Heterogeneity of patients with intermediate (BCLC B) Hepatocellular Carcinoma: proposal for a subclassification to facilitate treatment decisions

The intermediate stage of hepatocellular carcinoma (HCC) comprises a highly heterogeneous patient population and therefore poses unique challenges for therapeutic management, different from the early and advanced stages. Patients classified as having intermediate HCC by the Barcelona Clinic Liver Cancer (BCLC) staging system present with varying tumor burden and liver function. Transarterial chemoembolization (TACE) is currently recommended as the standard of care in this setting, but there is considerable variation in the clinical benefit patients derive from this treatment.In April 2012, a panel of experts convened to discuss unresolved issues surrounding the application of current guidelines when managing patients with intermediate HCC. The meeting explored the applicability of a subclassification system for intermediate HCC patients to tailor therapeutic interventions based on the evidence available to date and expert opinion. The present report summarizes the proposal of the expert panel: four substages of intermediate HCC patients, B1 to B4.

Chinese Whiteness: The Discourse Of Race In Modern And Contemporary Chinese Culture

This thesis chronicles the development of western forms of race and racism in China. It then studies contemporary China using theories derived from whiteness studies in order to explain the unique position that whites (Caucasians) have in China today. In Chapter I, I break down the definition of race and introduce a foundation for a whiteness studies approach to research. In Chapter II, I analyze how Chinese classified themselves and other humans prior to the western system of race. In Chapter III, I chronicle the introduction of western forms of race and racism to China, and the appropriation of these concepts to suit Chinese goals. In Chapter IV, I approach cultural phenomenon in contemporary China by situating them in their historical traditions as well as by approaching them as displaying an internalized racism and white privilege. Finally in the Conclusion, I postulate on what China¿s contemporary racial system means for China.

Mother-Child Spiritual Discourse: A Mixed Methods Study

Parents and children, starting at very young ages, discuss religious and spiritual issues¿where we come from, what happens to us after we die, is there a God, and so on. Unfortunately, few studies have analyzed the content and structure of parent-child conversation about religion and spirituality (Boyatzis & Janicki, 2003; Dollahite & Thatcher, 2009), and most studies have relied on self-report with no direct observation. The current study examined mother-child (M-C) spiritual discourse to learn about its content, structure, and frequency through a survey inventory in combination with direct video observation using a novel structured task. We also analyzed how mothers¿ religiosity along several major dimensions related to their communication behaviors within both methods. Mothers (N = 39, M age = 40) of children aged 3-12 completed a survey packet on M-C spiritual discourse and standard measures of mothers¿ religious fundamentalism, intrinsic religiosity, sanctification of parenting (how much the mother saw herself as doing God¿s work as a parent), and a new measure of parental openness to children¿s spirituality. Then, in a structured task in our lab, mothers (N = 33) and children (M age = 7.33) watched a short film or read a short book that explored death in an age-appropriate manner and then engaged in a videotaped conversation about the movie or book and their religious or spiritual beliefs. Frequency of M-C spiritual discourse was positively related to mothers¿ religious fundamentalism (r = .71, p = .00), intrinsic religiosity (r = .77, p = .00), and sanctification of parenting (r = .79, p = .00), but, surprisingly, was inversely related to mothers¿ v openness to child¿s spirituality (r = -.52, p = .00). Survey data showed that the two most common topics discussed were God (once a week) and religion as it relates to moral issues (once a week). According to mothers their children¿s most common method of initiating spiritual discourse was to repeat what he or she has heard parents or family say about religious issues (M = 2.97; once a week); mothers¿ most common method was to describe their own religious/spiritual beliefs (M = 2.92). Spiritual discourse most commonly occurred either at bedtime or mealtime as reported by 26% of mothers, with the most common triggers reported as daily routine/random thoughts (once a week) and observations of nature (once a week). Mothers¿ most important goals for spiritual discourse were to let their children know that they love them (M = 3.72; very important) and to help them become a good and moral person (M = 3.67; very important). A regression model showed that significant variance in frequency of mother-child spiritual discourse (R2 = .84, p = .00) was predicted by the mothers¿ importance of goals during discourse (ß = 0.46, p = .00), frequency that the mother¿s spirituality was deepened through spiritual discourse (ß = 0.39, p = .00), and the mother¿s fundamentalism (ß = 0.20, p = .05). In a separate regression, the mother¿s comfort in the structured task (ß = 0.70, p = .00), and the number of open-ended questions she asked (ß = -0.26, p = .03) predicted the reciprocity between mother and child (R2 = .62, p = .00). In addition, the mother¿s age (ß = 0.22, p = .059) and comfort during the task (ß = 0.73, p = .00) predicted the child¿s engagement within the structured task. Other findings and theoretical and methodological implications will be discussed.

Strong Dynamical Heterogeneity and Universal Scaling in Driven Granular Fluids

Large-scale simulations of two-dimensional bidisperse granular fluids allow us to determine spatial correlations of slow particles via the four-point structure factor S-4 (q, t). Both cases, elastic (epsilon = 1) and inelastic (epsilon < 1) collisions, are studied. As the fluid approaches structural arrest, i.e., for packing fractions in the range 0.6 <= phi <= 0.805, scaling is shown to hold: S-4 (q, t)/chi(4)(t) = s(q xi(t)). Both the dynamic susceptibility chi(4)(tau(alpha)) and the dynamic correlation length xi(tau(alpha)) evaluated at the alpha relaxation time tau(alpha) can be fitted to a power law divergence at a critical packing fraction. The measured xi(tau(alpha)) widely exceeds the largest one previously observed for three-dimensional (3d) hard sphere fluids. The number of particles in a slow cluster and the correlation length are related by a robust power law, chi(4)(tau(alpha)) approximate to xi(d-p) (tau(alpha)), with an exponent d - p approximate to 1.6. This scaling is remarkably independent of epsilon, even though the strength of the dynamical heterogeneity at constant volume fraction depends strongly on epsilon.

Effect of Methodological and Ecological Approaches on Heterogeneity of Nest-Site Selection of a Long-Lived Vulture

The application of scientific-based conservation measures requires that sampling methodologies in studies modelling similar ecological aspects produce comparable results making easier their interpretation. We aimed to show how the choice of different methodological and ecological approaches can affect conclusions in nest-site selection studies along different Palearctic meta-populations of an indicator species. First, a multivariate analysis of the variables affecting nest-site selection in a breeding colony of cinereous vulture (Aegypius monachus) in central Spain was performed. Then, a meta-analysis was applied to establish how methodological and habitat-type factors determine differences and similarities in the results obtained by previous studies that have modelled the forest breeding habitat of the species. Our results revealed patterns in nesting-habitat modelling by the cinereous vulture throughout its whole range: steep and south-facing slopes, great cover of large trees and distance to human activities were generally selected. The ratio and situation of the studied plots (nests/random), the use of plots vs. polygons as sampling units and the number of years of data set determined the variability explained by the model. Moreover, a greater size of the breeding colony implied that ecological and geomorphological variables at landscape level were more influential. Additionally, human activities affected in greater proportion to colonies situated in Mediterranean forests. For the first time, a meta-analysis regarding the factors determining nest-site selection heterogeneity for a single species at broad scale was achieved. It is essential to homogenize and coordinate experimental design in modelling the selection of species' ecological requirements in order to avoid that differences in results among studies would be due to methodological heterogeneity. This would optimize best conservation and management practices for habitats and species in a global context.

The Ideology, Politics and Autonomous Art of Richard Weiner: (An Event in Discourse)"

The first aim of the project was to compile documentation on the life and work of Richard Weiner, a Czech journalist, writer and poet who spent the best part of his life as Paris correspondent for Lidove noviny. Langerova looked at the contexts and the growing independence of certain parts of his work, the distribution of thematic compositional elements into different parts of discourse and their position in the autonomous space of a work of art. Looking at the features of minority literature and the contemporary contexts of Weiner's life and work Langerova focuses on the situation of the Jewish community (Wiener came from an assimilated Jewish family). For this minorities, the function of language as a medium of communication which is able to create an autonomous world became increasingly important. Literature, which is based on this function of language, is a political matter par excellence before it begins forming as an autonomous, independent and divergent place. This means that everything private and intimate is closely connected to political and social responsibility, while supposedly objective genres contain subjective features. Another important characteristic is "nomadism", which asks the question of "Where do I belong". This was very important in Czechoslovakia after World War I , as in the issue of Zionism. Although Weiner rejected Zionism, he asks this question in his writing and it is reflected at a symbolic level in his work, which shows a fundamental thematic and compositional plan of a journey, cross-roads and wandering. These theses were reflected in Weiner's life, which was a series of continuous transfers and unplanned moves, often when he thought he had found his place. As well as tracing the course of his life, and his relations with and views of other writers, Langerova looks at his writings in various areas. Her major focus is the divergence of trivial and great events into different types of discourse in Richard Weiner's work, their transfer (small into great, trivial into mythical) and their historical context.