Busulphan-melphalan is the superior myeloablative therapy (mat) for high risk neuroblastoma: results from the hr-nbl1/siopen trial

Purpose: The HR-NBL1 trial of the European SIOP Neuroblastoma Group randomised 2 MAT regimens to demonstrate superiority based on event free survival (EFS).Method: Response eligibility criteria prior to randomisation after Rapid COJEC Induction (J Clin Oncol, 2010) 3 4 2 courses of TVD (Cancer, 2003) included complete bone marrow remission andA ^ 3, but improved, mIBG positive spots. The MAT regimens were BuMel (oral busulfan till 2006, 4_150 mg/m2 in 4 equal doses, or after 2006 intravenous use according to body weight and melphalan 140 mg/m__/day) and CEM (carboplatin ctn. infusion (4xAUC 4.1 mg/ml.min/day), etoposide ctn. infusion (4_338 mg/m__day or 4_200 mg/m__/ day*), melphalan (3_70 mg/m__/day or 3_60 mg/m__/day*. *reduced if GFR<100 ml/ min/1.73m__)). A minimum of 3_10E6 CD34/kgBW PBSC were requested. VOD prophylaxis included ursadiol, but not prophylactic defibrotide. Local control included surgery and radiotherapy of 21 Gy. A total of 598 high risk neuroblastoma patients were randomised (296 BuMel, 302 CEM). The median age at randomisation was 3 years (1-17.2).Results: A significant difference in EFS in favour of BuMel (3-years EFS 49% vs. 33%) was observed as well as for overall survival (3-years OS 60% vs. 48%, p¼0.004) with a median follow up of 3 years. This difference was mainly related to the relapse and progression incidence, which was significantly (p<0.001) lower with BuMel (48% vs. 60%). The severe toxicity rate up to day 100 (ICU and toxic deaths) was below 10%, but was significantly higher for CEM (p¼0.014). The acute toxic death rate was 3% for BuMel and 5% for CEM (NS). The acute MAT toxicity profile favours the BuMel regimen in spite of a total VOD incidence of 18% (grade 3:5%). Based on these results and following advice from the DMC, the randomisation was closed early.

Case complexity and clinical outcome in diabetes mellitus. A prospective study using the INTERMED.

The aim of this study was to assess a population of patients with diabetes mellitus by means of the INTERMED, a classification system for case complexity integrating biological, psychosocial and health care related aspects of disease. The main hypothesis was that the INTERMED would identify distinct clusters of patients with different degrees of case complexity and different clinical outcomes. Patients (n=61) referred to a tertiary reference care centre were evaluated with the INTERMED and followed 9 months for HbA1c values and 6 months for health care utilisation. Cluster analysis revealed two clusters: cluster 1 (62%) consisting of complex patients with high INTERMED scores and cluster 2 (38%) consisting of less complex patients with lower INTERMED. Cluster 1 patients showed significantly higher HbA1c values and a tendency for increased health care utilisation. Total INTERMED scores were significantly related to HbA1c and explained 21% of its variance. In conclusion, different clusters of patients with different degrees of case complexity were identified by the INTERMED, allowing the detection of highly complex patients at risk for poor diabetes control. The INTERMED therefore provides an objective basis for clinical and scientific progress in diabetes mellitus. Ongoing intervention studies will have to confirm these preliminary data and to evaluate if management strategies based on the INTERMED profiles will improve outcomes.

MINERVE 2010: Prévision hydrométéorologique et gestion des crues sur le Rhône alpin

L'objectif prioritaire du projet de 3ème Correction du Rhône est d'améliorer la protection de la Vallée du Rhône en amont du lac Léman contre les crues. Dans ce contexte, le projet MINERVE vise à optimiser la gestion des flux hydrauliques, en profitant du réseau d'aménagements hydroélectriques existant sur le bassin versant. Pour ce faire, un modèle de prévisions hydrométéorologiques et un modèle d'aide à la décision pour l'exploitation préventive des aménagements sont développés.

Dépistage et intervention brève par internet pour la consommation d'alcool a risque: www.alcooquizz.ch [Web-based screening and brief intervention for unhealthy alcohol use: www.alcooquizz.ch].

Many individuals with unhealthy alcohol use have few or no contact with the health care system and are therefore unlikely to receive information or a brief intervention from a health care professional. Consequently, many Internet-based interventions have been developed. These interventions can reach a large population. We present in this report www.alcooquizz.ch, a website providing tailored feedback and information on alcohol use and its consequences. In six months and a half, more than 15000 individuals visited the website. It appropriately targets individuals with unhealthy alcohol use and users' satisfaction was high. Internet is a valuable option to provide health related information and secondary prevention interventions for unhealthy alcohol use.

Análise da capacidade combinatória entre linhagens de girassol

A capacidade geral (CGC) e a capacidade específica de combinação (CEC), entre duas linhagens macho-estéreis (mãe) e um grupo de sete linhagens S4 restauradoras de fertilidade (pai), foram estimadas para estudar o potencial desses materiais em programas de melhoramento de girassol (Helianthus annuus L.). O método IV de Griffing, adaptado para cruzamentos dialélicos parciais, foi usado na análise das combinações híbridas. Considerando a CGC para rendimento de aquênios e teor de óleo, os progenitores com maior potencial para o melhoramento foram CMS HA 302 (originária de uma população norte-americana) para ser usada como mãe, e as linhagens 89V2345)3382 e 89V2345)3311 (derivadas da população V2000, obtida por seleção sobre a população Issanka, originária da França) como pais nos cruzamentos. Para o rendimento de aquênios, os efeitos gênicos não aditivos foram importantes na determinação das diferenças entre progenitores. Considerando-se os efeitos gênicos aditivos e não-aditivos conjuntamente, as melhores combinações são CMS HA 302 x 89V2396)5333 para rendimento de aquênios e CMS HA 30379NW22 x 89V2345)3382 para teor de óleo e rendimento de óleo.

Iowa Department of Transportation Major Items - Preliminary Quantity Report, May 20, 2014; With Addendums

Weekly letting report.

Clones promissores de seringueira para a região do Vale do Ribeira, São Paulo

Este trabalho objetivou apresentar resultados da primeira seleção de clones de seringueira (Hevea brasiliensis (Willd. ex Adr. de Juss.) Muell.Arg.) da série IAC 300, e amazônicos das séries IAN e Fx, em experimento de pequena escala, visando produção, crescimento e resistência ao mal-das-folhas. A produção e o vigor de 20 clones foram avaliados por dois e nove anos, respectivamente, em PariqüeraAçú, no Vale do Ribeira, SP. Os clones IAC 301, IAC 304, IAC 306 e IAC 319 produziram satisfatoriamente nos dois primeiros anos de sangria. Os clones amazônicos IAN 6323, Fx 3864 e IAN 2903, com produções de 1.078 kg, 945 kg e 900 kg/ha/ano, respectivamente, foram superiores à testemunha IAN 873 (878 kg/ha/ano). Os clones selecionados apresentaram crescimento vigoroso, com extremos de perímetro do caule, na abertura do painel, de 37,40 cm (IAN 4493) a 53,75 cm (IAN 6323), e percentual de plantas aptas à sangria de 7,0% (IAN 4493) a 100% (IAN 6323 e IAC 302), exceto os clones Fx 3899 e IAN 3044. O IAC 315, com 7,37 mm, mostrou maior espessura de casca virgem que o IAN 873 (6,44 mm). Os clones IAC 320, IAC 306 e IAC 315 foram os mais resistentes ao Microcyclus ulei.

Mental Causation : Investigating the mind's powers in a natural world

4.6 Summary and Conclusion In this chapter, we have first tried to make precise the distinctions between the concepts of parthood and coincidence and the concepts of causation and causal influence. These distinc-tions had never been made entirely explicit in the debate on mental causation before, despite the fact that they constantly figure in its background. Section 4.2 then demonstrated that the at-tained definitions are both compatible with all the solutions elaborated in chapters 2 and 3 and that they are even of great help in clarifying both what precisely the mentioned accounts are claiming respectively and what their mutual connections are. In sections 4.3. and 4.4, we have then tried to explore two possible solutions to the problem of mental causation that, at least in these particular versions, have not been explicitly defended in the literature. These solutions we dubbed "overdeteiminationism lite" and "plural determinism". We found the accounts both to bear impressive explanatory capabilities and to be vulnerable to far fewer problems than is commonly supposed. We also found out that they have many corresponding aspects and that their theoretical costs stand in a relation of a relative mutual balance. Our final discussion in section 4.5 revealed, however, that overdetenninationism lite should probably be considered the more successful theory. The fact that it needs to endorse the existence of two kinds of causation, although not unproblematic itself, did not appear as a commitment as strong as that of an ontological hierarchy that extends over all time, which at least the broad version of plural determinism was forced to make.