Indications for penetrating keratoplasty and associated procedures, 1989-1995

Purpose. To identify changing trends in indications for penetrating keratoplasty and associated surgical procedures. Methods. Review of charts from all patients who underwent penetrating keratoplasty at Wills Eye Hospital from January 1, 1989 through December 31, 1995. Results. A total of 2,442 corneal transplants were performed in 2,186 patients. The leading indication for penetrating keratoplasty was pseudophakic corneal edema, accounting for 634 cases (26.0%); 54.7% of them were associated with anterior chamber intraocular lenses, 36.4% with posterior chamber intraocular lenses, and 3.1% with iris-fixated intraocular lenses. Regraft (17.8%), Fuchs' dystrophy (15.7%), and keratoconus (13.2%) followed pseudophakic corneal edema in frequency. Cataract extraction, with or without intraocular lens implantation, was combined with penetrating keratoplasty in 439 cases of 1,264 phakic eyes (34.7%). Intraocular lens exchange was performed in 285 of the 634 cases of pseudophakic cornea edema (44.9%). Conclusion. Pseudophakic corneal edema was the leading indication for penetrating keratoplasty, with an increasing number of cases associated with posterior chamber intraocular lenses during the study period (p = 0.001). The number of regrafts steadily increased between 1989 and 1995 (p = 0.001), being the second most common indication for corneal transplantation since 1992.

Dose-response relationship in phase 1 clinical trials: a European Drug Development Network (EDDN) Collaboration Study

Introduction: Because a dose–response relationship is characteristic of conventional chemotherapy, this concept is widely used for the development of novel cytotoxic (CTX) drugs. However, the need to reach the MTD to obtain optimal benefit with molecularly targeted agents (MTA) is controversial. In this study, we evaluated the relationship between dose and efficacy in a large cohort of phase I patients with solid tumors.

Experimental Design: We collected data on 1,182 consecutive patients treated in phase I trials in 14 European institutions in 2005–2007. Inclusion criteria were: (i) patients treated within completed single-agent studies in which a maximum-administered dose was defined and (ii) RECIST/survival data available.

Results: Seventy-two percent of patients were included in trials with MTA (N = 854) and 28% in trials with CTX (N = 328). The objective response (OR) rate was 3% and disease control at 6 months was 11%. OR for CTX was associated with higher doses (median 92% of MTD); this was not the case for MTA, where patients achieving OR received a median of 50% of MTD. For trials with MTA, patients treated at intermediate doses (40%–80%) had better survival compared with those receiving low or high doses (P = 0.038). On the contrary, there was a direct association between higher dose and better OS for CTX agents (P = 0.003).

Conclusion: Although these results support the development of novel CTX based on MTD, we found no direct relationship between higher doses and response with MTA in unselected patients. However, the longest OS was seen in patients treated with MTA at intermediate doses (40%–80% of MTD)

Ultrastructure of head organs (anterior adhesive apparatus) and posterior secretory systems of Caballeria liewi Lim, 1995 (Monogenea, Ancyrocephalidae)

Caballeria liewi Lim, 1995, uses adhesive secretions from the head organs and posterior secretory systems to assist in locomotion and attachment. Ultrastructural investigations show that the head organs of C. liewi consist of three pairs of antero-lateral pit-like openings bearing microvilli and ducts leading from two types of uninucleated gland cells (located lateral to the pharynx), one type producing rod-like (S1) bodies with an electron-dense matrix containing less electron-dense vesicles and the second type producing oval (S2) bodies with a homogeneous electron-dense matrix. Interlinking band-like structures are observed between S1 bodies and between S2 bodies. S1 body is synthesised in the granular endoplasmic reticulum, transported to a Golgi complex to be packaged into vesicles and routed into ducts for exudation. The synthesis of the S2 body is unresolved. Haptoral secretions manifested externally as net-like structures are derived from dual electron-dense (DED) secretory body produced in the peduncular gland cells. The DED body consists of a less electron-dense oval core in a homogeneous electron-dense matrix. On exocytosis into the pyriform haptoral reservoir, DED bodies are transformed into a secretion with two types of inclusions (less electron-dense oval and electron-dense spherical inclusions) in an electron-dense matrix. The secretions are further transformed (as small, oval, electron-dense bodies) when transported to the superficial anchor grooves, and on exudation into the gill tissues, the secretions become an electron-dense matrix. Secretory bodies associated with uniciliated structures, anchor sleeves and marginal hooks are also observed.

Global surveillance of cancer survival 1995–2009: analysis of individual data for 25 676 887 patients from 279 population-based registries in 67 countries (CONCORD-2)

BACKGROUND: Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control.

METHODS: Individual tumour records were submitted by 279 population-based cancer registries in 67 countries for 25·7 million adults (age 15-99 years) and 75,000 children (age 0-14 years) diagnosed with cancer during 1995-2009 and followed up to Dec 31, 2009, or later. We looked at cancers of the stomach, colon, rectum, liver, lung, breast (women), cervix, ovary, and prostate in adults, and adult and childhood leukaemia. Standardised quality control procedures were applied; errors were corrected by the registry concerned. We estimated 5-year net survival, adjusted for background mortality in every country or region by age (single year), sex, and calendar year, and by race or ethnic origin in some countries. Estimates were age-standardised with the International Cancer Survival Standard weights.

FINDINGS: 5-year survival from colon, rectal, and breast cancers has increased steadily in most developed countries. For patients diagnosed during 2005-09, survival for colon and rectal cancer reached 60% or more in 22 countries around the world; for breast cancer, 5-year survival rose to 85% or higher in 17 countries worldwide. Liver and lung cancer remain lethal in all nations: for both cancers, 5-year survival is below 20% everywhere in Europe, in the range 15-19% in North America, and as low as 7-9% in Mongolia and Thailand. Striking rises in 5-year survival from prostate cancer have occurred in many countries: survival rose by 10-20% between 1995-99 and 2005-09 in 22 countries in South America, Asia, and Europe, but survival still varies widely around the world, from less than 60% in Bulgaria and Thailand to 95% or more in Brazil, Puerto Rico, and the USA. For cervical cancer, national estimates of 5-year survival range from less than 50% to more than 70%; regional variations are much wider, and improvements between 1995-99 and 2005-09 have generally been slight. For women diagnosed with ovarian cancer in 2005-09, 5-year survival was 40% or higher only in Ecuador, the USA, and 17 countries in Asia and Europe. 5-year survival for stomach cancer in 2005-09 was high (54-58%) in Japan and South Korea, compared with less than 40% in other countries. By contrast, 5-year survival from adult leukaemia in Japan and South Korea (18-23%) is lower than in most other countries. 5-year survival from childhood acute lymphoblastic leukaemia is less than 60% in several countries, but as high as 90% in Canada and four European countries, which suggests major deficiencies in the management of a largely curable disease.

INTERPRETATION: International comparison of survival trends reveals very wide differences that are likely to be attributable to differences in access to early diagnosis and optimum treatment. Continuous worldwide surveillance of cancer survival should become an indispensable source of information for cancer patients and researchers and a stimulus for politicians to improve health policy and health-care systems.

Evangélicos en América Latina

Considerada tradicionalmente "el continente católico" por excelencia, Latinoamérica siempre ha contado con una presencia minoritaria protestante, y en los últimos treinta años, a pesar de llegar a concentrar en su territorio a la mitad de los católicos del mundo, ha visto una acelerada diversificación del universo religioso, con una proliferación impresionante de denominaciones y grupos, cuya mayorÍa se declara "evangélica". Este proceso, con frecuencia descrito con expresión simplista "invasión de las sectas", se muestra complejo en sus características y articulado en su composición. Frente a tal crecimiento numérico, que en el año 2000 deberÍa involucrar al 20% de la población del continente, la Iglesia Católica parece oscilar entre la crÍtica al papel "alienante" de estos movimientos y la adopción de sus formas culturales celebrativas y espiritualizantes. Además, desde la mitad de los años 80, luego -y acaso como consecuencia- de tal expansión, los evangélicos empezaron a afirmar una inédita presencia polÍtica, culminada en l991 con la obtención en Guatemala del máximo cargo del Estado por parte de Jorge Serrano, primer presidente evangélico elegido en Latinoamérica. Contando con un sólido arraigo popular, los partidos y políticos evangélicos ya están difundidos en todos los paÍses, con un papel que alterna el conservadorismo milenarista, el corporativismo confesional y la concientización liberadora. Con este número especial, SIAL pretende principalmente ofrecer algunos materiales para un mejor conocimiento de este dinámico y complejo fenómeno religioso y social.

Teoria da mente, linguagem e competências sociais em crianças ao nível pré-escolar

A compreensão dos estados mentais dos outros – Teoria da Mente (TM) – é um processo crucial no desenvolvimento cognitivo e social. A relação entre a Teoria da Mente e a Linguagem tem sido alvo de vários estudos ao longo das últimas décadas (Happé, 1995; de Villiers & Villiers, 2000; Astington, 2001; Ruffman et al., 2002; Lohmann & Tomasello, 2003; Astington & Baird, 2005; Astington & Pelletier, 2005; Farrar et al, 2009). Neste estudo avaliaram-se 229 crianças entre os 3 e os 7 anos que frequentavam jardim-de-infância. Destas 229 crianças, foram constituídos dois grupos, um constituído por crianças com desenvolvimento típico (GN) e outra por crianças com Perturbações da Fala/ Linguagem (GPFL), sendo que neste último foi ainda criado um sub-grupo de crianças com Perturbações Desenvolvimentais da Linguagem (SGPDL). Foi aplicado um teste de avaliação da TM, constituído por três sub-testes (Compreensão de falsas crenças de primeira ordem, crenças e desejos e acesso ao conhecimento) e um teste de avaliação de linguagem (T.A.L.C.) Foi também pedido aos cuidadores o preenchimento de um Questionário de Avaliação das Competências Sociais (Rydell et al., 1997). Verificou-se a existência de uma associação positiva e significativa entre a idade e a TM. Por outro lado, observou-se a presença de uma associação negativa e significativa entre a idade de início de fala e a TM. De uma forma geral, verifica-se que a TM está associada de forma positiva e estatisticamente significativa com os scores da linguagem, sendo esta relação mais forte relativamente aos aspectos relativos às Intenções comunicativas e score total de Expressão e Compreensão da linguagem. Vimos também que as crianças do SGPDL apresentaram scores inferiores ao nível da TM relativamente ao GN. Encontramos diferenças estatisticamente significativas em relação ao tempo de duração da prova de TM entre o GN e o GPFL, tendo estes últimos necessitado de maior tempo de resposta. Relativamente à associação existente entre competências sociais e TM, verificamos que não se encontrou a existência de correlações estatisticamente significativas, excepto para o factor “Altruísmo”. Pensa-se que este aspecto estará relacionado com o facto das competências de TM avaliadas neste estudo não se encontrarem associadas às questões emocionais, as quais constituem um sub-tipo de TM do tipo afectivo, mas antes do sub-tipo cognitivo. Os indivíduos GN apresentaram valores para a “Orientação Pró-Social”, “Iniciação Social” e score Total das Competências Sociais significativamente superiores às crianças do GPFL.

Curso: Representaciones de la metrópolis en la literatura y cine latinoamericanos a partir de 1960

l seminario sigue la línea establecida en el curso sobre los “Clásicos de la literatura de la metrópolis” impartido durante el semestre de 2008-2. En este semestre, se analizan novelas, cuentos, crónicas y películas latinoamericanos producidos a partir de 1960. Interpretamos textos desde el ciclo novelístico de Santa María, de Juan Carlos Onetti, pasando por el llamado boom de la década de 1960 (Guillermo Cabrera Infante, Julio Cortázar) y las crónicas mexicanas de los años 70 y 80 (Carlos Monsiváis, Cristina Pacheco, Elena Poniatowska) hasta llegar al análisis de novelas y cuentos más recientes de autores como Carmen Boullosa, Guillermo Fadanelli, Juan Forns, Ricardo Piglia, Guillermo Samperio, Fernando Vallejo, Rafael Ramírez Heredia. Además, analizamos películas recientes como: El callejón de los milagros, La virgen de los sicarios, Ciudade de Deus y Amores perros.

Duas poéticas individuais: a metaficção em Finisterra, de Carlos de Oliveira e em o Triunfo da Morte de Augusto Abelaira

Dissertação de mestrado, Literatura, Faculdade de Ciências Humanas e Sociais, Universidade do Algarve, 2005

Accessing prospective early years’ teachers’ knowledge on fractions in order to design tasks for developing teachers’ MKT

Fractions is perhaps one of the most complex and difficult topics pupils explore in the early years of schooling. Difficulties in learning this topic may have its genesis in the fact that fractions comprise a multifaceted construct (Kieren, 1995) or can be conceived as being grounded in the instructional approaches employed to teach fractions (Behr, Harel, Post & Lesh, 1993). Thus, students’ limited understanding might be related to how their teachers understand and interpret fractions — it’s thus related with teachers’ knowledge and practice. Although there is a generalized agreement on teachers’ role on/for students learning, most research on fractions focus on students, leaving aside teachers’ role (and their knowledge on the topic). Thus, teachers’ training has in certain respects been left behind. We still know little about how teachers’ knowledge on fractions influences students’ broader view of mathematics, and its connection and evolution within and along schooling. Aimed at conceptualize ways of improving teachers’ knowledge, training and practices, it’s of fundamental importance to access the areas of knowledge (here conceived as mathematical knowledge for teaching (MKT) (Ball, Thames & Phelps, 2008) in which (prospective) teachers are more deficitaries.

THE CITADEL THE MILITARY COLLEGE OF SOUTH CAROLINA ANNUAL REPORT 1994-1995

South Carolina laws require that each state agency submit an annual accountability report to the Governor and General Assembly that contains the agency's or department's mission, objectives to accomplish the mission, and performance measures that show the degree to which objectives are being met.

South Carolina Statistical Abstract 1995

The South Carolina Budget and Control Board, Office of Research and Statistics annually published Statistical Abstracts, a comprehensive, single-source reference of demographic and economic data pertinent to the state. This publication is now an online publication by the South Carolina Revenue and Fiscal Affairs Office.

Accountability Report 1995-96

Each year the South Carolina Department of Natural Resources reports to the Office of State Budget that includes the agency's mission, goals and objectives to accomplish the mission, and performance measures regarding the goals and objectives.