The effect of exemestane on serum lipid profile in postmenopausal women with metastatic breast cancer: a companion study to EORTC Trial 10951, 'Randomized phase II study in first line hormonal treatment for metastatic breast cancer with exemestane or tamoxifen in postmenopausal patients'.

BACKGROUND: The impact of aromatase inhibitors (AIs) on non-cancer-related outcomes, which are known to be affected by oestrogens, has become increasingly important in postmenopausal women with hormone-dependent breast cancer. So far, data related to the effect of AIs on lipid profile in postmenopausal women is scarce. This study, as a companion substudy of an EORTC phase II trial (10951), evaluated the impact of exemestane, a steroidal aromatase inactivator, on the lipid profile of postmenopausal metastatic breast cancer (MBC) patients. PATIENTS AND METHODS: The EORTC trial 10951 randomised 122 postmenopausal breast cancer patients to exemestane (E) 25 mg (n = 62) or tamoxifen (T) 20 mg (n = 60) once daily as a first-line treatment in the metastatic setting. Exemestane showed promising results in all the primary efficacy end points of the trial (response rate, clinical benefit rate and response duration), and it was well tolerated with low incidence of serious toxicity. As a secondary end point of this phase II trial, serum triglycerides (TRG), high-density lipoprotein cholesterol (HDL), total cholesterol (TC), lipoprotein a (Lip a), and apolipoproteins (Apo) B and A1 were measured at baseline and while on therapy (at 8, 24 and 48 weeks) to assess the impact of exemestane and tamoxifen on serum lipid profiles. Of the 122 randomised patients, those who had baseline and at least one other lipid assessment are included in the present analysis. The patients who received concomitant drugs that could affect lipid profile are included only if these drugs were administered throughout the study treatment. Increase or decrease in lipid parameters within 20% of baseline were considered as non-significant and thus unchanged. RESULTS: Seventy-two patients (36 in both arms) were included in the statistical analysis. The majority of patients had abnormal TC and normal TRG, HDL, Apo A1, Apo B and Lip a levels at baseline. Neither exemestane nor tamoxifen had adverse effects on TC, HDL, Apo A1, Apo B or Lip a levels at 8, 24 and 48 weeks of treatment. Exemestane and tamoxifen had opposite effects on TRG levels: exemestane lowered while tamoxifen increased TRG levels over time. There were too few patients with normal baseline TC and abnormal TRG, HDL, Apo A1, Apo B and Lip a levels to allow for assessment of E's impact on these subsets. The atherogenic risk determined by Apo A1:Apo B and TC:HDL ratios remained unchanged throughout the treatment period in both the E and T arms. CONCLUSIONS: Overall, exemestane has no detrimental effect on cholesterol levels and the atherogenic indices, which are well-known risk factors for coronary artery disease. In addition, it has a beneficial effect on TRG levels. These data, coupled with E's excellent efficacy and tolerability, support further exploration of its potential in the metastatic, adjuvant and chemopreventive setting.

VISION OF EQUINOX FOR ORCHESTRA

The artistic play of light seen on a pyramid in some Mayan ruins located in Cancun, Mexico provided the inspiration for Vision of Equinox. On both the spring and autumn equinox days, the sunlight projected on the pyramid forms a shape which looks like a serpent moving on the stairway of the pyramid. Vision of Equinox was composed with an image of light as the model for the artistic transfiguration of sound. The light image of sound changes its shape in each stage of the piece, using the orchestra in different ways - sometimes like a chamber ensemble, sometimes like one big instrument. The image of light casting on a pyramid is expressed by descending melodic lines that can be heard several times in the piece. At the final climax of the work, a complete and embodied artistic figure is formed and stated, expressing the appearance of the Mayan god Quetzalcoatl, the serpent, in my own imagination. The light and shadow which comprise this pyramid art are treated as two contrasting elements in my composition and become the two main motives in this piece. To express these two contrasting elements, I picked the numbers "5" and "2," and used them as "key numbers" in this piece. As a result, the intervals of a fifth and a second (sometimes inverted as a seventh) are the two main intervals used in the structure. The interval of a fifth was taken into account for the construction of the pyramid, which has five points of contact. The interval of a second was selected as a contrasting sonority to the fifth. Further, the numbers "5" and "2" are used as the number of notes which form the main motives in this piece; quintuplets are used throughout this piece, and the short motive made by two sixteenth notes is used as one of the main motives in this piece. Moreover, the shape of the pyramid provided a concept of symmetry, which is expressed by the setting of a central point of the music (pitch center) as well as the use of retrograde and inversion in this piece.

Noninvasive monitoring of tissue hemoglobin using UV-VIS diffuse reflectance spectroscopy: a pilot study.

We conducted a pilot study on 10 patients undergoing general surgery to test the feasibility of diffuse reflectance spectroscopy in the visible wavelength range as a noninvasive monitoring tool for blood loss during surgery. Ratios of raw diffuse reflectance at wavelength pairs were tested as a first-pass for estimating hemoglobin concentration. Ratios can be calculated easily and rapidly with limited post-processing, and so this can be considered a near real-time monitoring device. We found the best hemoglobin correlations were when ratios at isosbestic points of oxy- and deoxyhemoglobin were used, specifically 529/500 nm. Baseline subtraction improved correlations, specifically at 520/509 nm. These results demonstrate proof-of-concept for the ability of this noninvasive device to monitor hemoglobin concentration changes due to surgical blood loss. The 529/500 nm ratio also appears to account for variations in probe pressure, as determined from measurements on two volunteers.

Design of Scheduling Algorithms Using Game Theoretic Ideas

Scheduling a set of jobs over a collection of machines to optimize a certain quality-of-service measure is one of the most important research topics in both computer science theory and practice. In this thesis, we design algorithms that optimize {\em flow-time} (or delay) of jobs for scheduling problems that arise in a wide range of applications. We consider the classical model of unrelated machine scheduling and resolve several long standing open problems; we introduce new models that capture the novel algorithmic challenges in scheduling jobs in data centers or large clusters; we study the effect of selfish behavior in distributed and decentralized environments; we design algorithms that strive to balance the energy consumption and performance.

The technically interesting aspect of our work is the surprising connections we establish between approximation and online algorithms, economics, game theory, and queuing theory. It is the interplay of ideas from these different areas that lies at the heart of most of the algorithms presented in this thesis.

The main contributions of the thesis can be placed in one of the following categories.

1. Classical Unrelated Machine Scheduling: We give the first polygorithmic approximation algorithms for minimizing the average flow-time and minimizing the maximum flow-time in the offline setting. In the online and non-clairvoyant setting, we design the first non-clairvoyant algorithm for minimizing the weighted flow-time in the resource augmentation model. Our work introduces iterated rounding technique for the offline flow-time optimization, and gives the first framework to analyze non-clairvoyant algorithms for unrelated machines.

2. Polytope Scheduling Problem: To capture the multidimensional nature of the scheduling problems that arise in practice, we introduce Polytope Scheduling Problem (\psp). The \psp problem generalizes almost all classical scheduling models, and also captures hitherto unstudied scheduling problems such as routing multi-commodity flows, routing multicast (video-on-demand) trees, and multi-dimensional resource allocation. We design several competitive algorithms for the \psp problem and its variants for the objectives of minimizing the flow-time and completion time. Our work establishes many interesting connections between scheduling and market equilibrium concepts, fairness and non-clairvoyant scheduling, and queuing theoretic notion of stability and resource augmentation analysis.

3. Energy Efficient Scheduling: We give the first non-clairvoyant algorithm for minimizing the total flow-time + energy in the online and resource augmentation model for the most general setting of unrelated machines.

4. Selfish Scheduling: We study the effect of selfish behavior in scheduling and routing problems. We define a fairness index for scheduling policies called {\em bounded stretch}, and show that for the objective of minimizing the average (weighted) completion time, policies with small stretch lead to equilibrium outcomes with small price of anarchy. Our work gives the first linear/ convex programming duality based framework to bound the price of anarchy for general equilibrium concepts such as coarse correlated equilibrium.

I wanna be a protocol: online media and electronic structures of kinship

Heidegger famously identified Modernity with a technological leveling of being to a single order of a “standing reserve.” In a radically different tone, Gilles Deleuze articulated a single “plane of immanence” within which ontological distinctions between mind and body, God and world, interiority and exteriority become indiscernible. Taking such philosophical declarations as points of departure, this panel will consider how a collapse of ontological distinction emerged as a thematic and structural trope in literary and cinematic modernisms. We hope to consider how writers and film-makers of the 20th c. utilize the resources of their media to ask “the question of being” that troubled their philosophical contemporaries and heirs. In this vein, we will examine how these modernist ontologies of immanence describe the crisis of a subject saturated and eclipsed by a world which comprises her while also remaining strange or opaque. Papers will ask what is lost with the departure of a distinctly human sense of “being” and how the historical arrival of an alternative ontological order may be evident in the lived experience of modernity. In this sense, the relationship to departures and arrivals becomes the modern subject’s suspicion that he is unable to do either vis á vis the world.

Interprofessional attitudes amongst undergraduate students in the health professions: a longitudinal questionnaire survey

Background: Interprofessional education (IPE) introduced at the beginning of pre-registration training for healthcare professionals attempts to prevent the formation of negative interprofessional attitudes which may hamper future interprofessional collaboration. However, the potential for IPE depends, to some extent, on the readiness of healthcare students to learn together. Objectives: To measure changes in readiness for interprofessional learning, professional identification, and amount of contact between students of different professional groups; and to examine the influence of professional group, student characteristics and an IPE course on these scores over time. Design: Annual longitudinal panel questionnaire survey at four time-points of pre-registration students (n = 1683) drawn from eight healthcare groups from three higher education institutions (HEIs) in the UK. Results: The strength of professional identity in all professional groups was high on entry to university but it declined significantly over time for some disciplines. Similarly students’ readiness for interprofessional learning was high at entry but declined significantly over time for all groups, with the exception of nursing students. A small but significant positive relationship between professional identity and readiness for interprofessional learning was maintained over time. There was very minimal contact between students from different disciplines during their professional education programme. Students who reported gaining the least from an IPE course suffered the most dramatic drop in their readiness for interprofessional learning in the following and subsequent years; however, these students also had the lowest expectations of an IPE course on entry to their programme of study. Conclusion: The findings provide support for introducing IPE at the start of the healthcare students’ professional education to capitalise on students’ readiness for interprofessional learning and professional identities, which appear to be well formed from the start. However, this study suggests that students who enter with negative attitudes towards interprofessional learning may gain the least from IPE courses and that an unrewarding experience of such courses may further reinforce their negative attitudes.

ReaderBench: Automated evaluation of collaboration based on cohesion and dialogism

Dascalu, M., Trausan-Matu, S., McNamara, D.S., & Dessus, P. (2015). ReaderBench – Automated Evaluation of Collaboration based on Cohesion and Dialogism. International Journal of Computer-Supported Collaborative Learning, 10(4), 395–423. doi: 10.1007/s11412-015-9226-y

The potential use of mapped extent and distribution of habitats as indicators of Good Environmental Status (GES)

The Healthy and Biologically Diverse Seas Evidence Group (HBDSEG) has been tasked with providing the technical advice for the implementation of the Marine Strategy Framework Directive (MSFD) with respect to descriptors linked to biodiversity. A workshop was held in London to address one of the Research and Development (R&D) proposals entitled: ‘Mapping the extent and distribution of habitats using acoustic and remote techniques, relevant to indicators for area/extent/habitat loss.’ The aim of the workshop was to identify, define and assess the feasibility of potential indicators of benthic habitat distribution and extent, and identify the R&D work which could be required to fully develop these indicators. The main points that came out of the workshop were: (i) There are many technical aspects of marine habitat mapping that still need to be resolved if cost-effective spatial indicators are to be developed. Many of the technical aspects that need addressing surround issues of consistency, confidence and repeatability. These areas should be tackled by the JNCC Habitat Mapping and Classification Working Group and the HBDSEG Seabed Mapping Working Group. (ii) There is a need for benthic ecologists (through the HBDSEG Benthic Habitats Subgroup and the JNCC Marine Indicators Group) to finalise the list of habitats for which extent and/or distribution indicators should be considered for development, building upon the recommendations from this report. When reviewing the list of indicators, benthic habitats could also be distinguished into those habitats that are defined/determined primarily by physical parameters (although including biological assemblages) (e.g. subtidal shallow sand) and those defined primarily by their biological assemblage (e.g. seagrass beds). This distinction is important as some anthropogenic pressures may influence the biological component of the ecosystem despite not having a quantifiable effect on the physical habitat distribution/extent. (iii) The scale and variety of UK benthic habitats makes any attempt to undertake comprehensive direct mapping exercises prohibitively expensive (especially where there is a need for repeat surveys for assessment). There is a clear need therefore to develop a risk-based approach that uses indirect indicators (e.g. modelling), such as habitats at risk from pressures caused by current human activities, to develop priorities for information gathering. The next steps that came out of the workshop were: (i) A combined approach should be developed by the JNCC Marine Indicators Group together with the HBDSEG Benthic Habitats Subgroup, which will compile and ultimately synthesise all the criteria used by the three different groups from the workshop. The agreed combined approach will be used to undertake a final review of the habitats considered during the workshop, and to evaluate any remaining habitats in order to produce a list of habitats for indicator development for which extent and/or distribution indicators could be appropriate. (ii) The points of advice raised at this workshop, alongside the combined approach aforementioned, and the final list of habitats for extent and/or distribution indicator development will be used to develop a prioritised list of actions to inform the next round of R&D proposals for benthic habitat indicator development in 2014. This will be done through technical discussions within JNCC and the relevant HBDSEG Subgroups. The preparation of recommendations by these groups should take into account existing work programmes, and consider the limited resources available to undertake any further R&D work.

Kit-positive interstitial cells in the rabbit urethra: structural relationships with nerves and smooth muscle.

OBJECTIVE: To identify interstitial cells (ICs) in the wall of the rabbit urethra using antibodies to the Kit receptor, and to examine their location, morphology and relationship with nerves and smooth muscle cells (SMCs), as studies of enzymatically isolated cells from the rabbit urethra have established that there are specialized cells that show spontaneous electrical activity and have morphological properties of ICs. MATERIALS AND METHODS: Urethral tissues from rabbits were fixed, labelled with antibodies and examined with confocal microscopy. Some specimens were embedded in paraffin wax and processed for histology. Histological sections from the most proximal third and mid-third region of rabbit urethra were stained with Masson's Trichrome to show their cellular arrangement. RESULTS: Sections from both regions had outer longitudinal and inner circular layers of SM, and a lamina propria containing connective tissue and blood vessels; the lumen was lined with urothelial cells. The mid-third region had a more developed circular SM layer than the most-proximal samples, and had extensive inner longitudinal SM bundles in the lamina propria. Labelling with anti-Kit revealed immunopositive cells within the wall of the rabbit urethra, in the circular and longitudinal layers of the muscularis. Double-labelling with an antibody to SM myosin showed Kit-positive cells on the boundary of the SM bundles, orientated parallel to the axis of the bundles. Others were in spaces between the bundles and often made contact with each other. Kit-positive cells were either elongated, with several lateral branches, or stellate with branches coming from a central soma. Similar cells could be labelled with vimentin antibodies. Their relationship with intramural nerves was examined by double immunostaining with an anti-neurofilament antibody. There were frequent points of contact between Kit-positive cells and nerves, with similar findings in specimens double-immunostained with anti-neuronal nitric oxide synthase (nNOS). CONCLUSION: Kit-positive ICs were found within the SM layers of the rabbit urethra, in association with nerves, on the edge of SM bundles and in the interbundle spaces. The contact with nNOS-containing neurones might imply participation in the nitrergic inhibitory neurotransmission of the urethra. PMID: 17212607 [PubMed - indexed for MEDLINE]

Zipf and Type-Token rules for the English, Spanish, Irish and Latin languages

The Zipf curves of log of frequency against log of rank for a large English corpus of 500 million word tokens, 689,000 word types and for a large Spanish corpus of 16 million word tokens, 139,000 word types are shown to have the usual slope close to –1 for rank less than 5,000, but then for a higher rank they turn to give a slope close to –2. This is apparently mainly due to foreign words and place names. Other Zipf curves for highlyinflected Indo-European languages, Irish and ancient Latin, are also given. Because of the larger number of word types per lemma, they remain flatter than the English curve maintaining a slope of –1 until turning points of about ranks 30,000 for Irish and 10,000 for Latin. A formula which calculates the number of tokens given the number of types is derived in terms of the rank at the turning point, 5,000 for both English and Spanish, 30,000 for Irish and 10,000 for Latin.

Concentration and purification of entanglement for qubit systems with ancillary cavity fields

We propose schemes for entanglement concentration and purification for qubit systems encoded in flying atomic pairs. We use cavity-quantum electrodynamics as an illustrative setting within which our proposals can be implemented. Maximally entangled pure states of qubits can be produced as a result of our protocols. In particular, the concentration protocol yields Bell states with the largest achievable theoretical probability while the purification scheme produces arbitrarily pure Bell states. The requirements for the implementation of these protocols are modest, within the state of the art, and we address all necessary steps in two specific setups based on experimentally mature microwave technology.

The discursive capacity of graphic design

The relationship between rhetoric and graphic design is presented in this article. The comparison between a classical orator and a graphic designer, between a discourse and a piece of design comes from the connections between with the communication and creativity. We will see how an application of the fundamentals of rhetoric can open new doors to the professional practice, the education of graphic design and the same theory of the rhetoric of the image.By the analysis of a design is exemplified the points of union that show how the arguments, operations, figures of discourse and rhetorical phases are present in the creative process of graphic design and how designers, perhaps unconsciously, use techniques that were traditional. In other words, graphic design is a rhetorical construction.There is then a transposition of a discourse model created by linguistic signs to a discourse model consists of visual and typographic signs, causing design is seen as a discursivediscipline that goes beyond the aesthetic component.

'Last Vegas?'

This article, and the research out of which it springs, has a number of points of origin; it may also have more than one point of conclusion even as it argues that the current manifestation of Las Vegas could well be read as its last. This is not to say that Las Vegas will cease to create its new versions of itself; after all, this is one of the main sustaining factors of Las Vegas’ success in the last two decades as a new Strip on Las Vegas Boulevard has arisen from the demolitions and redesigns of the original Las Vegas Strip of the 1950s and 1960s. What is argued for here is a reading of Vegas as a terminal point within American culture and particularly within its visual realms. Las Vegas’ place within the dynamics of American visual and exhibition culture comes as the latest in a sequence which, since the nineteenth century, has included among its manifestations World’s Fairs, side shows, freak shows and travelling carnivals. America’s experiments in the visual domain have been updated in both the twentieth- and twenty-first centuries in a variety of spectacular forms and entertainment zones (Disneyland, EPCOT, the new Las Vegas). Vegas is the ultimate incarnation of a carnivalised display culture, the city’s casino Strip reclothed primarily as a theme park for digital camera-toting tourists than as a resort for dedicated gamblers. The possibility that the current incarnation of Las Vegas of late 2009 and 2010 will be the last Vegas hovers as a spectral remnant of the economic downturn and financial collapse of 2008, marked by the unfinished skeletons of projected new casino hotels on Las Vegas Boulevard and by a sudden reversal of fortune for the nation’s favourite gaming location.

"Thought-Tormented Music": Joyce and the Music of the Irish Revival

"In this special issue's opening essay, Martin Dowling devotes almost half of "'Thought-Tormented Music': Joyce and the Music of the Irish Revival" to what he calls "the situation of music in the Irish literary revival." He focuses chiefly on 1904, which was both an intensely productive period for the revival movement and a year chock-full of crucial events and decisions for Joyce. Drawing on the works of Pierre Bourdieu and Jaques Lacan, Dowling explores the revivalists' efforts to "de-anglicize" Irish music, to remove foreign influences that distorted the "pure tradition of Irish song," and to achieve an improbable harmony between the music favoured by the disappearing Anglo-Irish aristocracy and the Irish-speaking peasantry. Inevitably, disputes occurred over what constituted "authentic" Irish music. Factions quarrelled over whether pristine Irish music existed in the Atlantic seaboard or more inland; whether "authentic" songs were sung with or without instrumental accompaniment; and whether the piano, rather than the traditional harp, was a legitimate instrument of accompaniment. Having delineated the historical and theoretical context, Dowling offers a richly detailed analysis of Joyce's story "A Mother." He reveals how almost every element in the story--from the Eire Abu Society to the Antient Concert Rooms, from the conflict between Mrs. Kearney and Hoppy Holohan to the plight of Kathleen Kearney--is charged with meaning by the subtextual conflicts of the revivalists' agenda. Dowling explains also the "authenticity" in Joyce's depiction of vocal performances of "The Lass of Aughrim" in "The Dead" and "The Croppy Boy" in "Sirens," which he calls two "true gems" of authentic Irish music." --Introduction by Charles Rossman and Alan W. Friedman, Guest Editors, pp. 409-410

Discourse and Text

This article discusses tense and aspect in the context of attested forms of discourse and text. The emphasis is on the semantic, pragmatic, textual, and stylistic functions of tense in context, taking into account linguistic features in the surrounding discourse, as well as the importance of factors such as medium (spoken or written), register (degree of formality), text type (literary vs. journalistic vs. conversational etc.), and discourse mode (narrative vs. report vs. description, etc.). Thus, tense and aspect are analyzed not purely as part of a linguistic “system” as such, but in the context of particular texts or forms of discourse. The article also explores the concept of “markedness” through two case studies: the narrative present and the narrative imperfect. Finally, it assesses the roles played by tenses in conveying particular points of view in texts, including shifts and/or ambiguities in point of view; Segmented Discourse Representation Theory; internal focalization and the French imperfective past tense; and textual polyphony.