Extracapsular tumor spread and the risk of local, axillary and supraclavicular recurrence in node-positive, premenopausal patients with breast cancer

BACKGROUND: Extracapsular tumor spread (ECS) has been identified as a possible risk factor for breast cancer recurrence, but controversy exists regarding its role in decision making for regional radiotherapy. This study evaluates ECS as a predictor of local, axillary, and supraclavicular recurrence. PATIENTS AND METHODS: International Breast Cancer Study Group Trial VI accrued 1475 eligible pre- and perimenopausal women with node-positive breast cancer who were randomly assigned to receive three to nine courses of classical combination chemotherapy with cyclophosphamide, methotrexate, and fluorouracil. ECS status was determined retrospectively in 933 patients based on review of pathology reports. Cumulative incidence and hazard ratios (HRs) were estimated using methods for competing risks analysis. Adjustment factors included treatment group and baseline patient and tumor characteristics. The median follow-up was 14 years. RESULTS: In univariable analysis, ECS was significantly associated with supraclavicular recurrence (HR = 1.96; 95% confidence interval 1.23-3.13; P = 0.005). HRs for local and axillary recurrence were 1.38 (P = 0.06) and 1.81 (P = 0.11), respectively. Following adjustment for number of lymph node metastases and other baseline prognostic factors, ECS was not significantly associated with any of the three recurrence types studied. CONCLUSIONS: Our results indicate that the decision for additional regional radiotherapy should not be based solely on the presence of ECS.

Slope stability analysis of the Pacaya Volcano, Guatemala, using limit equilibrium and finite element method

The Pacaya volcanic complex is part of the Central American volcanic arc, which is associated with the subduction of the Cocos tectonic plate under the Caribbean plate. Located 30 km south of Guatemala City, Pacaya is situated on the southern rim of the Amatitlan Caldera. It is the largest post-caldera volcano, and has been one of Central America’s most active volcanoes over the last 500 years. Between 400 and 2000 years B.P, the Pacaya volcano had experienced a huge collapse, which resulted in the formation of horseshoe-shaped scarp that is still visible. In the recent years, several smaller collapses have been associated with the activity of the volcano (in 1961 and 2010) affecting its northwestern flanks, which are likely to be induced by the local and regional stress changes. The similar orientation of dry and volcanic fissures and the distribution of new vents would likely explain the reactivation of the pre-existing stress configuration responsible for the old-collapse. This paper presents the first stability analysis of the Pacaya volcanic flank. The inputs for the geological and geotechnical models were defined based on the stratigraphical, lithological, structural data, and material properties obtained from field survey and lab tests. According to the mechanical characteristics, three lithotechnical units were defined: Lava, Lava-Breccia and Breccia-Lava. The Hoek and Brown’s failure criterion was applied for each lithotechnical unit and the rock mass friction angle, apparent cohesion, and strength and deformation characteristics were computed in a specified stress range. Further, the stability of the volcano was evaluated by two-dimensional analysis performed by Limit Equilibrium (LEM, ROCSCIENCE) and Finite Element Method (FEM, PHASE 2 7.0). The stability analysis mainly focused on the modern Pacaya volcano built inside the collapse amphitheatre of “Old Pacaya”. The volcanic instability was assessed based on the variability of safety factor using deterministic, sensitivity, and probabilistic analysis considering the gravitational instability and the effects of external forces such as magma pressure and seismicity as potential triggering mechanisms of lateral collapse. The preliminary results from the analysis provide two insights: first, the least stable sector is on the south-western flank of the volcano; second, the lowest safety factor value suggests that the edifice is stable under gravity alone, and the external triggering mechanism can represent a likely destabilizing factor.

Relaxation in hypertrophic cardiomyopathy and hypertensive heart disease: relations between hypertrophy and diastolic function

AIM To determine the relation between the extent and distribution of left ventricular hypertrophy and the degree of disturbance of regional relaxation and global left ventricular filling. METHODS Regional wall thickness (rWT) was measured in eight myocardial regions in 17 patients with hypertrophic cardiomyopathy, 12 patients with hypertensive heart disease, and 10 age matched normal subjects, and an asymmetry index calculated. Regional relaxation was assessed in these eight regions using regional isovolumetric relaxation time (rIVRT) and early to late peak filling velocity ratio (rE/A) derived from Doppler tissue imaging. Asynchrony of rIVRT was calculated. Doppler left ventricular filling indices were assessed using the isovolumetric relaxation time, the deceleration time of early diastolic filling (E-DT), and the E/A ratio. RESULTS There was a correlation between rWT and both rIVRT and rE/A in the two types of heart disease (hypertrophic cardiomyopathy: r = 0.47, p < 0.0001 for rIVRT; r = -0.20, p < 0.05 for rE/A; hypertensive heart disease: r = 0.21, p < 0.05 for rIVRT; r = -0.30, p = 0.003 for rE/A). The degree of left ventricular asymmetry was related to prolonged E-DT (r = 0. 50, p = 0.001) and increased asynchrony (r = 0.42, p = 0.002) in all patients combined, but not within individual groups. Asynchrony itself was associated with decreased E/A (r = -0.39, p = 0.01) and protracted E-DT (r = 0.69, p < 0.0001) and isovolumetric relaxation time (r = 0.51, p = 0.001) in all patients. These correlations were still significant for E-DT in hypertrophic cardiomyopathy (r = 0.56, p = 0.02) and hypertensive heart disease (r = 0.59, p < 0.05) and for isovolumetric relaxation time in non-obstructive hypertrophic cardiomyopathy (n = 8, r = 0.87, p = 0.005). CONCLUSIONS Non-invasive ultrasonographic examination of the left ventricle shows that in both hypertrophic cardiomyopathy and hypertensive heart disease, the local extent of left ventricular hypertrophy is associated with regional left ventricular relaxation abnormalities. Asymmetrical distribution of left ventricular hypertrophy is indirectly related to global left ventricular early filling abnormalities through regional asynchrony of left ventricular relaxation.

Assessing the state of Sustainable Land Management research in Kyrgyzstan and Tajikistan

This article synthesizes findings from a review of the state of research on sustainable land management in Kyrgyzstan and Tajikistan and from an analysis of the interface between research and action. Using the Global Land Project (GLP 2005) analytical framework, we analyzed the distribution of 131 selected publications (including a clearly defined set of local and international academic and gray literature) across the framework's components and links in a social–ecological system. There is a strong emphasis in the literature on the impact of changes in land use and management on ecosystems; however, there is little research on the implications for ecosystem services. This finding is opposed to that of a similar analysis of publications at the global scale (Björnsen Gurung et al 2012). Another major gap was the lack of research on Kyrgyzstan and Tajikistan regarding the influence of global factors on social and ecological systems, despite social, economic, and political integration into global structures since the collapse of the Soviet Union and the increasing influence of climate change. Our analysis disaggregated academic literature published in the region and international academic literature, revealing stark differences. These differences are partly attributable to the legacy of the late Soviet era principle of “rational use of land resources,” which fit the planned economy but lacks approaches for decentralized resource governance. Finally, the emphasis of research on systems knowledge, the lack of transdisciplinary research, and the critical feedback of stakeholders at a regional sustainable land management forum suggest that actionable sustainable land management research on Kyrgyzstan and Tajikistan is rare. Recommendations are made for targeted, application-focused, multistakeholder research and knowledge sharing, including local and international researchers as well as practitioners, policy-makers, and land users.

Naive B-cell trafficking is shaped by local chemokine availability and LFA-1-independent stromal interactions.

It is not known how naive B cells compute divergent chemoattractant signals of the T-cell area and B-cell follicles during in vivo migration. Here, we used two-photon microscopy of peripheral lymph nodes (PLNs) to analyze the prototype G-protein-coupled receptors (GPCRs) CXCR4, CXCR5, and CCR7 during B-cell migration, as well as the integrin LFA-1 for stromal guidance. CXCR4 and CCR7 did not influence parenchymal B-cell motility and distribution, despite their role during B-cell arrest in venules. In contrast, CXCR5 played a nonredundant role in B-cell motility in follicles and in the T-cell area. B-cell migration in the T-cell area followed a random guided walk model, arguing against directed migration in vivo. LFA-1, but not α4 integrins, contributed to B-cell motility in PLNs. However, stromal network guidance was LFA-1 independent, uncoupling integrin-dependent migration from stromal attachment. Finally, we observed that despite a 20-fold reduction of chemokine expression in virus-challenged PLNs, CXCR5 remained essential for B-cell screening of antigen-presenting cells. Our data provide an overview of the contribution of prototype GPCRs and integrins during naive B-cell migration and shed light on the local chemokine availability that these cells compute.

Public management and regional development

Este trabajo tiene por objetivo analizar los elementos de la gestión pública del desarrollo regional a partir de las condiciones del desarrollo regional y las nociones de desarrollo local y desarrollo sustentable. Bajo estas premisas se avanzan planteamientos esquemáticos en torno a la gestión pública del desarrollo local

Public management and regional development

Este trabajo tiene por objetivo analizar los elementos de la gestión pública del desarrollo regional a partir de las condiciones del desarrollo regional y las nociones de desarrollo local y desarrollo sustentable. Bajo estas premisas se avanzan planteamientos esquemáticos en torno a la gestión pública del desarrollo local

Public management and regional development

Este trabajo tiene por objetivo analizar los elementos de la gestión pública del desarrollo regional a partir de las condiciones del desarrollo regional y las nociones de desarrollo local y desarrollo sustentable. Bajo estas premisas se avanzan planteamientos esquemáticos en torno a la gestión pública del desarrollo local

210Pb dates, radiocarbon ages and sedimentation and accumulation rates of sediment cores JM99-1198 and MD99-2297

The magnitude of Late Holocene climatic variations are less significant than those that took place during ice ages and deglaciations. However, detailed knowledge about this period is vital in order to understand and model future climate scenarios both as a result of natural climate variation and the effects of global warming. Oceanic heat flux is important for the sensitive climate regime of northern Europe. Our aim is to connect hydrographical changes, reflected by the dinoflagellates cyst (dinocysts) assemblages in the sediments in the Malangen fjord, to local and regional climatic phases. Previous studies have shown that dinocyst assemblages are influenced by temperature, salinity, and the availability of nutrients (e.g. de Vernal et al. 2005, doi:10.1016/j.quascirev.2004.06.014; de Vernal et al. 2001, doi:10.1002/jqs.659; Grosfjeld et al. this volume; Rochon et al. 2008, doi:10.1016/j.marmicro.2008.04.001; Solignac et al. this volume). Dinoflagellates are mostly unicellular organisms that make up one of the main groups of phytoplankton. They are able to regulate their depth within the photic zone and to concentrate along oceanic fronts, which provide nutrient-enriched waters. The dinoflagellate cysts are the hypnozygotes of dinoflagellates naturally produced during the life cycle. Their wall is composed of a highly resistant organic material, which has a high potential to fossilize. Because dinocysts species are linked to particular abiotic and biotic parameters, the dinocyst assemblages provide information about past surface water conditions. Since each fjord has its own hydrographic setting, it is necessary to establish a firm link between the dinocyst composition of the sediment surface samples and the surface water conditions. Indeed the modern dinocyst distribution in subarctic fjords is little known. Thus, in addition to detailing dinocyst results from two shallow cores, several sediment surface samples located along a transect running from the head to the mouth of the fjord, and extending onto the shelf, are also presented.

Abundance of diatoms and foraminifers in the surface sediment layer of the southeastern Laptev Sea shelf

The study of diatoms and benthic foraminifers from the southeastern shelf of the Laptev Sea shows that their most diverse and abundant recent assemblages populate the peripheral underwater part of the Lena River delta representing the marginal filter of the sea. This area is characterized by intense interaction between fresh waters of Siberian rivers and basin seawater, Atlantic one included. Local Late Holocene (~last 2300 years) environments reflect the main regional and global paleoclimatic changes, the Medieval Warm Period (~600-1100 years B.P.) and the Little Ice Age (~100-600 years B.P.) inclusive. In addition, composition and distribution of planktonic foraminifers implies strong influence of Atlantic water during the Holocene optimum ~5100-6200 years B.P.

Species richness and similarity of vascular plants in the Spanish dehesas at two spatial scales

Aims of study: The goals of this paper are to summarize and to compare plant species richness and floristic similarity at two spatial scales; mesohabitat (normal, eutrophic, and oligotrophic dehesas) and dehesa habitat; and to establish guidelines for conserving species diversity in dehesas. Area of study: We considered four dehesa sites in the western Peninsular Spain, located along a climatic and biogeographic gradient from north to south. Main results: Average alpha richness for mesohabitats was 75.6 species, and average alpha richness for dehesa sites was 146.3. Gamma richness assessed for the overall dehesa habitat was 340.0 species. The species richness figures of normal dehesa mesohabitat were significantly lesser than of the eutrophic mesohabitat and lesser than the oligotrophic mesohabitat too. No significant differences were found for species richness among dehesa sites. We have found more dissimilarity at local scale (mesohabitat) than at regional scale (habitat). Finally, the results of the similarity assessment between dehesa sites reflected both climatic and biogeographic gradients. Research highlights: An effective conservation of dehesas must take into account local and regional conditions all along their distribution range for ensuring the conservation of the main vascular plant species assemblages as well as the associated fauna

R&D, Spillovers, Innovation Systems and the Genesis of Regional Growth in Europe. Bruges European Economic Research (BEER) Papers 5/October 2006

Research on the impact of innovation on regional economic performance in Europe has fundamentally followed three approaches: a) the analysis of the link between investment in R&D, patents, and economic growth; b) the study of the existence and efficiency of regional innovation systems; and c) the examination of geographical diffusion of regional knowledge spillovers. These complementary approaches have, however, rarely been combined. Important operational and methodological barriers have thwarted any potential cross-fertilization. In this paper, we try to fill this gap in the literature by combining in one model R&D, spillovers, and innovation systems approaches. A multiple regression analysis is conducted for all regions of the EU-25, including measures of R&D investment, proxies for regional innovation systems, and knowledge and socio-economic spillovers. This approach allows us to discriminate between the influence of internal factors and external knowledge and institutional flows on regional economic growth. The empirical results highlight how the interaction between local and external research with local and external socioeconomic and institutional conditions determines the potential of every region in order to maximise its innovation capacity. They also indicate the importance of proximity for the transmission of economically productive knowledge, as spillovers show strong distance decay effects. In the EU-25 context, only the innovative efforts pursued within a 180 minute travel radius have a positive and significant impact on regional growth performance.

(Table 2) Facies and grain-size description for Mississippi Fan sediments of DSDP Leg 96

Eight lithologic facies recognized in the Mississippi Fan sediments drilled during DSDP Leg 96 are defined on the basis of lithology, sedimentary structures, composition, and texture. Of these, the calcareous biogenic sediments are of minor importance, volumetrically, as compared with the dominant resedimented terrigenous facies. Clay, mud, and silt are the most abundant sediments at all the sites drilled, with some sand and gravel in the midfan channel fill and an abundance of sand on the lower fan. Facies distribution and vertical sequences reflect the importance of sediment type and supply in controlling fan development. Sea-level changes and diapiric activity have also played an important role. Clay and sand fraction mineralogy closely mirror the dominant sediment source, namely, the Mississippi River system and adjacent continental shelf. Local and regional variation in composition on the fan mostly reflects facies differences.

Analysis of the Hydrogeological Conditions and the Effects of Development on the Hydraulic Head at Redmond Ridge East

Redmond Ridge East (RRE) is a large-scale master plan community in East King County, WA. In this report, I evaluate the spatial variability of the Quaternary Advance Outwash (Qva) at RRE and the time-series data for 16 water wells with the intent to better understand groundwater below the RRE area. I investigate changes between pre- and post-development conditions through the determination of temporal changes in annual water level, annual water level fluctuations, hydraulic head response to precipitation, and ambient drainage of the aquifer. I also perform a basic analysis of the annual aquifer recharge and a determination for the storage through the implementation of the water table fluctuation (WTF) method. Associated Earth Sciences (AESI) was tasked with monitoring the geological and environmental impacts during the development of RRE and collected the data I use in this report. AESI involvement in monitoring began in 1998 and extends to the present. Sixteen wells were identified in the RRE area with adequate temporal data to conduct the analysis. A comparison of the well logs and aquifer testing data allowed local variations in the Qva to be mapped. The WTF was used to determine a range of reasonable specific yield values for locations where the Qva was unconfined. Yearly average of the seasonal water level high and lows, and the fluctuations were quantified. Temporal relationships were established through linear regression. The average water level was found to be increasing in some locations, and the corresponding fluctuations were found to decrease. However, no clear change between pre- and post-development was observed. The response of hydraulic head to precipitation was investigated through an analysis of hydrographs for ten wells. Periods of consistent response and the corresponding precipitation during each period were delineated. A linear relationship between precipitation and water level change was determined. The threshold precipitation under which there is a positive response in the hydraulic head was established. No observable changes were apparent between pre- and post-development conditions. The ambient drainage for the Qva was calculated using recessional periods on the hydrograph. The transmissivity of Qva varies with thickness of the overlying lodgment till and thickness of the Qva, itself. Water level fluctuations observed in the Qva are consistent with regional observations. Localized areas in the Qva display the large 10 foot fluctuations and these anomalies are likely due to a combination of the local variability in the storativity as well as the concentration and channeling of water due to geographical variations in the Qva and the overlying topography. All trends seen in the RRE area remained relatively constant through time. There was no evidence showing an effect of development on the hydraulic head at RRE. This implies that the style and distribution of infiltration has not changed as a result of development, and that any measures in place are properly mitigating the effects of development on the RRE region.

Wiring the country: Local telecommunications and Australian rural communities

In rural Australia in the early twenty-first century, telecommunications reform has seen the rise of local telecommunications as a new way to wire the country, delivering new technologies and meeting community needs and aspirations. 1his paper discusses the prospects for local telecommunications in light of a research project on online rural communities commissioned by the Telstra Consumer Consultative Council. Based on interviews conducted in three small towns in rural eastern Australia, the paper examines the role of community networking as a new force in telecommunications service delivery, posing questions for local and regional communications policy development.