EGF61 polymorphism predicts complete pathologic response to cetuximab-based chemoradiation independent of KRAS status in locally advanced rectal cancer patients

BACKGROUND: Cetuximab has shown significant clinical activity in metastatic colon cancer. However, cetuximab-containing neoadjuvant chemoradiation has not been shown to improve tumor response in locally advanced rectal cancer patients in recent phase I/II trials. We evaluated functional germline polymorphisms of genes involved in epidermal growth factor receptor pathway, angiogenesis, antibody-dependent cell-mediated cytotoxicity, DNA repair, and drug metabolism, for their potential role as molecular predictors for clinical outcome in locally advanced rectal cancer patients treated with preoperative cetuximab-based chemoradiation.

METHODS: 130 patients (74 men and 56 women) with locally advanced rectal cancer (4 with stage II, 109 with stage III, and 15 with stage IV, 2 unknown) who were enrolled in phase I/II clinical trials treated with cetuximab-based chemoradiation in European cancer centers were included. Genomic DNA was extracted from formalin-fixed paraffin-embedded tumor samples and genotyping was done by using PCR-RFLP assays. Fisher's exact test was used to examine associations between polymorphisms and complete pathologic response (pCR) that was determined by a modified Dworak classification system (grade III vs. grade IV: complete response).

RESULTS: Patients with the epidermal growth factor (EGF) 61 G/G genotype had pCR of 45% (5/11), compared with 21% (11/53) in patients heterozygous, and 2% (1/54) in patients homozygous for the A/A allele (P < 0.001). In addition, this association between EGF 61 G allele and pCR remained significant (P = 0.019) in the 59 patients with wild-type KRAS.

CONCLUSION: This study suggested EGF A+61G polymorphism to be a predictive marker for pCR, independent of KRAS mutation status, to cetuximab-based neoadjuvant chemoradiation of patients with locally advanced rectal cancer.

Wounded Spaces: When Planning Degraded Cairo’s Urban Memory

This paper examines the position of planning practices operated under precise guidelines for displaying modernity. Cultivating the spatial qualities of Cairo since the 1970s has unveiled centralised ideologies and systems of governance and economic incentives. I present a discussion of the wounds that result from the inadequate upgrading ventures in Cairo, which I argue, created scars as enduring evidence of unattainable planning methods and processes that undermined its locales. In this process, the paper focuses on the consequences of eviction rather than the planning methods in one of the city’s traditional districts. Empirical work is based on interdisciplinary research, public media reports and archival maps that document actions and procedures put in place to alter the visual, urban, and demographic characteristics of Cairo’s older neighbourhoods against a backdrop of decay to shift towards a global spectacular. The paper builds a conversation about the power and fate these spaces were subject to during hostile transformations that ended with their being disused. Their existence became associated with sores on the souls of its ex-inhabitants, as outward signs of inward scars showcasing a lack of equality and social justice in a context where it was much needed.

Precarious spaces and urban change in post-conflict Belfast

The Northern Ireland conflict is shaped by an ethno-national contest between a minority Catholic/Nationalist/Republican population who broadly want to see the reunification of Ireland; and a majority Protestant/Unionist/Loyalist one, who mainly wish to maintain the sovereign connection with Britain. After nearly three decades of violence, which intensified segregation in schooling, labour markets and especially housing, a Peace Agreement was signed on Good Friday 1998. This paper is concerned with the peace process after the Agreement, not so much for the ambiguous political compromise, but for the way in which the city is constitutive of transformation and how Belfast in particular, is now embedded with a range of social instabilities and spatial contradictions. The Agreement encouraged rapid economic expansion, inward investment, especially in knowledge–intensive sectors and a short-lived optimism that markets and the neo-liberal fix would drive the post-conflict, post-industrial and post-political city. Capital would trump ethnicity and the economic uplift would bind citizens to a new expression of hope based on property speculation, tourism and global corporate investment.

Peace by Piece: (Re) imagining Division in Belfast’s Contested Spaces through Memory

This paper investigates processes and actions of diversifying memories of division in Northern Ireland’s political conflict known as the Troubles. Societal division is manifested in its built fabric and territories that have been adopted by predominant discourses of a fragmented society in Belfast; the unionist east and the nationalist west. The aim of the paper is to explore current approaches in planning contested spaces that have changed over time, leading to success in many cases. The argument is that divided cities, like Belfast, feature spatial images and memories of division that range from physical, clear-cut segregation to manifested actions of violence and have become influential representations in the community’s associative memory. While promoting notions of ‘re-imaging’ by current councils demonstrates a total erasure of the Troubles through cleansing its local collective memory, there yet remains an attempt to communicate a different tale of the city’s socio-economic past, to elaborate its supremacy for shaping future lived memories. Yet, planning Belfast’s contested areas is still suffering from a poor understanding of the context and its complexity against overambitious visions. 

“CAPACITAR O DOENTE ONCOLÓGICO COM DOENÇA AVANÇADA E/OU O CUIDADOR PARA A GESTÃO DA DOR EM DOMICÍLIO” “EMPOWER THE ONCOLOGIC PATIENT WITH ADVANCED DISEASE AT HOME AND/OR THE CAREGIVER FOR THE MANAGEMENT OF PAIN”

RESUMO ABSTRACT Comunicações orais e Posters Oral communications and posters Este formulário, após preenchido, e aceites as condições descritas no regulamento das Comunicações orais e Posters deve ser enviado para isnr@porto.ucp.pt After complete this form and accept the conditions described in the oral communications and posters regulation, please sent to isnr@porto.ucp.pt Tipo de comunicação (comunicação oral ou poster): Comunicação oral Type of communication: (oral communication or poster): Oral comunication Título (Title): “CAPACITAR O DOENTE ONCOLÓGICO COM DOENÇA AVANÇADA E/OU O CUIDADOR PARA A GESTÃO DA DOR EM DOMICÍLIO” “EMPOWER THE ONCOLOGIC PATIENT WITH ADVANCED DISEASE AT HOME AND/OR THE CAREGIVER FOR THE MANAGEMENT OF PAIN” Autoria (Authors): CORREIA, Isabel* (doutoranda em Enfermagem na Universidade de Lisboa) LOPES, Manuel (orientador do projeto) Afiliação dos autores (Authors affiliation): – Professora adjunta na Universidade de Évora, Escola Superior de Enfermagem de São João de Deus de Évora, doutoranda em enfermagem Universidade de Lisboa - – Professor Doutor em Enfermagem, Diretor da Escola Superior de Enfermagem de São João de Deus de Évora, Universidade de Évora E-mail: icorreia@uevora.pt - 964078445 mjl@uevora.pt Resumo (3000 caracteres com espaços) INTRODUÇÃO Um dos sintomas mais frequentes no doente oncológico com doença avançada é a dor. Segundo Palliative Care in European, a dor oncológica, tem uma importância especial porque o cancro é a segunda causa de morte em Portugal e por existir dor moderada a intensa em mais de 90% dos doentes em situação oncológica terminal. O desenvolvimento de um programa estruturado de intervenção de enfermagem que vá de encontro às necessidades do doente oncológico com doença avançada e/ou cuidador, relativamente à gestão da dor, poderá ter um impacto muito significativo no controlo da dor e de outros sintomas. OBJETIVOS Avaliar o efeito de um programa de Intervenção de Enfermagem na capacidade de gestão da dor por parte do doente oncológico com doença avançada e/ou o cuidador em domicílio. MATERIAIS E MÉTODOS A implementação do programa tem a duração prevista para 6 semanas. Compreende duas sessões educativas, três telefonemas e uma sessão de avaliação final. O programa foi elaborado, após uma Revisão sistemática de Literatura, com base no programa “ THE PRO-SELF”, nas Orientações Genéricas preconizadas pelo Plano Nacional de Luta Contra a dor e na Intervenção de enfermagem “Controle da Dor” da Nursing Intervention Classification (NIC). RESULTADOS O projeto encontra-se na fase de implementação e avaliação do programa educativo. No início os doentes não apresentam informação relativamente à gestão da dor, no final demonstram capacidade para a monitorização da dor e de outros sintomas e para a gestão da terapêutica, realizando os registos num diário de bordo. A literacia, a situação clínica e a disponibilidade interferem na capacidade de gestão. A proximidade da morte e a alteração do estado de consciência interferem na autonomia e na tomada de decisão. CONCLUSÃO Em fase de colheita e análise de dados. REFERÊNCIAS BIBLIOGRÁFICAS 1. FREIXO, Manuel. Metodologia Cientifica - Fundamentos, Metodos e Tecnicas. s.l. : Piaget, 2011. 2. Bulechek, Gloria M. e etal. Classificaçaõ das Intervenções de Enfermagem (NIC). Rio de Janeiro : elsevier, 2010. 3. Tsigaroppoulos, T. e etal. Problems faced by relatives caring for cancer patients at home. International Journal Of Nursing Practice. 15, 2009, Vol. 1, Nursing Pratice. 4. west, C.:Dodd,M., et al. Pain Control Program-an effective approach for cancer pain management. Oncology Nursing Forum. 1, 2003, Vol. 30, Oncology Nursing. 5. NR/rdonlyres/6861126B-C57A-46E1-B065-316C0CF8DACD/0/ControlodaDor.pdf, . (2008). . Consultado em 30 de Novembro de 2012 a partir de. Direcção-Geral da Saúde . http://www.portaldasaude.pt. [Online] 2008. [Citação: 30 de Novembro de 2012.] http://www.portaldasaude.pt/NR/rdonlyres/6861126B-C57A-46E1-B065-316COCF8DACD/0/Controlodador.pdf . Abstract (3000 characters with spaces) INTRODUCTION One of the most frequent symptoms in oncological patient with advanced disease is pain. According to Palliative Care in European, oncological pain, has a special importance because the cancer is the second most common cause of death in Portugal and there is moderate to severe pain in more than 90 % of patients in oncological terminal situation. The development of a structured program of nursing intervention that will meet the needs of the oncological patient with advanced disease and/or caregiver at home on pain management, will be able to provide for the management of pain, increasing knowledge for the control of pain while minimizing the associated symptoms that influence the quality of life of the patient and the caregiver's anxiety. PURPOSE/GOAL/AIM To evaluate the effect of an educational program of Nursing Intervention on pain management by the oncological patient with advanced disease and/or caregiver. RESEARCH/PROBLEM What is the effect of a structured program of nursing intervention directed to the patient and/or oncological patient caregiver with advanced disease at home, in the management of pain? METHODOLOGY Almost experimental study, with assessment of the management capacity of the oncological patient pain with advanced disease at home and/or informal caregiver, before and after the intervention of nursing (educational program) and transverse evaluation throughout the study. Population: oncological patients with advanced disease at home, with more than 18 years, and or family caregiver, attending an Oncology Unit – Hospital during the day. RESULTS Made an application in an Oncology service in oncological patients with advanced disease at home, it was found that at the beginning the patients did not present information regarding pain management, at the end demonstrated capacity for monitoring of pain and other symptoms and therapeutic management, performing a logbook records. CONCLUSION In the process of collection and analysis of data. KEYWORDS Educational Program; oncological patient; oncological pain.

Besov spaces and the Laplacian on fractal H-sets

Nesta tese são estudados espaços de Besov de suavidade generalizada em espaços euclidianos, numa classe de fractais designados conjuntos-h e em estruturas abstractas designadas por espaços-h. Foram obtidas caracterizações e propriedades para estes espaços de funções. Em particular, no caso de espaços de Besov em espaços euclidianos, foram obtidas caracterizações por diferenças e por decomposições em átomos não suaves, foi provada uma propriedade de homogeneidade e foram estudados multiplicadores pontuais. Para espaços de Besov em conjuntos-h foi obtida uma caracterização por decomposições em átomos não suaves e foi construído um operador extensão. Com o recurso a cartas, os resultados obtidos para estes espaços de funções em fractais foram aplicados para definir e trabalhar com espaços de Besov de suavidade generalizada em estruturas abstractas. Nesta tese foi também estudado o laplaciano fractal, considerado a actuar em espaços de Besov de suavidade generalizada em domínios que contêm um conjunto-h fractal. Foram obtidos resultados no contexto de teoria espectral para este operador e foi estudado, à custa deste operador, um problema de Dirichlet fractal no contexto de conjuntos-h.

The analysis of political will and its role in leadership: a study of portuguese mayors

This thesis analyses the concept of Political Will, suggests its operationalization and establishes a typological theory that provides the necessary support for the diverse strategies of action of a leader. It claims that political leadership styles articulate a choice of action that results from the Political Will of a leader, which is determined by his intention and his discerned possibilities to act. One main research question guided our research: How does a political leader select and change his leadership style? The most illustrative literature on political leadership is reviewed and the characteristics of democratic governance are analyzed. This is followed by an overview of the most noteworthy theories on the theme and a claim for the need of concept coherence, given the multiplicity of the existent standpoints. After that, we concentrate on leadership styles, with a focus on the local governance context. Human action and intentionality are addressed with particular attention, as well as the motivational drivers for action, in order to advance a conceptualization of Political Will through two dimensions: intention and possibility. This analysis led to a number of relevant propositions: (1) Political Will ‘exists’ when the agent has the intent and the possibility to act; (2) these two dimensions ‘translate’ simultaneously what the agent believes he must do and can do; (3) Intention and possibility reflect diverse but limited worldviews; (4) political leadership styles result from the agent’s Political Will; (5) different combinations of the expected and actual worldviews result in different leadership styles; and (6) political leadership styles can change accordingly to several strategies which allow conformity or reflect reaction to worldviews. We suggested the operationalization of the two dimensions of Political Will through the analytical tool of Grid-group Theory, which provided the identification of the heuristic devices that allowed further comprehension on the subjectivity of the agent’s choice. Four standard property spaces – representing four types of leadership styles – result from a preliminary approach to this process. Afterwards, and because these dimensions operate simultaneously, we advance on the analysis and suggest some plausible heuristical conflicts to happen and describe which consequences, strategies and type migrations are conceivable. An inclusive and more complete set of resulting property spaces renders fourteen different types of leadership styles and sixty different predictable causal paths that result from the expected migration strategies. Case-studies were conducted as plausibility probes designed to provide improvements to our theoretical claims and addressed the cases we selected for research purposes: Portuguese Mayors. The findings from five case studies are discussed and the probable impact and congruence of each with the theoretical claims are assessed. The communalities of the causal mechanisms related to the function of intention and possibility as the dimensions of Political Will and their role in explaining different leadership styles are, finally, addressed. To conclude, we advance some repercussions, mainly in the public policies field of research, and suggest a number of different and necessary paths for further work.

Volatile terpenoids and C13 norisoprenoids in wines: development of rapid methods of analysis and evaluation of the sesquiterpenoids biological potential

Vitis vinifera L., the most widely cultivated fruit crop in the world, was the starting point for the development of this PhD thesis. This subject was exploited following on two actual trends: i) the development of rapid, simple, and high sensitive methodologies with minimal sample handling; and ii) the valuation of natural products as a source of compounds with potential health benefits. The target group of compounds under study were the volatile terpenoids (mono and sesquiterpenoids) and C13 norisoprenoids, since they may present biological impact, either from the sensorial point of view, as regards to the wine aroma, or by the beneficial properties for the human health. Two novel methodologies for quantification of C13 norisoprenoids in wines were developed. The first methodology, a rapid method, was based on the headspace solid-phase microextraction combined with gas chromatography-quadrupole mass spectrometry operating at selected ion monitoring mode (HS-SPME/GC-qMS-SIM), using GC conditions that allowed obtaining a C13 norisoprenoid volatile signature. It does not require any pre-treatment of the sample, and the C13 norisoprenoid composition of the wine was evaluated based on the chromatographic profile and specific m/z fragments, without complete chromatographic separation of its components. The second methodology, used as reference method, was based on the HS-SPME/GC-qMS-SIM, allowing the GC conditions for an adequate chromatographic resolution of wine components. For quantification purposes, external calibration curves were constructed with β-ionone, with regression coefficient (r2) of 0.9968 (RSD 12.51 %) and 0.9940 (RSD of 1.08 %) for the rapid method and for the reference method, respectively. Low detection limits (1.57 and 1.10 μg L-1) were observed. These methodologies were applied to seventeen white and red table wines. Two vitispirane isomers (158-1529 L-1) and 1,1,6-trimethyl-1,2-dihydronaphthalene (TDN) (6.42-39.45 μg L-1) were quantified. The data obtained for vitispirane isomers and TDN using the two methods were highly correlated (r2 of 0.9756 and 0.9630, respectively). A rapid methodology for the establishment of the varietal volatile profile of Vitis vinifera L. cv. 'Fernão-Pires' (FP) white wines by headspace solid-phase microextraction combined with comprehensive two-dimensional gas chromatography with time-of-flight mass spectrometry (HS-SPME/GCxGC-TOFMS) was developed. Monovarietal wines from different harvests, Appellations, and producers were analysed. The study was focused on the volatiles that seem to be significant to the varietal character, such as mono and sesquiterpenic compounds, and C13 norisoprenoids. Two-dimensional chromatographic spaces containing the varietal compounds using the m/z fragments 93, 121, 161, 175 and 204 were established as follows: 1tR = 255-575 s, 2tR = 0,424-1,840 s, for monoterpenoids, 1tR = 555-685 s, 2tR = 0,528-0,856 s, for C13 norisoprenoids, and 1tR = 695-950 s, 2tR = 0,520-0,960 s, for sesquiterpenic compounds. For the three chemical groups under study, from a total of 170 compounds, 45 were determined in all wines, allowing defining the "varietal volatile profile" of FP wine. Among these compounds, 15 were detected for the first time in FP wines. This study proposes a HS-SPME/GCxGC-TOFMS based methodology combined with classification-reference sample to be used for rapid assessment of varietal volatile profile of wines. This approach is very useful to eliminate the majority of the non-terpenic and non-C13 norisoprenic compounds, allowing the definition of a two-dimensional chromatographic space containing these compounds, simplifying the data compared to the original data, and reducing the time of analysis. The presence of sesquiterpenic compounds in Vitis vinifera L. related products, to which are assigned several biological properties, prompted us to investigate the antioxidant, antiproliferative and hepatoprotective activities of some sesquiterpenic compounds. Firstly, the antiradical capacity of trans,trans-farnesol, cis-nerolidol, α-humulene and guaiazulene was evaluated using chemical (DPPH• and hydroxyl radicals) and biological (Caco-2 cells) models. Guaiazulene (IC50= 0.73 mM) was the sesquiterpene with higher scavenger capacity against DPPH•, while trans,trans-farnesol (IC50= 1.81 mM) and cis-nerolidol (IC50= 1.48 mM) were more active towards hydroxyl radicals. All compounds, with the exception of α-humulene, at non-cytotoxic levels (≤ 1 mM), were able to protect Caco-2 cells from oxidative stress induced by tert-butyl hydroperoxide. The activity of the compounds under study was also evaluated as antiproliferative agents. Guaiazulene and cis-nerolidol were able to more effectively arrest the cell cycle in the S-phase than trans,trans-farnesol and α-humulene, being the last almost inactive. The relative hepatoprotection effect of fifteen sesquiterpenic compounds, presenting different chemical structures and commonly found in plants and plant-derived foods and beverages, was assessed. Endogenous lipid peroxidation and induced lipid peroxidation with tert-butyl hydroperoxide were evaluated in liver homogenates from Wistar rats. With the exception of α-humulene, all the sesquiterpenic compounds under study (1 mM) were effective in reducing the malonaldehyde levels in both endogenous and induced lipid peroxidation up to 35% and 70%, respectively. The developed 3D-QSAR models, relating the hepatoprotection activity with molecular properties, showed good fit (R2LOO > 0.819) with good prediction power (Q2 > 0.950 and SDEP < 2%) for both models. A network of effects associated with structural and chemical features of sesquiterpenic compounds such as shape, branching, symmetry, and presence of electronegative fragments, can modulate the hepatoprotective activity observed for these compounds. In conclusion, this study allowed the development of rapid and in-depth methods for the assessment of varietal volatile compounds that might have a positive impact on sensorial and health attributes related to Vitis vinifera L. These approaches can be extended to the analysis of other related food matrices, including grapes and musts, among others. In addition, the results of in vitro assays open a perspective for the promising use of the sesquiterpenic compounds, with similar chemical structures such as those studied in the present work, as antioxidants, hepatoprotective and antiproliferative agents, which meets the current challenges related to diseases of modern civilization.

Intimate Ecologies: An exploration of the languages of contemporary exhibitions and making in museums and related cultural spaces in the UK

Intimate Ecologies considers the practice of exhibition-making over the past decade in formal museum and gallery spaces and its relationship to creating a concept of craft in contemporary Britain. Different forms of expression found in traditions of still life painting, film and moving image, poetic text and performance are examined to highlight the complex layers of language at play in exhibitions and within a concept of craft. The thesis presents arguments for understanding the value of embodied material knowledge to aesthetic experience in exhibitions, across a spectrum of human expression. These are supported by reference to exhibition case studies, critical and theoretical works from fields including social anthropology, architecture, art and design history and literary criticism and a range of individual, original works of art. Intimate Ecologies concludes that the museum exhibition, as a creative medium for understanding objects, becomes enriched by close study of material practice, and embodied knowledge that draws on a concept of craft. In turn a concept of craft is refreshed by the makers’ participation in shifting patterns of exhibition-making in cultural spaces that allow the layers of language embedded in complex objects to be experienced from different perspectives. Both art-making and the experience of objects are intimate, and infinitely varied: a vibrant ecology of exhibition-making gives space to this diversity.

Like branches in a river : viagens estrada afora e cidade adentro no cinema americano

Tese de doutoramento, Estudos de Literatura e de Cultura (Estudos Americanos), Universidade de Lisboa, Faculdade de Letras

A identidade social : trajectória de um discurso ideológico em José Saramago e Miguel Otero Silva

Tese de doutoramento, Estudos de Literatura e de Cultura (Estudos Comparatistas), Universidade de Lisboa, Faculdade de Letras, 2014

From "Spaces of Fear" to "Fearscapes": Mapping for Reframing Theories About the Spatialization of Fear in Urban Space

The article engages with theory about the processes of spatialization of fear in contemporary Western urban space (fortification, privatization, exclusion/seclusion, fragmentation, polarization) and their relation to fear of crime and violence. A threefold taxonomy is outlined (Enclosure, Post-Public Space, Barrier), and “spaces of fear” in the city of Palermo are mapped with the aim of exploring the cumulative large-scale effects of the spatialization of fear on a concrete urban territory. Building on empirical evidence, the author suggests that mainstream theories be reframed as part of a less hegemonic and more discursive approach and that theories mainly based on the analyses of global cities be deprovincialized. The author argues for the deconstruction of the concept of “spaces of fear” in favor of the more discursive concept of “fearscapes” to describe the growing landscapes of fear in contemporary Western cities.