centrally randomised in a 1:1 ratio with interactive voice response system to receive temozolomide chemoradiotherapy with cilengitide 2000 mg intravenously twice weekly (cilengitide group) or temozolomide chemoradiotherapy alone (control group). Patients and investigators were unmasked to treatment allocation. Maintenance temozolomide was given for up to six cycles, and cilengitide was given for up to 18 months or until disease progression or unacceptable toxic effects. The primary endpoint was overall survival. We analysed survival outcomes by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00689221. FINDINGS: Overall, 3471 patients were screened. Of these patients, 3060 had tumour MGMT status tested; 926 patients had a methylated MGMT promoter, and 545 were randomly assigned to the cilengitide (n=272) or control groups (n=273) between Oct 31, 2008, and May 12, 2011. Median overall survival was 26·3 months (95% CI 23·8-28·8) in the cilengitide group and 26·3 months (23·9-34·7) in the control group (hazard ratio 1·02, 95% CI 0·81-1·29, p=0·86). None of the predefined clinical subgroups showed a benefit from cilengitide. We noted no overall additional toxic effects with cilengitide treatment. The most commonly reported adverse events of grade 3 or worse in the safety population were lymphopenia (31 [12%] in the cilengitide group vs 26 [10%] in the control group), thrombocytopenia (28 [11%] vs 46 [18%]), neutropenia (19 [7%] vs 24 [9%]), leucopenia (18 [7%] vs 20 [8%]), and convulsion (14 [5%] vs 15 [6%]). INTERPRETATION: The addition of cilengitide to temozolomide chemoradiotherapy did not improve outcomes; cilengitide will not be further developed as an anticancer drug. Nevertheless, integrins remain a potential treatment target for glioblastoma. FUNDING: Merck KGaA, Darmstadt, Germany.

Discounting Arduousness

[cat] Hi ha una literatura creixent que considera desviacions del descompte exponencial estàndar. En aquest article combinem preferències temporalment inconsistents (descompte no constant) amb preferències recursives. Aquest formalisme l’apliquem a les propietats relatives a la demanda del que anomenem bens ardus. La justificació del descompte no estàndar proposat ve donada pel fet que la producció i el consum no són separables per a aquest tipus de bens. L’esforç implica que els individus descompten el consum d’aquests bens d’una manera especial, amb la presència de preferències esbiaixades i d’un ajustament recursiu dinàmic. D’aquesta manera, la voluntat de realitzar un esforç, caracteritzada per un factor de descompte, resulta endògena.

Specialisation in Europe and asymmetric shocks: potential risks of EMU

Most optimistic views, based on Optimum Currency Areas (OCA) literature, have concluded that the probability of asymmetric shocks to occur at anational level will tend to diminish in the Economic and Monetary Union (EMU)as a result of the intensification of the integration process during the most recent years. Therefore, since Economic Geography Theories predict a higherspecialisation of regions, it is expected that asymmetric shocks will increase.Previous studies have examined to what extent asymmetric shocks have been relevant in the past using, mainly, static measures of asymmetries such as the correlation coefficients between series of shocks previously calculated from astructural VAR model (Bayoumi and Eichengreen, 1992).In this paper, we study the evolution of manufacturing specific asymmetries in Europe from a dynamic point of view (applying the modelproposed by Haldane and Hall, 1991) in order to obtain new evidence about potential risks of EMU.

Ruin Theory with Excess of Loss Reinsurance and Reinstatements

The present paper studies the probability of ruin of an insurer, if excess of loss reinsurance with reinstatements is applied. In the setting of the classical Cramer-Lundberg risk model, piecewise deterministic Markov processes are used to describe the free surplus process in this more general situation. It is shown that the finite-time ruin probability is both the solution of a partial integro-differential equation and the fixed point of a contractive integral operator. We exploit the latter representation to develop and implement a recursive algorithm for numerical approximation of the ruin probability that involves high-dimensional integration. Furthermore we study the behavior of the finite-time ruin probability under various levels of initial surplus and security loadings and compare the efficiency of the numerical algorithm with the computational alternative of stochastic simulation of the risk process. (C) 2011 Elsevier Inc. All rights reserved.

Potencialidad de la modelización state-space y el filtro de Kalman para el anàlisis regional : una aplicación para el índice de actividad industrial

El déficit existente a nuestro país con respecto a la disponibilidad de indicadores cuantitativos con los que llevar a término un análisis coyuntural de la actividad industrial regional ha abierto un debate centrado en el estudio de cuál es la metodología más adecuada para elaborar indicadores de estas características. Dentro de este marco, en este trabajo se presentan las principales conclusiones obtenidas en anteriores estudios (Clar, et. al., 1997a, 1997b y 1998) sobre la idoneidad de extender las metodologías que actualmente se están aplicando a las regiones españolas para elaborar indicadores de la actividad industrial mediante métodos indirectos. Estas conclusiones llevan a plantear una estrategia distinta a las que actualmente se vienen aplicando. En concreto, se propone (siguiendo a Israilevich y Kuttner, 1993) un modelo de variables latentes para estimar el indicador de la producción industrial regional. Este tipo de modelo puede especificarse en términos de un modelo statespace y estimarse mediante el filtro de Kalman. Para validar la metodología propuesta se estiman unos indicadores de acuerdo con ella para tres de las cuatro regiones españolas que disponen d¿un Índice de Producción Industrial (IPI) elaborado mediante el método directo (Andalucía, Asturias y el País Vasco) y se comparan con los IPIs publicados (oficiales). Los resultados obtenidos muestran el buen comportamiento de l¿estrategia propuesta, abriendo así una línea de trabajo con la que subsanar el déficit al que se hacía referencia anteriormente