Long-term outcome of patients with spinal myxopapillary ependymoma: treatment results from the MD Anderson Cancer Center and institutions from the Rare Cancer Network.

BACKGROUND Spinal myxopapillary ependymomas (MPEs) are slowly growing ependymal gliomas with preferential manifestation in young adults. The aim of this study was to assess the outcome of patients with MPE treated with surgery, radiotherapy (RT), and/or chemotherapy. METHODS The medical records of 183 MPE patients (male: 59%) treated at the MD Anderson Cancer Center and 11 institutions from the Rare Cancer Network were retrospectively reviewed. Mean patient' age at diagnosis was 35.5 ± 15.8 years. Ninety-seven (53.0%) patients underwent surgery without RT, and 86 (47.0%) were treated with surgery and/or RT. Median RT dose was 50.4 Gy. Median follow-up was 83.9 months. RESULTS Fifteen (8.2%) patients died, 7 of unrelated cause. The estimated 10-year overall survival was 92.4% (95% CI: 87.7-97.1). Treatment failure was observed in 58 (31.7%) patients. Local failure, distant spinal relapse, and brain failure were observed in 49 (26.8%), 17 (9.3%), and 11 (6.0%) patients, respectively. The estimated 10-year progression-free survival was 61.2% (95% CI: 52.8-69.6). Age (<36 vs ≥36 y), treatment modality (surgery alone vs surgery and RT), and extent of surgery were prognostic factors for local control and progression-free survival on univariate and multivariate analysis. CONCLUSIONS In this series, treatment failure of MPE occurred in approximately one third of patients. The observed recurrence pattern of primary spinal MPE was mainly local, but a substantial number of patients failed nonlocally. Younger patients and those not treated initially with adjuvant RT or not undergoing gross total resection were significantly more likely to present with tumor recurrence/progression.

Institutions as key drivers of collective action in WUAs [Water User Associations] of Uzbekistan

This paper presents a multifactor approach for performance assessment of Water Users Associations (WUAs) in Uzbekistan in order to identify the drivers for improved and effi cient performance of WUAs. The study was carried out in the Fergana Valley where the WUAs were created along the South Fergana Main Canal during the last 10 years. The farmers and the employees of 20 WUAs were questioned about the WUAs’ activities and the quantitative and qualitative data were obtained. This became a base for the calculation of 36 indicators divided into 6 groups: Water supply, technical conditions, economic conditions, social and cultural conditions, organizational conditions and information conditions. All the indicators assessed with a differentiated point system adjusted for subjectivity of several of them give the total maximal result for the associations of 250 point. The WUAs of the Fergana Valley showed the score between 145 and 219 points, what refl ects a highly diverse level of the WUAs performance in the region. The analysis of the indicators revealed that the key points of the WUA’s success are the organizational and institutional conditions including the participatory factors and awareness of both the farmers and employees about the work of WUA. The research showed that the low performance of the WUAs is always explained by the low technical and economic conditions along with weak organization and information dissemination conditions. It is clear that it is complicated to improve technical and economic conditions immediately because they are cost-based and cost-induced. However, it is possible to improve the organizational conditions and to strengthen the institutional basis via formal and information institutions which will gradually lead to improvement of economic and technical conditions of WUAs. Farmers should be involved into the WUA Governance and into the process of making common decisions and solving common problems together via proper institutions. Their awareness can also be improved by leading additional trainings for increasing farmers’ agronomic and irrigation knowledge, teaching them water saving technologies and acquainting them with the use of water measuring equipment so it can bring reliable water supply, transparent budgeting and adequate as well as equitable water allocation to the water users.

American Judaism : the religion and religious institutions of the jewish people in the United States ; a historical survey

by Joseph Leiser

The Jews of Philadelphia : their history from the earliest settlements to the present time. A record of events and institutions, and of leading members of the Jewish community in every sphere of activity

Henry Samuel Morais

Institutions and coalitions in policy processes: a cross-sectoral comparison

Actors with joint beliefs in a decision-making process form coalitions in order to translate their goals into policy. Yet, coalitions are not formed in an institutional void, but rather institutions confer opportunities and constraints to actors. This paper studies the institutional conditions under which either coalition structures with a dominant coalition or with competing coalitions emerge. It takes into account three conditions, i.e. the degree of federalism of a project, its degree of Europeanisation and the openness of the pre-parliamentary phase of the decision-making process. The cross-sectoral comparison includes the 11 most important decision-making processes in Switzerland between 2001 and 2006 with a fuzzy-set Qualitative Comparative Analysis. Results suggest that Europeanisation or an open pre-parliamentary phase lead to a dominant coalition, whereas only a specific combination of all three conditions is able to explain a structure with competing coalitions.

Institutions for sustainable governance of forests: Equity, robustness and cross-level interactions in Mawlyngbna, Meghalaya, India

This study adopts Ostrom’s Social-Ecological Systems (SES) framework in empirical fieldwork to explain how local forestry institutions affect forest ecosystems and social equity in the community of Mawlyngbna in North-East India. Data was collected through 26 semi-structured interviews, participatory timeline development, policy documents, direct observation, periodicals, transect walks, and a concurrent forest-ecological study in the village. Results show that Mawlyngbna's forests provide important sources of livelihood benefits for the villagers. However, ecological disturbance and diversity varies among the different forest ownership types and forest-based livelihood benefits are inequitably distributed. Based on a bounded rationality approach, our analysis proposes a set of causal mechanisms that trace these observed social-ecological outcomes to the attributes of the resource system, resource units, actors and governance system. We analyse opportunities and constraints of interactions between the village, regional, and state levels. We discuss how Ostrom’s design principles for community-based resource governance inform the explanation of robustness but have a blind spot in explaining social equity. We report experiences made using the SES framework in empirical fieldwork. We conclude that mapping cross-level interactions in the SES framework needs conceptual refinement and that explaining social equity of forest governance needs theoretical advances.

Lactate dehydrogenase concentration in nasal wash fluid indicates severity of rhinovirus-induced wheezy bronchitis in preschool children.

The clinical course of rhinovirus (RV)-associated wheezing illnesses is difficult to predict. We measured lactate dehydrogenase concentrations, RV load, antiviral and proinflammatory cytokines in nasal washes obtained from 126 preschool children with RV wheezy bronchitis. lactate dehydrogenase values were inversely associated with subsequent need for oxygen therapy. lactate dehydrogenase may be a useful biomarker predicting disease severity in RV wheezy bronchitis.