STRATEGIC-1: A multiple-lines, randomized, open-label GERCOR phase III study in patients with unresectable wild-type RAS metastatic colorectal cancer.

BACKGROUND: The management of unresectable metastatic colorectal cancer (mCRC) is a comprehensive treatment strategy involving several lines of therapy, maintenance, salvage surgery, and treatment-free intervals. Besides chemotherapy (fluoropyrimidine, oxaliplatin, irinotecan), molecular-targeted agents such as anti-angiogenic agents (bevacizumab, aflibercept, regorafenib) and anti-epidermal growth factor receptor agents (cetuximab, panitumumab) have become available. Ultimately, given the increasing cost of new active compounds, new strategy trials are needed to define the optimal use and the best sequencing of these agents. Such new clinical trials require alternative endpoints that can capture the effect of several treatment lines and be measured earlier than overall survival to help shorten the duration and reduce the size and cost of trials. METHODS/DESIGN: STRATEGIC-1 is an international, open-label, randomized, multicenter phase III trial designed to determine an optimally personalized treatment sequence of the available treatment modalities in patients with unresectable RAS wild-type mCRC. Two standard treatment strategies are compared: first-line FOLFIRI-cetuximab, followed by oxaliplatin-based second-line chemotherapy with bevacizumab (Arm A) vs. first-line OPTIMOX-bevacizumab, followed by irinotecan-based second-line chemotherapy with bevacizumab, and by an anti-epidermal growth factor receptor monoclonal antibody with or without irinotecan as third-line treatment (Arm B). The primary endpoint is duration of disease control. A total of 500 patients will be randomized in a 1:1 ratio to one of the two treatment strategies. DISCUSSION: The STRATEGIC-1 trial is designed to give global information on the therapeutic sequences in patients with unresectable RAS wild-type mCRC that in turn is likely to have a significant impact on the management of this patient population. The trial is open for inclusion since August 2013. TRIAL REGISTRATION: STRATEGIC-1 is registered at Clinicaltrials.gov: NCT01910610, 23 July, 2013. STRATEGIC-1 is registered at EudraCT-No.: 2013-001928-19, 25 April, 2013.

Ilmastonmuutoksen vaikutus energialiiketoimintaan

Tässä kandidaatin työssä tarkasteltiin ilmastonmuutoksen vaikutuksia energialiiketoimintaan Suomessa. Ilmastonmuutoksen vaikutuksia on tutkittu RCAO- ilmastomallilla, missä luotiin ilmaston muuttumisen skenaariot eri ilmastotekijöille ajanjaksolle 2016- 2045. Mallin avulla saadut tulokset ovat suuntaa antavia ja niihin on suhtauduttava kriittisesti. Ilmastonmuutoksen myötä on odotettavissa, että vikojen määrä tulee lisääntymään. Suomessa suuri osa keskijänniteverkosta on rakennettu metsien läpi ja ne ovat erittäin vika-alttiita. Tuulisuuden lisääntyminen, ukkosmäärien kasvu ja tykkylumi lisäävät tulevaisuudessa metsien keskelle rakennettujen verkkojen vikoja ellei niitä kehitetä vikavarmemmiksi. Verkkojen siirtäminen teiden varsiin ja kaapelointiasteen lisääminen ovat varmasti oikeita ratkaisuja tulevaisuuden kannalta. Verkkoyhtiöille ilmastonmuutos aiheuttaa luultavasti enemmän haittoja kuin hyötyjä. Vikojen lisääntyminen ja kunnossapidon kasvu aiheuttavat kuluja ja heikentävät energialiiketoiminnan kannattavuutta. Verkon luotettavuuden parantaminen näkyy investointikustannusten kasvuna. Sadannan lisääntyminen ja routaantumisen vähentyminen pehmentää maata ja heikentää kunnossapitoon käytettävien koneiden liikkumista maastossa.

Neuroinflammatory TNFα Impairs Memory via Astrocyte Signaling.

The occurrence of cognitive disturbances upon CNS inflammation or infection has been correlated with increased levels of the cytokine tumor necrosis factor-α (TNFα). To date, however, no specific mechanism via which this cytokine could alter cognitive circuits has been demonstrated. Here, we show that local increase of TNFα in the hippocampal dentate gyrus activates astrocyte TNF receptor type 1 (TNFR1), which in turn triggers an astrocyte-neuron signaling cascade that results in persistent functional modification of hippocampal excitatory synapses. Astrocytic TNFR1 signaling is necessary for the hippocampal synaptic alteration and contextual learning-memory impairment observed in experimental autoimmune encephalitis (EAE), an animal model of multiple sclerosis (MS). This process may contribute to the pathogenesis of cognitive disturbances in MS, as well as in other CNS conditions accompanied by inflammatory states or infections.

Pediatric advance care planning from the perspective of health care professionals: a qualitative interview study.

BACKGROUND: Pediatric advance care planning differs from the adult setting in several aspects, including patients' diagnoses, minor age, and questionable capacity to consent. So far, research has largely neglected the professionals' perspective. AIM: We aimed to investigate the attitudes and needs of health care professionals with regard to pediatric advance care planning. DESIGN: This is a qualitative interview study with experts in pediatric end-of-life care. A qualitative content analysis was performed. SETTING/PARTICIPANTS: We conducted 17 semi-structured interviews with health care professionals caring for severely ill children/adolescents, from different professions, care settings, and institutions. RESULTS: Perceived problems with pediatric advance care planning relate to professionals' discomfort and uncertainty regarding end-of-life decisions and advance directives. Conflicts may arise between physicians and non-medical care providers because both avoid taking responsibility for treatment limitations according to a minor's advance directive. Nevertheless, pediatric advance care planning is perceived as helpful by providing an action plan for everyone and ensuring that patient/parent wishes are respected. Important requirements for pediatric advance care planning were identified as follows: repeated discussions and shared decision-making with the family, a qualified facilitator who ensures continuity throughout the whole process, multi-professional conferences, as well as professional education on advance care planning. CONCLUSION: Despite a perceived need for pediatric advance care planning, several barriers to its implementation were identified. The results remain to be verified in a larger cohort of health care professionals. Future research should focus on developing and testing strategies for overcoming the existing barriers.

Monitoimityöstökeskuksen kokonaistehokkuuden parantaminen kokonaisvaltaisella tuottavalla kunnossapidolla

Tämän diplomityön tavoitteena oli tutustua kokonaisvaltaisen tuottavan kunnossapidon teoriaan ja soveltaa sitä Abloy Oy Joensuun tehtaalla pilottikohteeksi valittuun koneeseen. Pilottikohteeksi oli valittu uusi Sveitsiläinen Hydromat-monitoimityöstökeskus, jonka kokonaistehokkuutta (OEE) pyrittiin parantamaan kokonaisvaltaisella tuottavalla kunnossapidolla (TPM). Työn kirjallisuusosuudessa tarkastellaan teoriatietoja, jotka liittyvät yleisesti kunnossapitoon ja tarkemmin TPM-toimintaan. Lisäksi käsitellään kunnossapidon mittareita ja tietojärjestelmiä. Työn empiirisessä osassa selvitetään, kuinka TPM-toiminta otettiin käyttöön Hydromat-monitoimityöstökeskuksen osalta. Eniten resursseja käytettiin koneen asetusaikojen lyhentämiseen. Lisäksi koneen käyttäjien itsenäiseen kunnossapitoon siirtyminen kuului työn sisältöön. Työssä on selvitetty myös uuden tuotannon seurantataulun käyttöönotto. Seurantataulusta nähdään useita tuotantotietoja kuten kokonaistehokkuus. Työn merkittävimmät tulokset osoittavat, että asetusajat ovat tällä hekellä hyvin pitkiä tavoitteisiin nähden. Asetusaikojen lyhentyminen halutulle tasolle vaatii koneen käyttäjien pitkän oppimisprosessin sekä optimaaliset toimintaolosuhteet. Lisäksi havaittiin, että uuden toimintamallin esitteleminen ja sen käyttöönotto valmistavassa teollisuudessa on vaativa prosessi.

Patterns of impact resulting from a 'sit less, move more' web-based program in sedentary office employees

Purpose Encouraging office workers to ‘sit less and move more’ encompasses two public health priorities. However, there is little evidence on the effectiveness of workplace interventions for reducing sitting, even less about the longer term effects of such interventions and still less on dual-focused interventions. This study assessed the short and mid-term impacts of a workplace web-based intervention (Walk@WorkSpain, W@WS; 2010-11) on self-reported sitting time, step counts and physical risk factors (waist circumference, BMI, blood pressure) for chronic disease. Methods Employees at six Spanish university campuses (n=264; 42±10 years; 171 female) were randomly assigned by worksite and campus to an Intervention (used W@WS; n=129; 87 female) or a Comparison group (maintained normal behavior; n=135; 84 female). This phased, 19-week program aimed to decrease occupational sitting time through increased incidental movement and short walks. A linear mixed model assessed changes in outcome measures between the baseline, ramping (8 weeks), maintenance (11 weeks) and followup (two months) phases for Intervention versus Comparison groups.A significant 2 (group) × 2 (program phases) interaction was found for self-reported occupational sitting (F[3]=7.97, p=0.046), daily step counts (F[3]=15.68, p=0.0013) and waist circumference (F[3]=11.67, p=0.0086). The Intervention group decreased minutes of daily occupational sitting while also increasing step counts from baseline (446±126; 8,862±2,475) through ramping (+425±120; 9,345±2,435), maintenance (+422±123; 9,638±3,131) and follow-up (+414±129; 9,786±3,205). In the Comparison group, compared to baseline (404±106), sitting time remained unchanged through ramping and maintenance, but decreased at follow-up (-388±120), while step counts diminished across all phases. The Intervention group significantly reduced waist circumference by 2.1cms from baseline to follow-up while the Comparison group reduced waist circumference by 1.3cms over the same period. Conclusions W@WSis a feasible and effective evidence-based intervention that can be successfully deployed with sedentary employees to elicit sustained changes on “sitting less and moving more”.

Efficacy of methotrexate to prevent postoperative recurrence of Crohn's disease

BACKGROUND: endoscopic postoperative recurrence (POR) of Crohn’s disease (CD) is the presence of lesions in previously unaffected intestinal segments and occurs in up to 85% of patients one year after bowel resection. Patients at low risk for POR can either remain untreated until lesions recur or receive immediate prevention after surgery with mesalazine, azathioprine (AZA) and/or metronidazole, although with moderate benefit. Out of the postoperative setting, methotrexate (MTX) has been shown to be efficacious for induction and maintenance of remission and has been established as the second-line immunosuppressant for patients with CD unresponsive or intolerant to AZA.AIMS: to determine the efficacy and safety of MTX to prevent endoscopic and clinical POR at 24 weeks after surgery in low risk patientsMETHODS: the study consists on a multicenter, randomized, double-blind and placebo-controlled clinical trial that will enroll 132 patients at low risk for POR (non-smokers, first intestinal resection, non-penetrating behavior). Patients will be randomized to receive subcutaneous MTX at doses of 25 mg/week or an identical placebo, for 24 weeks. Endoscopic and clinical assessment of POR will be performed after 24 weeks (6 months) of treatment. The main outcome is endoscopic POR, defined as a Rutgeerts score of >i2, and secondary outcomes include clinical POR, defined as >i2 lesions plus a Crohn’s Disease Activity Index (CDAI) >150, and description of adverse events

Sistema per gestionar les incidències d'un servei d'informàtica amb una arquitectura J2EE distribuïda en tres nivells

Tant en la meva etapa d’estudiant com en la meva curta vida laboral, he participat en el desenvolupament de varies aplicacions de gestió, tant d’escriptori com web, que majoritàriament sempre estaven dividides en tres capes però en dos nivells: la base de dades i l’aplicació, que contenia tant la lògica de negoci com la vista. Des de fa temps he tingut la curiositat i la necessitat d’intentar desenvolupar una aplicació de gestió que estigui distribuïda en tres o més nivells, separant el model de dades i la lògica de negoci de la vista. Crec que el treball de fi de carrera és idoni per desenvolupar-la. L’aplicació a desenvolupar anirà destinada a la gestió d’un servei d’informàtica, que s’encarrega de resoldre les incidències, inventariar i realitzar el manteniment preventiu dels equips informàtics d’una o de varies empreses. Es crearà una aplicació que contindrà el model de dades i la lògica de negoci. També es crearan dues aplicacions clients: una aplicació d’escriptori que donarà accés a totes i cadascuna de les funcionalitats del sistema i una aplicació web que oferirà un accés lleuger i des de qualsevol ubicació a les funcionalitats d’explotació del sistema. Per últim, també es crearà una altre aplicació web que s’encarregarà de generar els llistats sol•licitats per les dues aplicacions clients. D’aquesta manera també es centralitzarà la gestió dels llistats de les aplicacions del sistema. Per desenvolupar el sistema, s’utilitzarà la plataforma J2EE de Java, i es comptarà amb l’ajuda de marcs de treball com, per exemple, Oracle ADF o JasperReports. Com a conclusió general, puc assegurar que si es distribueixen les tres capes d’un sistema en tres nivells s’obtenen beneficis en l’administració, en el manteniment, en l’escalabilitat, en la flexibilitat i en la reutilització de les aplicacions. El principal inconvenient és el possible augment de lentitud en les aplicacions clients.

O ensino de reações orgânicas usando química computacional: I. reações de adição eletrofílica a alquenos

Basic concepts that play an important role in some organic reactions are revisited in this paper, which reports a pedagogical experience involving undergraduate and graduate students. A systematic procedure has been applied in order to use widespread available computational tools. This paper aims to discuss the use of computers in teaching electrophilic addition reactions to alkenes. Two classical examples have been investigated: addition to non-conjugated alkenes and addition to conjugated dienes. The results were compared with those normally discussed in organic textbooks. Several important concepts, such as conformational analysis and energy control (kinetic and thermodynamic) involved in reaction mechanisms can be taught more efficiently if one connects theoretical and practical tools.

Determinação de As, Cd e Pb em amêndoas e mesocarpo de babaçu, sapucaia, xixá e castanha-do-pará por espectrometria de absorção atômica

This work describes methods for the simultaneous determination of Cd and Pb by graphite furnace atomic absorption spectrometry and As by hydride generation atomic absorption spectrometry in Brazilian nuts. The samples (~ 0.300 g) were digested to clear solutions in a closed vessel microwave oven. The pyrolysis and atomization temperatures for simultaneous determinations of Cd and Pb were 1100 and 2100 °C, respectively, using 0.5% (w v-1) NH4H2PO4 + 0.03% (w v-1) Mg(NO3)2 as chemical modifier. The limits of detection (3Δ) were 3.8 μg kg-1 for As, 0.86 μg kg-1 for Cd and 13 μg kg-1 for Pb. The reliability of the entire procedures was confirmed by peach leaves (No. 1547 - NIST) certified reference material analysis and addition and recovery tests. The found concentrations presented no statistical differences at the 95% confidence level.

Contribuição da fitoquímica para o desenvolvimento de um país emergente

The sustainable development of an emergent country is dependent on a consistent scientific, technologic and innovative policy, on nature and biodiversity, on a rational exploration of natural resources to feeding, social advance and economical aim along with maintenance of health and diseases treatment. Phytochemical investigations may be used to contribute with development throughout undergraduate and graduate career preparing professionals with qualification to these activities, as researcher and professor, including discovering and divulgation of new scientific knowlegments. The role of organic compounds produced by secondary metabolism of plants in the development of new drugs is presented (e. g.) throughout exposition using examples of features involved in this activity, since the recognition of a plant-derived popular medicine, until the laboratory semi-synthesis of its main constituents. Several aspects related to the use of some vegetable species in treatment of many tropical diseases are pointed. Economical and social importance of isolation, structural characterization, pharmacological investigation and chemical transformations of new natural organic substances isolated from the plants are related.

Síntese e caracterização de copolímeros do tipo ABA para encapsulação de hemoglobina bovina

The use of biopolymers for the development of oxygen carriers has been extensively investigated. In this work, three different ABA triblock copolymers were synthesized and used to encapsulate purified bovine hemoglobin, using a double emulsion technique. The effect of polymer composition, homogenization velocity, and addition of a surfactant, on the protein entrapment was evaluated. These copolymers, which have a hydrophilic block, achieved higher values of encapsulation efficiency than the corresponding homopolymers. The increase in homogenization strength also promoted an increase in encapsulation efficiency. Capsules formation occurred even in the absence of PVA.

Investigação eletroquímica e calorimétrica da interação de novos agentes antitumorais biscatiônicos com DNA

Biscationic amidines bind in the DNA minor groove and present biological activity against a range of infectious diseases. Two new biscationic compounds (bis-α,ω-S-thioureido, amino and sulfide analogues) were synthesized in good yields and fully characterized, and their interaction with DNA was also investigated. Isothermal titration calorimetry (ITC) was used to measure the thermodynamic properties of binding interactions between DNA and these ligands. A double stranded calf thymus DNA immobilized on an electrode surface was used to study the possible DNA-interacting abilities of these compounds towards dsDNA in situ. A remarkable interaction of these compounds with DNA was demonstrated and their potential application as anticancer agents was furthered.

The structures of the honeydew oligosaccharides synthesized by Claviceps africana

The structures of the principal oligosaccharides in the honeydew exudate of the sorghum ergot pathogen Claviceps africana, which has become epidemic in the Americas, have been characterized through linkage analysis using FAB-MS and GC-MS techniques, as 1,6-di-b-D-fructofuranosyl-D-mannitol and 1,5-di-b-D-fructofuranosyl-D-arabitol trisaccharides, 1-b-D-fructofuranosyl-D-mannitol and 5-b-D-fructofuranosyl-D-arabitol disaccharides and other minor disaccharides and trisaccharides. Their structural diversity is explained according to perceived biosynthetic interrelationships in pathways that appear to be unique amongst ergot fungi, particularly concerning intra-molecular reduction of fructose. The oligosaccharide, 1,6-di-b-D-fructofuranosyl-D-mannitol, which inhibits C. africana macrospore germination at a concentration in water of 1 g/mL or more, forms together with other slightly less bioactive oligosaccharides, the basis of a novel strategy to limit ergot disease losses in hybrid sorghum seed production.

Imazapyr root exudation from eucalypt seedlings cultivated in nutritive solution

Imazapyr has been used in Brazilian eucalypt cultivation for the maintenance of clearings and coppicing control in areas undergoing stand reform. However, inquiries have been made as to the final fate of the molecule. Imazapyr root exudation in eucalypt plants was evaluated through a bioassay under greenhouse conditions, by applying different herbicide doses (0.000, 0.375, 0.750, 1.125, and 1.500 kg ha-1 a.i.) on Eucalyptus grandis seedlings derived from vegetative propagation, hydroponically cultivated in 2.500 ml vases. Forty-day-old seedlings of the same clone were used as bioindicators, transplanted to the vases two days after herbicide application. After a period of 13 days of coexistence, the sprayed plants were removed and discarded; ten days later, the visual symptoms of toxicity were evaluated and the total dry biomass (aerial part and roots) of the bioindicators were determined. The lowest herbicide dose (0.375 kg ha-1 a.i.) affected the total biomass and growth, being most evident in the aerial part, with larger I50 for root dry biomass. The E. grandis seedlings exuded imazapyr, and/or its metabolites, in concentrations capable of affecting the growth of plants of the same species.