Neoadjuvant chemotherapy and extrapleural pneumonectomy of malignant pleural mesothelioma with or without hemithoracic radiotherapy (SAKK 17/04): a randomised, international, multicentre phase 2 trial

BACKGROUND Postoperative hemithoracic radiotherapy has been used to treat malignant pleural mesothelioma, but it has not been assessed in a randomised trial. We assessed high-dose hemithoracic radiotherapy after neoadjuvant chemotherapy and extrapleural pneumonectomy in patients with malignant pleural mesothelioma. METHODS We did this phase 2 trial in two parts at 14 hospitals in Switzerland, Belgium, and Germany. We enrolled patients with pathologically confirmed malignant pleural mesothelioma; resectable TNM stages T1-3 N0-2, M0; WHO performance status 0-1; age 18-70 years. In part 1, patients were given three cycles of neoadjuvant chemotherapy (cisplatin 75 mg/m(2) and pemetrexed 500 mg/m(2) on day 1 given every 3 weeks) and extrapleural pneumonectomy; the primary endpoint was complete macroscopic resection (R0-1). In part 2, participants with complete macroscopic resection were randomly assigned (1:1) to receive high-dose radiotherapy or not. The target volume for radiotherapy encompassed the entire hemithorax, the thoracotomy channel, and mediastinal nodal stations if affected by the disease or violated surgically. A boost was given to areas at high risk for locoregional relapse. The allocation was stratified by centre, histology (sarcomatoid vs epithelioid or mixed), mediastinal lymph node involvement (N0-1 vs N2), and T stage (T1-2 vs T3). The primary endpoint of part 1 was the proportion of patients achieving complete macroscopic resection (R0 and R1). The primary endpoint in part 2 was locoregional relapse-free survival, analysed by intention to treat. The trial is registered with ClinicalTrials.gov, number NCT00334594. FINDINGS We enrolled patients between Dec 7, 2005, and Oct 17, 2012. Overall, we analysed 151 patients receiving neoadjuvant chemotherapy, of whom 113 (75%) had extrapleural pneumonectomy. Median follow-up was 54·2 months (IQR 32-66). 52 (34%) of 151 patients achieved an objective response. The most common grade 3 or 4 toxic effects were neutropenia (21 [14%] of 151 patients), anaemia (11 [7%]), and nausea or vomiting (eight [5%]). 113 patients had extrapleural pneumonectomy, with complete macroscopic resection achieved in 96 (64%) of 151 patients. We enrolled 54 patients in part 2; 27 in each group. The main reasons for exclusion were patient refusal (n=20) and ineligibility (n=10). 25 of 27 patients completed radiotherapy. Median total radiotherapy dose was 55·9 Gy (IQR 46·8-56·0). Median locoregional relapse-free survival from surgery, was 7·6 months (95% CI 4·5-10·7) in the no radiotherapy group and 9·4 months (6·5-11·9) in the radiotherapy group. The most common grade 3 or higher toxic effects related to radiotherapy were nausea or vomiting (three [11%] of 27 patients), oesophagitis (two [7%]), and pneumonitis (two [7%]). One patient died of pneumonitis. We recorded no toxic effects data for the control group. INTERPRETATION Our findings do not support the routine use of hemithoracic radiotherapy for malignant pleural mesothelioma after neoadjuvant chemotherapy and extrapleural pneumonectomy. FUNDING Swiss Group for Clinical Cancer Research, Swiss State Secretariat for Education, Research and Innovation, Eli Lilly.

Induction chemoradiation in stage IIIA/N2 non-small-cell lung cancer: a phase 3 randomised trial

BACKGROUND One of the standard options in the treatment of stage IIIA/N2 non-small-cell lung cancer is neoadjuvant chemotherapy and surgery. We did a randomised trial to investigate whether the addition of neoadjuvant radiotherapy improves outcomes. METHODS We enrolled patients in 23 centres in Switzerland, Germany and Serbia. Eligible patients had pathologically proven, stage IIIA/N2 non-small-cell lung cancer and were randomly assigned to treatment groups in a 1:1 ratio. Those in the chemoradiotherapy group received three cycles of neoadjuvant chemotherapy (100 mg/m(2) cisplatin and 85 mg/m(2) docetaxel) followed by radiotherapy with 44 Gy in 22 fractions over 3 weeks, and those in the control group received neoadjuvant chemotherapy alone. All patients were scheduled to undergo surgery. Randomisation was stratified by centre, mediastinal bulk (less than 5 cm vs 5 cm or more), and weight loss (5% or more vs less than 5% in the previous 6 months). The primary endpoint was event-free survival. Analyses were done by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00030771. FINDINGS From 2001 to 2012, 232 patients were enrolled, of whom 117 were allocated to the chemoradiotherapy group and 115 to the chemotherapy group. Median event-free survival was similar in the two groups at 12·8 months (95% CI 9·7-22·9) in the chemoradiotherapy group and 11·6 months (8·4-15·2) in the chemotherapy group (p=0·67). Median overall survival was 37·1 months (95% CI 22·6-50·0) with radiotherapy, compared with 26·2 months (19·9-52·1) in the control group. Chemotherapy-related toxic effects were reported in most patients, but 91% of patients completed three cycles of chemotherapy. Radiotherapy-induced grade 3 dysphagia was seen in seven (7%) patients. Three patients died in the control group within 30 days after surgery. INTERPRETATION Radiotherapy did not add any benefit to induction chemotherapy followed by surgery. We suggest that one definitive local treatment modality combined with neoadjuvant chemotherapy is adequate to treat resectable stage IIIA/N2 non-small-cell lung cancer. FUNDING Swiss State Secretariat for Education, Research and Innovation (SERI), Swiss Cancer League, and Sanofi.

Texas Medical Center --- Its Origins

This document details the people and institutions who were instrumental in the establishment and development of the Texas Medical Center (TMC). Biographical information about the founders, role the M. D. Anderson Foundation, and opening of the main institutions in the early 1950s is detailed. A copy of a speech given in 1958 by W. B. Bates, one of the trustees of the M. D. Anderson Foundation, on the history and development of the TMC is significant because he was one of the founders of the TMC. This document was commissioned by the Houston Chamber of Commerce in 1971 as the Texas Medical Center began a new phase of expansion with the pending addition of The University of Texas Medical School at Houston. It includes information about each of the 21 institutions which comprised the TMC at that time.

Lugar que ocupa la evaluación en los proyectos de investigación. Una opinión construida en base a la experiencia

El presente trabajo surge ante una invitación por parte de las autoridades del Departamento de Educación Física para participar de las 3ras. Jornadas de Investigación en Educación Corporal. Tiene como intención dar respuesta a la convocatoria en cuanto a plantear opinión y experiencia acerca del lugar que ocupa la evaluación en los Proyectos de Investigación. Se parte de contextualizar tres núcleos temáticos polísémicos y de variabilidad interpretativa como son: opinión, experiencia y evaluación. El trabajo se centra en el planteo de cuestiones e interrogantes a partir de un breve análisis de las políticas sobre evaluación con inicio en la década del 90 y realiza un recorte en el análisis de las normas vigentes y que tienen como cometido por una lado impulsar la generación de conocimientos a partir de la elaboración de proyectos de investigación y por otro pautar aspectos a considerar al momento de acreditar los proyectos de referencia. En este sentido se analiza en forma sucinta el Decreto 2427/93 y con especial énfasis los Artículos 31 a 34 de la Resolución nº 811/03- Manual de Procedimientos del MECyT. El texto concluye abogando por la necesidad de construir una cultura evaluativa en el ámbito académico- universitario.

Lugar que ocupa la evaluación en los proyectos de investigación. Una opinión construida en base a la experiencia

El presente trabajo surge ante una invitación por parte de las autoridades del Departamento de Educación Física para participar de las 3ras. Jornadas de Investigación en Educación Corporal. Tiene como intención dar respuesta a la convocatoria en cuanto a plantear opinión y experiencia acerca del lugar que ocupa la evaluación en los Proyectos de Investigación. Se parte de contextualizar tres núcleos temáticos polísémicos y de variabilidad interpretativa como son: opinión, experiencia y evaluación. El trabajo se centra en el planteo de cuestiones e interrogantes a partir de un breve análisis de las políticas sobre evaluación con inicio en la década del 90 y realiza un recorte en el análisis de las normas vigentes y que tienen como cometido por una lado impulsar la generación de conocimientos a partir de la elaboración de proyectos de investigación y por otro pautar aspectos a considerar al momento de acreditar los proyectos de referencia. En este sentido se analiza en forma sucinta el Decreto 2427/93 y con especial énfasis los Artículos 31 a 34 de la Resolución nº 811/03- Manual de Procedimientos del MECyT. El texto concluye abogando por la necesidad de construir una cultura evaluativa en el ámbito académico- universitario.

Lugar que ocupa la evaluación en los proyectos de investigación. Una opinión construida en base a la experiencia

El presente trabajo surge ante una invitación por parte de las autoridades del Departamento de Educación Física para participar de las 3ras. Jornadas de Investigación en Educación Corporal. Tiene como intención dar respuesta a la convocatoria en cuanto a plantear opinión y experiencia acerca del lugar que ocupa la evaluación en los Proyectos de Investigación. Se parte de contextualizar tres núcleos temáticos polísémicos y de variabilidad interpretativa como son: opinión, experiencia y evaluación. El trabajo se centra en el planteo de cuestiones e interrogantes a partir de un breve análisis de las políticas sobre evaluación con inicio en la década del 90 y realiza un recorte en el análisis de las normas vigentes y que tienen como cometido por una lado impulsar la generación de conocimientos a partir de la elaboración de proyectos de investigación y por otro pautar aspectos a considerar al momento de acreditar los proyectos de referencia. En este sentido se analiza en forma sucinta el Decreto 2427/93 y con especial énfasis los Artículos 31 a 34 de la Resolución nº 811/03- Manual de Procedimientos del MECyT. El texto concluye abogando por la necesidad de construir una cultura evaluativa en el ámbito académico- universitario.

Unlocking the Potential of Zambian Micro, Small and Medium Enterprises "Learning from the international best practices - the Southeast Asian Experience"

This paper examines the SMEs performance in Zambia and attempts to identify some practical lessons that Zambia can learn from Southeast Asian countries (with reference to Malaysia) in order to facilitate industrial development through unlocking the potential of its SMEs sector. Malaysia and Zambia were at the same level of economic development as evidenced by similar per capita incomes but Zambia has remained behind economically and its manufacturing sector has stagnated as if both countries did not have similar initial endowments. It therefore, becomes imperative that Zambia learns from such countries on how they managed to take-off economically with a focus on SME development. Training (education), research & development, market availability and technological advancement through establishment of industrial linkages coupled with cluster formation were some of the outstanding strategies identified that Zambia could use as a “key” to unlock its SMEs’ potential as it strives to meet the UN MDGs in particular halving its poverty levels by 2015 and also realizing its vision of becoming a middle income earner by 2030.

Migration to an a on-line laboatory in mechanical engineering. The case of a cam-follower design practice.

The European Higher Education Area (EHEA) has leaded to a change in the way the subjects are taught. One of the more important aspects of the EHEA is to support the autonomous study of the students. Taking into account this new approach, the virtual laboratory of the subject Mechanisms of the Aeronautical studies at the Technical University of Madrid is being migrated to an on-line scheme. This virtual laboratory consist on two practices: the design of cam-follower mechanisms and the design of trains of gears. Both practices are software applications that, in the current situation, need to be installed on each computer and the students carry out the practice at the computer classroom of the school under the supervision of a teacher. During this year the design of cam-follower mechanisms practice has been moved to a web application using Java and the Google Development Toolkit. In this practice the students has to design and study the running of a cam to perform a specific displacement diagram with a selected follower taking into account that the mechanism must be able to work properly at high speed regime. The practice has maintained its objectives in the new platform but to take advantage of the new methodology and try to avoid the inconveniences that the previous version had shown. Once the new practice has been ready, a pilot study has been carried out to compare both approaches: on-line and in-lab. This paper shows the adaptation of the cam and follower practice to an on-line methodology. Both practices are described and the changes that has been done to the initial one are shown. They are compared and the weak and strong points of each one are analyzed. Finally we explain the pilot study carried out, the students impression and the results obtained.

Simulation of academic performance rates, estimation of indicators of subjects and of a complete degree

The purpose of this paper is to present a program written in Matlab-Octave for the simulation of the time evolution of student curricula, i.e, how students pass their subjects along time until graduation. The program computes, from the simulations, the academic performance rates for the subjects of the study plan for each semester as well as the overall rates, which are a) the efficiency rate defined as the ratio of the number of students passing the exam to the number of students who registered for it and b) the success rate, defined as the ratio of the number of students passing the exam to the number of students who not only registered for it but also actually took it. Additionally, we compute the rates for the bachelor academic degree which are established for Spain by the National Quality Evaluation and Accreditation Agency (ANECA) and which are the graduation rate (measured as the percentage of students who finish as scheduled in the plan or taking an extra year) and the efficiency rate (measured as the percentage of credits which a student who graduated has really taken). The simulation is done in terms of the probabilities of passing all the subjects in their study plan. The application of the simulator to Polytech students in Madrid, where requirements for passing are specially stiff in first and second year subjects, is particularly relevant to analyze student cohorts and the probabilities of students finishing in the minimum of four years, or taking and extra year or two extra years, and so forth. It is a very useful tool when designing new study plans. The calculation of the probability distribution of the random variable "number of semesters a student has taken to complete the curricula and graduate" is difficult or even unfeasible to obtain analytically, and this is even truer when we incorporate uncertainty in parameter estimation. This is why we apply Monte Carlo simulation which not only provides illustration of the stochastic process but also a method for computation. The stochastic simulator is proving to be a useful tool for identification of the subjects most critical in the distribution of the number of semesters for curriculum vitae (CV) completion and subsequently for a decision making process in terms of CV planning and passing standards in the University. Simulations are performed through a graphical interface where also the results are presented in appropriate figures. The Project has been funded by the Call for Innovation in Education Projects of Universidad Politécnica de Madrid (UPM) through a Project of its school Escuela Técnica Superior de Ingenieros Industriales ETSII during the period September 2010-September 2011.

Competence assessment of final year projects for undergraduate telecommunication students

The value of project-based learning has lead to the inclusion of project development activities in engineering courses, being the Final Year Project (FYP) the most remarkable one. Several approaches have been proposed for assessing and grading FYPs but, among them, rubrics are becoming a standard for such type of assessment. However, due to the different characteristics and orientations of the projects (some are more practically oriented, some more theoretically), and the high amount of different competences to be evaluated (knowledge, working capability, communication skills, etc.), the definition of one unique rubric suitable for the evaluation of all FYPs presented in different degree programs, is a big challenge. In a former work, the educational outcomes expected from the FYP were defined and resulted in a proposal for their assessment. Afterwards, the proposal has been tested during one year within an educational innovation-project at the Universidad Politécnica de Madrid which involved the follow-up of 8 undergraduate telecommunication students elaborating their FYPs. In this publication, our experience will be described, based on the emerging work taking place through the formalisation of the process which consisted in the following steps: i) establishment of a schedule for the whole process (publication of FYPs topics, selection of applying students and their enrolment, assignation of a jury to each FYP, elaboration and follow-up of FYPs, final report submission, oral presentation, etc.); ii) design of rubrics for each of three assessment parts: working process, final report and oral presentation; and iii) follow-up and evaluation of the involved FYPs. Finally, problems that appeared during this experience (e.g. administrative aspects, criticisms and suggestions from the students, tutors and juries involved) are discussed and some modifications in the assessment system will be proposed in order to solve or minimize these problems.

Tutoring and mentoring project for foreign students of forest engineering degrees

We present an innovative educational project dedicated to improve the academic performance of foreign students by enhancing the integration of international students during their academic attendance in the programs offered at Universidad Politécnica de Madrid?s School of Forest Engineering (Spain).

Results of students surveys in similar courses given in different centers of the Technical University of Madrid

We present and analyze the results of surveys conducted in recent years with students from two related subjects, but taught in different centers of the University of Madrid. These surveys are part of the objectives of various projects of educational innovation, and applied through the platform Moodle.

Development and implementation of a virtual laboratory for training process improvement in the mechanics of continuous media

The project arises from the need to develop improved teaching methodologies in field of the mechanics of continuous media. The objective is to offer the student a learning process to acquire the necessary theoretical knowledge, cognitive skills and the responsibility and autonomy to professional development in this area. Traditionally the teaching of the concepts of these subjects was performed through lectures and laboratory practice. During these lessons the students attitude was usually passive, and therefore their effectiveness was poor. The proposed methodology has already been successfully employed in universities like University Bochum, Germany, University the South Australia and aims to improve the effectiveness of knowledge acquisition through use by the student of a virtual laboratory. This laboratory allows to adapt the curricula and learning techniques to the European Higher Education and improve current learning processes in the University School of Public Works Engineers -EUITOP- of the Technical University of Madrid -UPM-, due there are not laboratories in this specialization. The virtual space is created using a software platform built on OpenSim, manages 3D virtual worlds, and, language LSL -Linden Scripting Language-, which imprints specific powers to objects. The student or user can access this virtual world through their avatar -your character in the virtual world- and can perform practices within the space created for the purpose, at any time, just with computer with internet access and viewfinder. The virtual laboratory has three partitions. The virtual meeting rooms, where the avatar can interact with peers, solve problems and exchange existing documentation in the virtual library. The interactive game room, where the avatar is has to resolve a number of issues in time. And the video room where students can watch instructional videos and receive group lessons. Each audiovisual interactive element is accompanied by explanations framing it within the area of knowledge and enables students to begin to acquire a vocabulary and practice of the profession for which they are being formed. Plane elasticity concepts are introduced from the tension and compression testing of test pieces of steel and concrete. The behavior of reticulated and articulated structures is reinforced by some interactive games and concepts of tension, compression, local and global buckling will by tests to break articulated structures. Pure bending concepts, simple and composite torsion will be studied by observing a flexible specimen. Earthquake resistant design of buildings will be checked by a laboratory test video.