Adjuvant chemotherapy for localised resectable soft-tissue sarcoma of adults: meta-analysis of individual data

BACKGROUND: Individually, randomised trials have not shown conclusively whether adjuvant chemotherapy benefits adult patients with localised resectable soft-tissue sarcoma.METHODS: A quantitative meta-analysis of updated data from individual patients from all available randomised trials was carried out to assess whether adjuvant chemotherapy improves overall survival, recurrence-free survival, and local and distant recurrence-free intervals (RFI) and whether chemotherapy is differentially effective in patients defined by age, sex, disease status at randomisation, disease site, histology, grade, tumour size, extent of resection, and use of radiotherapy.FINDINGS: 1568 patients from 14 trials of doxorubicin-based adjuvant chemotherapy were included (median follow-up 9.4 years). Hazard ratios of 0.73 (95% CI 0.56-0.94, p = 0.016) for local RFI, 0.70 (0.57-0.85, p = 0.0003) for distant RFI, and 0.75 (0.64-0.87, p = 0.0001) for overall recurrence-free survival, correspond to absolute benefits from adjuvant chemotherapy of 6% (95% CI 1-10), 10% (5-15), and 10% (5-15), respectively, at 10 years. For overall survival the hazard ratio of 0.89 (0.76-1.03) was not significant (p = 0.12), but represents an absolute benefit of 4% (1-9) at 10 years. These results were not affected by prespecified changes in the groups of patients analysed. There was no consistent evidence that the relative effect of adjuvant chemotherapy differed for any subgroup of patients for any endpoint. However, the best evidence of an effect of adjuvant chemotherapy for survival was seen in patients with sarcomas of the extremities.INTERPRETATION: The meta-analysis provides evidence that adjuvant doxorubicin-based chemotherapy significantly improves the time to local and distant recurrence and overall recurrence-free survival. There is a trend towards improved overall survival.

Nonvitamin-k-antagonist oral anticoagulants in patients with atrial fibrillation and previous stroke or transient ischemic attack: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND AND PURPOSE: To assess whether the combined analysis of all phase III trials of nonvitamin-K-antagonist (non-VKA) oral anticoagulants in patients with atrial fibrillation and previous stroke or transient ischemic attack shows a significant difference in efficacy or safety compared with warfarin. METHODS: We searched PubMed until May 31, 2012, for randomized clinical trials using the following search items: atrial fibrillation, anticoagulation, warfarin, and previous stroke or transient ischemic attack. Studies had to be phase III trials in atrial fibrillation patients comparing warfarin with a non-VKA currently on the market or with the intention to be brought to the market in North America or Europe. Analysis was performed on intention-to-treat basis. A fixed-effects model was used as more appropriate than a random-effects model when combining a small number of studies. RESULTS: Among 47 potentially eligible articles, 3 were included in the meta-analysis. In 14 527 patients, non-VKAs were associated with a significant reduction of stroke/systemic embolism (odds ratios, 0.85 [95% CI, 074-0.99]; relative risk reduction, 14%; absolute risk reduction, 0.7%; number needed to treat, 134 over 1.8-2.0 years) compared with warfarin. Non-VKAs were also associated with a significant reduction of major bleeding compared with warfarin (odds ratios, 0.86 [95% CI, 075-0.99]; relative risk reduction, 13%; absolute risk reduction, 0.8%; number needed to treat, 125), mainly driven by the significant reduction of hemorrhagic stroke (odds ratios, 0.44 [95% CI, 032-0.62]; relative risk reduction, 57.9%; absolute risk reduction, 0.7%; number needed to treat, 139). CONCLUSIONS: In the context of the significant limitations of combining the results of disparate trials of different agents, non-VKAs seem to be associated with a significant reduction in rates of stroke or systemic embolism, hemorrhagic stroke, and major bleeding when compared with warfarin in patients with previous stroke or transient ischemic attack.

Split sex ratios in the social Hymenoptera: a meta-analysis

The study of sex allocation in social Hymenoptera (ants, bees, and wasps) provides an excellent opportunity for testing kin-selection theory and studying conflict resolution. A queen-worker conflict over sex allocation is expected because workers are more related to sisters than to brothers, whereas queens are equally related to daughters and sons. If workers fully control sex allocation, split sex ratio theory predicts that colonies with relatively high or low relatedness asymmetry (the relatedness of workers to females divided by the relatedness of workers to males) should specialize in females or males, respectively. We performed a meta-analysis to assess the magnitude of adaptive sex allocation biasing by workers and degree of support for split sex ratio theory in the social Hymenoptera. Overall, variation in relatedness asymmetry (due to mate number or queen replacement) and variation in queen number (which also affects relatedness asymmetry in some conditions) explained 20.9% and 5% of the variance in sex allocation among colonies, respectively. These results show that workers often bias colony sex allocation in their favor as predicted by split sex ratio theory, even if their control is incomplete and a large part of the variation among colonies has other causes. The explanatory power of split sex ratio theory was close to that of local mate competition and local resource competition in the few species of social Hymenoptera where these factors apply. Hence, three of the most successful theories explaining quantitative variation in sex allocation are based on kin selection.

Thirty new loci for age at menarche identified by a meta-analysis of genome-wide association studies.

To identify loci for age at menarche, we performed a meta-analysis of 32 genome-wide association studies in 87,802 women of European descent, with replication in up to 14,731 women. In addition to the known loci at LIN28B (P = 5.4 × 10⁻⁶⁰) and 9q31.2 (P = 2.2 × 10⁻³³), we identified 30 new menarche loci (all P < 5 × 10⁻⁸) and found suggestive evidence for a further 10 loci (P < 1.9 × 10⁻⁶). The new loci included four previously associated with body mass index (in or near FTO, SEC16B, TRA2B and TMEM18), three in or near other genes implicated in energy homeostasis (BSX, CRTC1 and MCHR2) and three in or near genes implicated in hormonal regulation (INHBA, PCSK2 and RXRG). Ingenuity and gene-set enrichment pathway analyses identified coenzyme A and fatty acid biosynthesis as biological processes related to menarche timing.

Advanced mapping of environmental data: Geostatistics, Machine Learning and Bayesian Maximum Entropy

This book combines geostatistics and global mapping systems to present an up-to-the-minute study of environmental data. Featuring numerous case studies, the reference covers model dependent (geostatistics) and data driven (machine learning algorithms) analysis techniques such as risk mapping, conditional stochastic simulations, descriptions of spatial uncertainty and variability, artificial neural networks (ANN) for spatial data, Bayesian maximum entropy (BME), and more.

Can the trabecular bone score be considered as a major clinical risk factor of osteoporotic fractures? A meta-like analysis.

To have an added value over BMD, a CRF of osteoporotic fracture must be predictable of the fracture, independent of BMD, reversible and quantifiable. Many major recognized CRF exist. Out of these factors many of them are indirect factor of bone quality. TBS predicts fracture independently of BMD as demonstrated from previous studies. The aim of the study is to verify if TBS can be considered as a major CRF of osteoporotic fracture. Existing validated datasets of Caucasian women were analyzed. These datasets stem from different studies performed by the authors of this report or provided to our group. However, the level of evidence of these studies will vary. Thus, the different datasets were weighted differently according to their design. This meta-like analysis involves more than 32000 women (≥50years) with 2000 osteoporotic fractures from two prospective studies (OFELY&MANITOBA) and 7 cross-sectional studies. Weighted relative risk (RR) for TBS was expressed for each decrease of one standard deviation as well as per tertile difference (TBS=1.300 and 1.200) and compared with those obtained for the major CRF included in FRAX®. Overall TBS RR obtained (adjusted for age) was 1.79 [95%CI-1.37-2.37]. For all women combined, RR for fracture for the lowest compared with the middle TBS tertile was 1.55[1.46-1.68] and for the lowest compared with the highest TBS tertile was 2.8[2.70-3.00]. TBS is comparable to most of the major CRF and thus could be used as one of them. Further studies have to be conducted to confirm these first findings.

Cooperative learning: learning to cooperate, cooperating to learn

This research project is an attempt to give arguments in favour of using cooperative learning activities in FL classrooms as an effective approach to learning. The arguments offered are presented from two different perspectives: the first one is based on the empirical study of three students working together to achieve a common goal. The second one is a compilation of the trainee teacher's experiences during her practicum periods in a high school regarding group work. This part is illustrated by some examples that emphasize that cooperative learning can facilitate learning, promote socialisation and increase students' self-esteem

The learning process as a cooperative task among teachers and students

This research project gathers several ideas and guidelines on professional improvement as a teacher. This study includes two empirical studies. The first one focuses mainly on the teacher's figure. It is meant to be a study of the several resources that the teacher uses in order to construct the student's knowledge in an English classroom context. The second empirical study focuses on the students. It is a study on how students learn cooperatively by analyzing their oral productions when working in small groups

How to avoid gender bias in classroom interaction? A cooperative learning experience

This project aims to analyse the kind of questions the teacher asks students in order to encourage them to participate in her classes. Consequently, the researcher has read relevant literature and has analysed a short excerpt of a video recorded during her first practicum. She has also analysed a number of activities carried out during her second practicum in order to find out if she had improved her questioning skills in the classroom

La implementació dels ECTS a la titulació de Formació del Professorat : fomentant l'aprenentatge significatiu mitjançant b-learning, metodologies didàctiques innovadores i l'avaluació contínua

Aquest projecte ha servit per (1) establir un treball col·laboratiu entre el professorat que habitualment impartim les assignatures de Didàctica general i atenció a la diversitat i Organització del Centre Escolar; (2) dissenyar conjuntament espais del campus virtual en la plataforma moodle; (3) compartir material i experiències docents fent formació entre iguals; (4) dissenyar i desenvolupar accions didàctiques innovadores per afavorir l'aprenentatge significatiu; (5) prendre posició respecte a l'elaboració dels nous graus de Formació del Professorat i reelaborar els plans docents nous. Les noves titulacions, el disseny per competències, l’EEES ens ha obligat a fer una reflexió sobre la nostra docència, l’educació superior i la formació dels futurs mestres. Aquest projecte ha recolzat la tasca habitual, donant-li una orientació concreta, en ell hem estat implicat un grup important de professors i professores així com d’alumnes perquè s’ha implementat en els 13 grups d’alumnes de Formació del Professorat i en dues assignatures troncals i obligatòries. Per fer seguiment del treball hem analitzat els productes d’aprenentatges, els espais moodle, així mateix hem anat recollint les valoracions dels estudiants fent qüestionaris i grups de discussió. Tot i que el treball desenvolupat es considera positiu, hi ha aspectes per millorar que també es destaquen en l’informe: dificultats per manca de temps, poc reconeixement, necessitat de cohesionar i estabilitzar equips docents, necessitat d’incorporar tècniques especialistes en el disseny d’entorns virtuals d’aprenentatge en els equips docents, entre d’altres. D’altra banda amb l’elaboració dels nous plans d’estudis les assignatures amb les que hem treballat han perdut l’entitat i el pes que tenien per tenir-ne una altra i en des de 2007 fins a ara hem anat perdent professorat estable i incorporant associats. Fets que fan necessari seguir avançant d’altres maneres, per tant finalitzem un projecte, però es necessari replantejar-se un altre.

Cooperative learning in the ESL classroom

This research explores the advantages and disadvantages of collaborative learning departing from two different methodological studies. In the first one, we will go deep into the reflections about group work of a student-teacher in her first experiences during a two months practicum in Sabadell's Emily Bronte. In the second one, we will analyze in a more empirical way the interaction that takes place among a trio of students engaged in a question-answering task about a text based on a three minutes vignette recorded on January 2010