Cancer and fertility preservation: International recommendations from an expert meeting

In the last years, thanks to the improvement in the prognosis of cancer patients, a growing attention has been given to the fertility issues. International guidelines on fertility preservation in cancer patients recommend that physicians discuss, as early as possible, with all patients of reproductive age their risk of infertility from the disease and/or treatment and their interest in having children after cancer, and help with informed fertility preservation decisions. As recommended by the American Society of Clinical Oncology and the European Society for Medical Oncology, sperm cryopreservation and embryo/oocyte cryopreservation are standard strategies for fertility preservations in male and female patients, respectively; other strategies (e.g. pharmacological protection of the gonads and gonadal tissue cryopreservation) are considered experimental techniques. However, since then, new data have become available, and several issues in this field are still controversial and should be addressed by both patients and their treating physicians. In April 2015, physicians with expertise in the field of fertility preservation in cancer patients from several European countries were invited in Genova (Italy) to participate in a workshop on the topic of "cancer and fertility preservation". A total of ten controversial issues were discussed at the conference. Experts were asked to present an up-to-date review of the literature published on these topics and the presentation of own unpublished data was encouraged. On the basis of the data presented, as well as the expertise of the invited speakers, a total of ten recommendations were discussed and prepared with the aim to help physicians in counseling their young patients interested in fertility preservation. Although there is a great interest in this field, due to the lack of large prospective cohort studies and randomized trials on these topics, the level of evidence is not higher than 3 for most of the recommendations highlighting the need of further research efforts in many areas of this field. The participation to the ongoing registries and prospective studies is crucial to acquire more robust information in order to provide evidence-based recommendations.

Ovarian suppression using luteinizing hormonereleasing hormone agonists during chemotherapy to preserve ovarian function and fertility of breast cancer patients: A meta-analysis of randomized studies

Background: The role of temporary ovarian suppression with luteinizing hormone-releasing hormone agonists (LHRHa) in the prevention of chemotherapy-induced premature ovarian failure (POF) is still controversial. Our meta-analysis of randomized, controlled trials (RCTs) investigates whether the use of LHRHa during chemotherapy in premenopausal breast cancer patients reduces treatment-related POF rate, increases pregnancy rate, and impacts disease-free survival (DFS). Methods: A literature search using PubMed, Embase, and the Cochrane Library, and the proceedings of major conferences, was conducted up to 30 April 2015. Odds ratios (ORs) and 95% confidence intervals (CIs) for POF (i.e. POF by study definition, and POF defined as amenorrhea 1 year after chemotherapy completion) and for patients with pregnancy, as well hazard ratios (HRs) and 95% CI for DFS, were calculated for each trial. Pooled analysis was carried out using the fixed- and random-effects models. Results: A total of 12 RCTs were eligible including 1231 breast cancer patients. The use of LHRHa was associated with a significant reduced risk of POF (OR 0.36, 95% CI 0.23-0.57; P < 0.001), yet with significant heterogeneity (I2 = 47.1%, Pheterogeneity = 0.026). In eight studies reporting amenorrhea rates 1 year after chemotherapy completion, the addition of LHRHa reduced the risk of POF (OR 0.55, 95% CI 0.41-0.73, P < 0.001) without heterogeneity (I2 = 0.0%, Pheterogeneity = 0.936). In five studies reporting pregnancies, more patients treated with LHRHa achieved pregnancy (33 versus 19 women; OR 1.83, 95% CI 1.02-3.28, P = 0.041; I2 = 0.0%, Pheterogeneity = 0.629). In three studies reporting DFS, no difference was observed (HR 1.00, 95% CI 0.49-2.04, P = 0.939; I2 = 68.0%, Pheterogeneity = 0.044). Conclusion: Temporary ovarian suppression with LHRHa in young breast cancer patients is associated with a reduced risk of chemotherapy-induced POF and seems to increase the pregnancy rate, without an apparent negative consequence on prognosis.

Potential Therapeutic Targets in Triple Negative Breast Cancer

Triple negative breast cancers (TNBC) are often described as biologically aggressive tumors, with poorer survival compared to other breast cancer subtypes. The fact that TNBC lacks an obvious target like estrogen receptor and HER2 represents a major challenge in the management of these patients. Genomic analyses have revealed that TNBC comprises a diverse group of cancers, which have distinct molecular profiles and different prognosis. These studies also highlighted molecular aberrations that could serve as potential treatment targets. On the other hand, a high percentage of TNBCs express some important surface receptors that have been already exploited in the development of promising targeted therapies, which are currently tested in clinical trials. In this review, we will provide an overview on the molecular diversity of TNBC with special emphasis on the evolving role of some potential biomarkers that may be utilized in the near future.

Special Issues in the Young and Pregnant Patient with Breast Cancer

This chapter presents a series of multiple choice questions and answers on the special issues in the young and pregnant patient with breast cancer. It also presents a series of case studies with questions and answers on the special issues in the young and pregnant patient with breast cancer. The chapter examines whether the genomic testing by Oncotype DX or MammaPrint be helpful in managing the patient. It also examines the factors that are the most important in determining the risk of chemotherapyinduced amenorrhea (CIA) in the patient, and a role for sentinel lymph node biopsy (SLNB) in patients diagnosed with breast cancer during pregnancy. The chapter discusses counselling of a patient who became accidentally pregnant on maintenance therapy with trastuzumab or tamoxifen. In addition, It examines the options that could be offered to preserve fertility.

Big bang bifurcations in von Bertalanffy’s dynamics with strong and weak Allee effects

The main purpose of this work was to study population dynamic discrete models in which the growth of the population is described by generalized von Bertalanffy's functions, with an adjustment or correction factor of polynomial type. The consideration of this correction factor is made with the aim to introduce the Allee effect. To the class of generalized von Bertalanffy's functions is identified and characterized subclasses of strong and weak Allee's functions and functions with no Allee effect. This classification is founded on the concepts of strong and weak Allee's effects to population growth rates associated. A complete description of the dynamic behavior is given, where we provide necessary conditions for the occurrence of unconditional and essential extinction types. The bifurcation structures of the parameter plane are analyzed regarding the evolution of the Allee limit with the aim to understand how the transition from strong Allee effect to no Allee effect, passing through the weak Allee effect, is realized. To generalized von Bertalanffy's functions with strong and weak Allee effects is identified an Allee's effect region, to which is associated the concepts of chaotic semistability curve and Allee's bifurcation point. We verified that under some sufficient conditions, generalized von Bertalanffy's functions have a particular bifurcation structure: the big bang bifurcations of the so-called box-within-a-box type. To this family of maps, the Allee bifurcation points and the big bang bifurcation points are characterized by the symmetric of Allee's limit and by a null intrinsic growth rate. The present paper is also a significant contribution in the framework of the big bang bifurcation analysis for continuous 1D maps and unveil their relationship with the explosion birth and the extinction phenomena.

En memoria de la arquitectura : Túnel Azul (ca.1975-2007)

Este artículo hace parte de la revista Papel de colgadura de la Facultad de Derecho y Ciencias Sociales de la Universidad Icesi de Cali, es una publicación de difusión y agitación cultural. La revista nace de la pasión por la música, los libros, las ilustraciones, el graffiti, los cómics, la web, la fiesta, el cine, la cafeína y de las tardes de tertulia con empanadas y cerveza, que circula en versión impresa dos veces al año, pero su versión digital se actualiza con mayor frecuencia.

In vitro technique for selecting onion FOR white rot disease- resistance

In vitro selection is one of the most effective and efficient techniques for plant improvement. This is due to its ability to isolate plants with the desired character(s), either by applying a selection agent on the culture media to drive the selection of somaclones with the required character(s), or by establishing particular conditions that change in the genomes of somaclones toward the required character. The objective of this study was to identify a suitable protocol for in vitro selection of Allium white rot disease ( Sclerotium cepivorum ) tolerance in commercial Egyptian onion varieties, namely Giza 20, Giza 6 and Beheri Red. Oxalic acid (OA), the phytotoxin produced by Sclerotium cepivorum, was used as the selective agent. Seeds of the three Egyptian varieties were germinated on four concentrations (0.0, 0.02, 0.2, 2 and 20 mM) of Oxalic acid. Among the tested cultivars, Beheri Red had the highest germination frequency (52%) at all concentrations tested, followed by Giza 20 (42.6%), and Giza 6 at (32%). Cotyledon explants from the varieties were cultured on toxic MSBDK medium, supplemented with 0, 3, 6 and 12 mM OA. The survival of calli on MSBDK free toxic medium was 70.7% for all tested cultivars; however, MSBDK-stressed medium, with 3 mM OA reduced the viable calli to 42.1%. The highest OA concentration (12 mM) completely inhibited calli induction from cotyledons explants. A medium supplement with 3 mM OA retarded 80% of calli growth. Among 156 tested calli of Beheri Red, only 23 calli (14.7%) survived on toxic medium for 45 days. Similarly, there was 15.6% survival for Giza 20 calli, while 40.1% of the Giza 6 calli survived. Plantlets were regenerated from surviving calli and transplanted onto ex vitro, and formed bulb after acclimatisation.

Ontology-Based Workflow Design for the Coordination of Homecare Interventions

Part 20: Health and Care Networks

Cynomolgus monkeys ( Macaca fascicularis ) experimentally infected with B19V and hepatitis A virus: no evidence of the co-infection as a cause of acute liver failure

This study was conducted to analyse the course and the outcome of the liver disease in the co-infected animals in order to evaluate a possible synergic effect of human parvovirus B19 (B19V) and hepatitis A virus (HAV) co-infection. Nine adult cynomolgus monkeys were inoculated with serum obtained from a fatal case of B19V infection and/or a faecal suspension of acute HAV. The presence of specific antibodies to HAV and B19V, liver enzyme levels, viraemia, haematological changes, and necroinflammatory liver lesions were used for monitoring the infections. Seroconversion was confirmed in all infected groups. A similar pattern of B19V infection to human disease was observed, which was characterised by high and persistent viraemia in association with reticulocytopenia and mild to moderate anaemia during the period of investigation (59 days). Additionally, the intranuclear inclusion bodies were observed in pro-erythroblast cell from an infected cynomolgus and B19V Ag in hepatocytes. The erythroid hypoplasia and decrease in lymphocyte counts were more evident in the co-infected group. The present results demonstrated, for the first time, the susceptibility of cynomolgus to B19V infection, but it did not show a worsening of liver histopathology in the co-infected group.

Development and optimization of fluoxetine orally disintegrating tablets using Box-Behnken design

Purpose: To develop and optimise some variables that influence fluoxetine orally disintegrating tablets (ODTs) formulation. Methods: Fluoxetine ODTs tablets were prepared using direct compression method. Three-factor, 3- level Box-Behnken design was used to optimize and develop fluoxetine ODT formulation. The design suggested 15 formulations of different lubricant concentration (X1), lubricant mixing time (X2), and compression force (X3) and then their effect was monitored on tablet weight (Y1), thickness (Y2), hardness (Y3), % friability (Y4), and disintegration time (Y5). Results: All powder blends showed acceptable flow properties, ranging from good to excellent. The disintegration time (Y5) was affected directly by lubricant concentration (X1). Lubricant mixing time (X2) had a direct effect on tablet thickness (Y2) and hardness (Y3), while compression force (X3) had a direct impact on tablet hardness (Y3), % friability (Y4) and disintegration time (Y5). Accordingly, Box-Behnken design suggested an optimized formula of 0.86 mg (X1), 15.3 min (X2), and 10.6 KN (X3). Finally, the prediction error percentage responses of Y1, Y2, Y3, Y4, and Y5 were 0.31, 0.52, 2.13, 3.92 and 3.75 %, respectively. Formula 4 and 8 achieved 90 % of drug release within the first 5 min of dissolution test. Conclusion: Fluoxetine ODT formulation has been developed and optimized successfully using Box- Behnken design and has also been manufactured efficiently using direct compression technique.

Confrontation de l'architecture de l'Iran avec la modernité occidentale : constance de la question identitaire

À la fin du 19e siècle, l’Iran commence à se transformer radicalement. Ce changement est le résultat d’un processus de métamorphose socioculturelle, avec le désir d’effacer les méthodes du passé et de recommencer ; une ambition de faire un renouvellement fondamental dans la société, en bénéficiant des grandes idées progressistes de l'Occident moderne. Cette volonté s’est renforcée à la suite des premières visites en Europe d’étudiants et de Nassereddin Shah, le roi de l'Iran, dans les années 1870. Dans ce contexte, les Iraniens et leurs gouvernants, considérant leurs infériorités politico-économiques, ont décidé de remplacer les frustrations internationales par des idées nationalistes et une propagande de suprématie raciale ou religieuse, notamment concertant « l'identité culturelle ». Suivant ces tentatives pour réformer les infrastructures sociopolitiques de l'Iran, tous les domaines culturels du pays, incluant l’architecture, ont été modifiés, selon les idéologies des dirigeants de l’Iran pendant trois périodes historiques du pays : l'époque Qadjar (dès le règne de Nassereddin Shah en 1848), l'époque Pahlavi (1925-1979) et l'époque Post-révolution islamique (1979- jusqu'à présent). L'idée générale de notre mémoire est d'étudier le processus de modernisation de l'architecture de l'Iran, de même que les influences majeures de tous ces changements, concrétisés par des fusions éclectiques et des idées pluralistes – souvent basées sur la politique. De là, en usant des approches de l’histoire sociale et culturelle de l’art, nous analysons des exemples de monuments de l'architecture publique de l'Iran depuis l'entrée de l'Iran dans la modernité, pour chacune des trois périodes mentionnées. Cela, afin de comprendre si les architectes iraniens ont trouvé de nouvelles conceptions pour opérer un déploiement créatif des principes traditionnels et pour trouver de nouvelles orientations dans le processus général de leur évolution architecturale. Autrement dit, nous cherchons à savoir si l'architecture iranienne, avec tous les changements stylistiques dans le processus de conceptualisation, a pu trouver - depuis l'intervention de la modernité occidentale et de l'architecture moderne - son propre langage de la modernité en architecture.

Confrontation de l'architecture de l'Iran avec la modernité occidentale : constance de la question identitaire

À la fin du 19e siècle, l’Iran commence à se transformer radicalement. Ce changement est le résultat d’un processus de métamorphose socioculturelle, avec le désir d’effacer les méthodes du passé et de recommencer ; une ambition de faire un renouvellement fondamental dans la société, en bénéficiant des grandes idées progressistes de l'Occident moderne. Cette volonté s’est renforcée à la suite des premières visites en Europe d’étudiants et de Nassereddin Shah, le roi de l'Iran, dans les années 1870. Dans ce contexte, les Iraniens et leurs gouvernants, considérant leurs infériorités politico-économiques, ont décidé de remplacer les frustrations internationales par des idées nationalistes et une propagande de suprématie raciale ou religieuse, notamment concertant « l'identité culturelle ». Suivant ces tentatives pour réformer les infrastructures sociopolitiques de l'Iran, tous les domaines culturels du pays, incluant l’architecture, ont été modifiés, selon les idéologies des dirigeants de l’Iran pendant trois périodes historiques du pays : l'époque Qadjar (dès le règne de Nassereddin Shah en 1848), l'époque Pahlavi (1925-1979) et l'époque Post-révolution islamique (1979- jusqu'à présent). L'idée générale de notre mémoire est d'étudier le processus de modernisation de l'architecture de l'Iran, de même que les influences majeures de tous ces changements, concrétisés par des fusions éclectiques et des idées pluralistes – souvent basées sur la politique. De là, en usant des approches de l’histoire sociale et culturelle de l’art, nous analysons des exemples de monuments de l'architecture publique de l'Iran depuis l'entrée de l'Iran dans la modernité, pour chacune des trois périodes mentionnées. Cela, afin de comprendre si les architectes iraniens ont trouvé de nouvelles conceptions pour opérer un déploiement créatif des principes traditionnels et pour trouver de nouvelles orientations dans le processus général de leur évolution architecturale. Autrement dit, nous cherchons à savoir si l'architecture iranienne, avec tous les changements stylistiques dans le processus de conceptualisation, a pu trouver - depuis l'intervention de la modernité occidentale et de l'architecture moderne - son propre langage de la modernité en architecture.

ESL teacher profiles of ICT integration in their classroom practices and assessment activities : a portrait viewed through the lens of some Quebec teachers’ social representations

Abstract : Information and communication technologies (ICTs, henceforth) have become ubiquitous in our society. The plethora of devices competing with the computer, from iPads to the Interactive whiteboard, just to name a few, has provided teachers and students alike with the ability to communicate and access information with unprecedented accessibility and speed. It is only logical that schools reflect these changes given that their purpose is to prepare students for the future. Surprisingly enough, research indicates that ICT integration into teaching activities is still marginal. Many elementary and secondary schoolteachers are not making effective use of ICTs in their teaching activities as well as in their assessment practices. The purpose of the current study is a) to describe Quebec ESL teachers’ profiles of using ICTs in their daily teaching activities; b) to describe teachers’ ICT integration and assessment practices; and c) to describe teachers’ social representations regarding the utility and relevance of ICT use in their daily teaching activities and assessment practices. In order to attain our objectives, we based our theoretical framework, principally, on the social representations (SR, henceforth) theory and we defined most related constructs which were deemed fundamental to the current thesis. We also collected data from 28 ESL elementary and secondary school teachers working in public and private sectors. The interview guide used to that end included a range of items to elicit teachers’ SR in terms of ICT daily use in teaching activities as well as in assessment practices. In addition, we carried out our data analyses from a textual statistics perspective, a particular mode of content analysis, in order to extract the indicators underlying teachers’ representations of the teachers. The findings suggest that although almost all participants use a wide range of ICT tools in their practices, ICT implementation is seemingly not exploited to its fullest potential and, correspondingly, is likely to produce limited effects on students’ learning. Moreover, none of the interviewees claim that they use ICTs in their assessment practices and they still hold to the traditional paper-based assessment (PBA, henceforth) approach of assessing students’ learning. Teachers’ common discourse reveals a gap between the positive standpoint with regards to ICT integration, on the one hand, and the actual uses of instructional technology, on the other. These results are useful for better understanding the way ESL teachers in Quebec currently view their use of ICTs, particularly for evaluation purposes. In fact, they provide a starting place for reconsidering the implementation of ICTs in elementary and secondary schools. They may also be useful to open up avenues for the development of a future research program in this regard.

Desafíos de la movilización social para generar transformaciones en las instituciones: la movilización fallida en Egipto periodo 2010-2013

Este estudio de caso busca evaluar los alcances y limitaciones que tiene la movilización social para lograr transformaciones en las instituciones a partir del estudio de la movilización social en Egipto durante el período 2010-2013. Se analiza y se explica en qué sentido las instituciones de movimiento lento, como las estructuras de poder y estructuras mentales, han frustrado lo acontecido en Egipto conocido como la primavera árabe. Siguiendo la perspectiva de las instituciones de Gérard Roland y Alejandro Portes, se avanza hacia el resultado de la investigación de que las instituciones de movimiento lento tienen en cuenta aspectos estructurales de una sociedad tales como el poder y la cultura. Por ello, no pueden ser cambiadas con facilidad ya que cuentan con bases sólidas que han sido construidas mediante procesos históricos fundamentados en ideologías y valores.

El rol de la Unión Africana (UA) en el Cuerno de África a partir del caso de Somalia - AMISOM (2007-2013)

El propósito de esta monografía es comprender cuál ha sido el rol de la Unión Africana (UA), dentro de la misión de paz AMISOM en el periodo de 2007- 2013. Por ello, el trabajo abarca aspectos geopolíticos e históricos, que han influido en la configuración del conflicto armado de Somalía y que han llevado progresivamente a la creación, evolución e implementación de mecanismos como las misiones de paz. Además, se abarcan los planteamientos del neo-funcionalismo y el neo-regionalismo para comprender las estructuras y las dinámicas propias de la UA y así, comprender la naturaleza tanto de sus acciones, como de sus propósitos; propósitos que aclaman el fomento del panafricanismo. Desde aquí se puede entender como su rol ha contribuido con el crecimiento del mercado de la industria militar en la región, a costa de la responsabilidad de proteger. Por último, se concluye que dichas dinámicas han llevado a la creación de comunidades de inseguridad.