Doxorubicin and paclitaxel versus doxorubicin and cyclophosphamide as first-line chemotherapy in metastatic breast cancer: The European Organization for Research and Treatment of Cancer 10961 Multicenter Phase III Trial.

PURPOSE: To compare the efficacy and tolerability of the combination of doxorubicin and paclitaxel (AT) with a standard doxorubicin and cyclophosphamide (AC) regimen as first-line chemotherapy for metastatic breast cancer. PATIENTS AND METHODS: Eligible patients were anthracycline-naive and had bidimensionally measurable metastatic breast cancer. Two hundred seventy-five patients were randomly assigned to be treated with AT (doxorubicin 60 mg/m(2) as an intravenous bolus plus paclitaxel 175 mg/m(2) as a 3-hour infusion) or AC (doxorubicin 60 mg/m(2) plus cyclophosphamide 600 mg/m(2)) every 3 weeks for a maximum of six cycles. A paclitaxel (200 mg/m(2)) and cyclophosphamide (750 mg/m(2)) dose escalation was planned at cycle 2 if no grade >or= 3 neutropenia occurred in cycle 1. The primary efficacy end point was progression-free survival (PFS). Secondary end points were response rate (RR), safety, overall survival (OS), and quality of life. RESULTS: A median number of six cycles were delivered in the two treatment arms. The relative dose-intensity and delivered cumulative dose of doxorubicin were lower in the AT arm. Dose escalation was only possible in 17% and 20% of the AT and AC patients, respectively. Median PFS was 6 months in the two treatments arms. RR was 58% versus 54%, and median OS was 20.6 versus 20.5 months in the AT and AC arms, respectively. The AT regimen was characterized by a higher incidence of febrile neutropenia, 32% versus 9% in the AC arm. CONCLUSION: No differences in the efficacy study end points were observed between the two treatment arms. Treatment-related toxicity compromised doxorubicin-delivered dose-intensity in the paclitaxel-based regimen

Clinical staging versus laparotomy and combined modality with MOPP versus ABVD in early-stage hodgkin's disease: the H6 twin randomized trials from the european organization for research and treatment of cancer lymphoma cooperative group

info:eu-repo/semantics/published

Where are cultural and social in ecosystem services? A framework for constructive engagement

A focus on ecosystem services (ES) is seen as a means for improving decisionmaking. In the research to date, the valuation of the material contributions of ecosystems to human well-being has been emphasized, with less attention to important cultural ES and nonmaterial values. This gap persists because there is no commonly accepted framework for eliciting less tangible values, characterizing their changes, and including them alongside other services in decisionmaking. Here, we develop such a framework for ES research and practice, addressing three challenges: (1) Nonmaterial values are ill suited to characterization using monetary methods; (2) it is difficult to unequivocally link particular changes in socioecological systems to particular changes in cultural benefits; and (3) cultural benefits are associated with many services, not just cultural ES. There is no magic bullet, but our framework may facilitate fuller and more socially acceptable integrations of ES information into planning and management. © 2012 by American Institute of Biological Sciences. All rights reserved.

Harm, hype and evidence: ELSI research and policy guidance.

There has been much investment in research on the ethical, legal and social issues (ELSI) associated with genetic and genomic research. This research should inform the development of the relevant policy. So far, much of the relevant policy - such as in the areas of patents, genetic testing and genetic discrimination - seems to be informed more by speculation of harm and anecdote than by available evidence. Although a quest for evidence cannot always be allowed to delay policy choice, it seems axiomatic to us that policy options are improved by the incorporation of evidence.

Symmetrical freedom quilts: the ethnomathematics of ways of communication, liberation, and art

Symmetrical Freedom Quilts may be considered as links between mathematics, history, ethnomathematics, and the art of quilting. A quilt theme is a pedagogical way to integrate mathematics, art, and history in an interdisciplinary approach. This article combines an ethnomathematical-historical perspective by elaborating a history project related to the Underground Railroad. This work will allow teachers to develop classroom projects that help students to better understand geometry, especially concepts of symmetry and transformations. One of the objectives of this project is to stimulate student’s creativity and interest, because quilts may be considered as cultural and mathematical expressions of student’s daily life.

Research and perspectives on processing instruction

This volume tracks the impact processing instruction has made since its conception. It provides an overview of new research trends on measuring the relative effects of processing instruction. Firstly, the authors explain processing instruction, both its main theoretical underpinnings as well as the guidelines for developing structured input practices. Secondly, they review the empirical research conducted, to date, so that readers have an overview of new research carried out on the effects of processing instruction. The authors finally reflect on the generalizability and limits of the research on processing instruction and offer future directions for processing instruction research.

Delivering processing instruction in classroom and virtual contexts

Processing Instruction (PI) is an approach to grammar instruction for second language learning. It derives its name from the fact that the instruction (both the explicit explanation as well as the practices) attempt to influence, alter, and/or improve the way learners process input. PI contrasts with traditional grammar instruction in many ways, most principally in its focus on input whereas traditional grammar instruction focuses on learners' output. The greatest contribution of PI to both theory and practice is the concept of "structured input", a form of comprehensible input that has been manipulated to maximize learners' benefit of exposure to input. This volume focuses on a new issue for PI, the role of technology in language learning. It examines empirically the differential effects of delivering PI in classrooms with an instructor and students interacting (with each other and with the instructor) versus on computers to students working individually. It also contributes to the growing body of research on the effects of PI on different languages as well as different linguistic items: preterite/imperfect aspectual contrast and negative informal commands in Spanish, the subjunctive of doubt and opinion in Italian, and the subjunctive of doubt in French. Further research contributions are made by comparing PI with other types of instruction, specifically, with meaning-oriented output instruction.

Theory and practice of manual blood pressure management

This article outlines the process of taking a manual blood pressure measurement. The author suggests that it is a skill that nursing students should be using in clinical practice rather than relying on automated monitors.

Continuing Professional Development: rhetoric and practice in the NHS

This article explores the experience of Continuing Professional Development (CPD) by supervisory-level clinical staff in the National Health Service. Four main themes are highlighted in the literature, namely the nature and experience of CPD, its relationship with human resource management practices and in particular in career development and planning. These themes are examined utilising sources of (triangulated) empirical data based on a 2500 sample survey conducted across five NHS Trusts. A key finding was that responsibility for learning and development was perceived as belonging to the individual rather than the organisation. Other findings concern a lack of resource-based commitment by the organisation to CPD for clinical staff undertaking supervisory-level roles and evidence of 'credentialism' with its emphasis on seeking certificated qualifications. The findings raise concerns about the potential for clinical staff to become disillusioned and to perceive a potential breach in their psychological contract because of problems in reconciling their own interests with those of their professional body, and that of their employer in relation to CPD.

Accelerating innovation in the built environment by research and education

Awareness of climate change and adaptations of building stock play a key role in the UK government’s environmental agenda. While some European countries and countries like Japan move forward by bringing their sustainability agenda to the public sector, the UK seems to be slow in embracing these ideas and long term sustainability in improved products and processes for better performance, efficiency and innovative application of renewable technology is yet to come. While funding remains a major constraint research show that a number of detrimental issues including; organisation, risk, mind sets of the stakeholders, planning constraints, reluctance to accept change and the unexploited markets are major contributing factors. Most of these barriers can be overcome with research, development and information and knowledge transfer techniques. Educating all stakeholders can act as an accelerator for innovation. This paper examines innovation in the built environment and how research and education can stimulate this process. It explores drivers and barriers for innovation and how research and education in construction, design, engineering and project management can enhance this process. It presents and discusses lessons learnt from two action research projects in relation to innovation.

Marine plankton phenology and life history in a changing climate: current research and future directions

Increasing availability and extent of biological ocean time series (from both in situ and satellite data) have helped reveal significant phenological variability of marine plankton. The extent to which the range of this variability is modified as a result of climate change is of obvious importance. Here we summarize recent research results on phenology of both phytoplankton and zooplankton. We suggest directions to better quantify and monitor future plankton phenology shifts, including (i) examining the main mode of expected future changes (ecological shifts in timing and spatial distribution to accommodate fixed environmental niches vs. evolutionary adaptation of timing controls to maintain fixed biogeography and seasonality), (ii) broader understanding of phenology at the species and community level (e.g. for zooplankton beyond Calanus and for phytoplankton beyond chlorophyll), (iii) improving and diversifying statistical metrics for indexing timing and trophic synchrony and (iv) improved consideration of spatio-temporal scales and the Lagrangian nature of plankton assemblages to separate time from space changes.

Climate change and marine benthos: a review of existing research and future directions in the North Atlantic

There is growing evidence that climate change could affect marine benthic systems. This review provides information of climate change‐related impacts on the marine benthos in the North Atlantic. We cover a number of related research aspects, mainly in connection to two key issues. First, is the relationship between different physical aspects of climate change and the marine benthos. This section covers: (a) the responses to changes in seawater temperature (biogeographic shifts and phenology); (b) altered Hydrodynamics; (c) ocean acidification (OA); and (d) sea‐level rise‐coastal squeeze. The second major issue addressed is the possible integrated impact of climate change on the benthos. This work is based on relationships between proxies for climate variability, notably the North Atlantic Oscillation (NAO) index, and the long‐term marine benthos. The final section of our review provides a series of conclusions and future directions to support climate change research on marine benthic systems. WIREs Clim Change 2015, 6:203–223. doi: 10.1002/wcc.330

Linking Research and Marketing: A Pharmaceutical Innovation

This chapter describes in very general terms the integration of clinical research and marketing, drawing on books by marketers and recent cases that have come to the public eye. The tools that have been used to accomplish this integration over the past half-century are various, but they all stem from a realization that in a rational world centered on health there need be no intrinsic divide between research and marketing. Most obviously, marketing drugs to physicians, who are professionals acting within their own spheres, depends crucially on research. Physicians respond, and need to see themselves as responding, to fact, figures, and studies. The well-chosen images and vehicles for marketing campaigns must be subordinated to research. Yet at the same time research is a means of increasing sales.