Postoperative Adjuvant Lapatinib and Concurrent Chemoradiotherapy Followed by Maintenance Lapatinib Monotherapy in High-Risk Patients With Resected Squamous Cell Carcinoma of the Head and Neck: A Phase III, Randomized, Double-Blind, Placebo-Controlled Study.

PURPOSE: This multicenter phase III study evaluated the efficacy and safety of lapatinib, an epidermal growth factor receptor/ErbB2 inhibitor, administered concomitantly with chemoradiotherapy and as maintenance monotherapy in patients with high-risk surgically treated squamous cell carcinoma of the head and neck (SCCHN). PATIENTS AND METHODS: Patients with resected stage II to IVA SCCHN, with a surgical margin ≤ 5 mm and/or extracapsular extension, were randomly assigned to chemoradiotherapy (66 Gy total radiation dose and cisplatin 100 mg/m(2) per day administered on days 1, 22, and 43) plus placebo or lapatinib (1,500 mg per day) before and during chemoradiotherapy, followed by 12 months of maintenance monotherapy. RESULTS: Six hundred eighty-eight patients were enrolled (lapatinib, n = 346; placebo, n = 342). With a median follow-up time of 35.3 months, the study ended early because of the apparent plateauing of disease-free survival (DFS) events. Median DFS assessed by an independent review committee was 53.6 months and not reached for lapatinib and placebo, respectively (hazard ratio, 1.10; 95% CI, 0.85 to 1.43). Investigator-assessed results confirmed the independent review committee assessment. No significant differences in DFS by human papillomavirus status or overall survival were observed between treatment arms. Similar numbers of patients in both treatment arms experienced adverse events (AEs), with more patients in the lapatinib arm than the placebo arm experiencing serious AEs (48% v 40%, respectively). The most commonly observed treatment-related AEs were diarrhea and rash, both predominantly in the lapatinib arm. CONCLUSION: Addition of lapatinib to chemoradiotherapy and its use as long-term maintenance therapy does not offer any efficacy benefits and had additional toxicity compared with placebo in patients with surgically treated high-risk SCCHN.

Le visage au-delà de l'apparence. Levinas et l'autre rive de l'éthique

In this article I look at the significance of Emmanuel Levinas' thought for an ethics of care. I argue that the meaning Levinas gives to the term « face » is a central aspect related to this issue. The face is in this French philosopher's view an ambiguous phenomenon, an enigma, that bears high ethical significance : beyond its physical appearance, the face of the other escapes every affort at representation, it indicates the way in which the representation of the other exceeds any idea of the other in me, and it is precisely this irreducibility of alterity that lights up its ethical meaning. In Levinas' view, to be oneself is to be for the other, and the otherness of the other manifests itself in the face-to-face encounter. Accordingly, responsibility is the response to the injunction, the interpellation, of the other's face, preceding the claim of justice, and humaneness is conceived as entangled in the other's face. Against this background, I suggest that Levinas' philosophical insight constitutes a turning point from a traditional to a new conception of responsibility that may bear great significance to a renewed understanding of an hermeneutics and an ethics of care.

Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants.

One of the global targets for non-communicable diseases is to halt, by 2025, the rise in the age-standardised adult prevalence of diabetes at its 2010 levels. We aimed to estimate worldwide trends in diabetes, how likely it is for countries to achieve the global target, and how changes in prevalence, together with population growth and ageing, are affecting the number of adults with diabetes. We pooled data from population-based studies that had collected data on diabetes through measurement of its biomarkers. We used a Bayesian hierarchical model to estimate trends in diabetes prevalence-defined as fasting plasma glucose of 7.0 mmol/L or higher, or history of diagnosis with diabetes, or use of insulin or oral hypoglycaemic drugs-in 200 countries and territories in 21 regions, by sex and from 1980 to 2014. We also calculated the posterior probability of meeting the global diabetes target if post-2000 trends continue. We used data from 751 studies including 4,372,000 adults from 146 of the 200 countries we make estimates for. Global age-standardised diabetes prevalence increased from 4.3% (95% credible interval 2.4-7.0) in 1980 to 9.0% (7.2-11.1) in 2014 in men, and from 5.0% (2.9-7.9) to 7.9% (6.4-9.7) in women. The number of adults with diabetes in the world increased from 108 million in 1980 to 422 million in 2014 (28.5% due to the rise in prevalence, 39.7% due to population growth and ageing, and 31.8% due to interaction of these two factors). Age-standardised adult diabetes prevalence in 2014 was lowest in northwestern Europe, and highest in Polynesia and Micronesia, at nearly 25%, followed by Melanesia and the Middle East and north Africa. Between 1980 and 2014 there was little change in age-standardised diabetes prevalence in adult women in continental western Europe, although crude prevalence rose because of ageing of the population. By contrast, age-standardised adult prevalence rose by 15 percentage points in men and women in Polynesia and Micronesia. In 2014, American Samoa had the highest national prevalence of diabetes (>30% in both sexes), with age-standardised adult prevalence also higher than 25% in some other islands in Polynesia and Micronesia. If post-2000 trends continue, the probability of meeting the global target of halting the rise in the prevalence of diabetes by 2025 at the 2010 level worldwide is lower than 1% for men and is 1% for women. Only nine countries for men and 29 countries for women, mostly in western Europe, have a 50% or higher probability of meeting the global target. Since 1980, age-standardised diabetes prevalence in adults has increased, or at best remained unchanged, in every country. Together with population growth and ageing, this rise has led to a near quadrupling of the number of adults with diabetes worldwide. The burden of diabetes, both in terms of prevalence and number of adults affected, has increased faster in low-income and middle-income countries than in high-income countries. Wellcome Trust.

Neuroprotection by selective neuronal deletion of Atg7 in neonatal brain injury.

Perinatal asphyxia induces neuronal cell death and brain injury, and is often associated with irreversible neurological deficits in children. There is an urgent need to elucidate the neuronal death mechanisms occurring after neonatal hypoxia-ischemia (HI). We here investigated the selective neuronal deletion of the Atg7 (autophagy related 7) gene on neuronal cell death and brain injury in a mouse model of severe neonatal hypoxia-ischemia. Neuronal deletion of Atg7 prevented HI-induced autophagy, resulted in 42% decrease of tissue loss compared to wild-type mice after the insult, and reduced cell death in multiple brain regions, including apoptosis, as shown by decreased caspase-dependent and -independent cell death. Moreover, we investigated the lentiform nucleus of human newborns who died after severe perinatal asphyxia and found increased neuronal autophagy after severe hypoxic-ischemic encephalopathy compared to control uninjured brains, as indicated by the numbers of MAP1LC3B/LC3B (microtubule-associated protein 1 light chain 3)-, LAMP1 (lysosomal-associated membrane protein 1)-, and CTSD (cathepsin D)-positive cells. These findings reveal that selective neuronal deletion of Atg7 is strongly protective against neuronal death and overall brain injury occurring after HI and suggest that inhibition of HI-enhanced autophagy should be considered as a potential therapeutic target for the treatment of human newborns developing severe hypoxic-ischemic encephalopathy.

O uso de calorimetria em ecologia

The macroscopic effects caused by sun radiation and the mankind-nature interactions in a ecosystem are firstly presented. However, the importance of calorimetric determinations to clarify some phenomena related to the living microorganism populations and their interactions with the food additive or inhibitor agents are reported. The collect values illustrate the occurence a great deal of effects in this microscopic world. For this subject, the reachest Latosol soil was selected due to the content of organic matter and consequently in microorganisms. Microbial activity was stimulated by addition of glucose, which showed to be the best nutrient source. Inhibitory effect was detected with many compounds used in the agriculture like some herbicides and fungicides. Although the assays are based on the use of the microcalorimetry, other techniques like respirometry contributes strongly to the understanding of the ecosystem. The main objective in this exposition is to stimulate by means of many interesting examples, the importance of preserving the environment in order to establish direct analogies by using the Chemistry in the daily life.

Raideliikenteen opastimien valoyksiköiden koteloiden tuotekehitys

Nykyisin raideliikenteen käytössä olevan opastinjärjestelmän mukaiset opastimet ovat kunnossapidollisesti erittäin haastavia. Niiden korkeus aiheuttaa kunnossapitohenkilöstölle työturvallisuusriskin ja monimutkaiset opastinulokkeet ja - portaalit ovat kalliita rakentaa. Nykyisin käytössä oleva opastinjärjestelmä onkin tarkoitus korvata Opastinjärjestelmä 2010 -nimisellä järjestelmällä, jonka kehitystyö on aloitettu Ratahallintokeskuksessa vuonna 2006. Tämä diplomityö on osa kyseistä kehitystyötä. Työn tarkoituksena on raideliikenteen käyttöön tulevien Opastinjärjestelmä 2010:n mukaisten opastimien valoyksiköiden koteloiden rakenteen suunnittelu ja materiaalinvalinta. Suunnittelutyöhön sisältyvät myös valoyksiköiden häikäisysuojien suunnittelu, sekä opastimien koteloiden liittäminen opastimien jalkoihin. Uusille opastimille suunnitellaan myös putkipaaluperustus. Opastinjärjestelmä 2010:n mukaisten opastimien myötä opastinten sijoittelua voidaan parantaa, ja niiden kunnossapito helpottuu. Uuden järjestelmän opastimien kotelot tarjoavat opastimien valoyksiköille entistä avointa levyrakennetta paremman ilkivaltasuojan. Uusissa opastimissa otetaan käyttöön LED-valoyksiköt, joka vähentää kunnossapitokustannuksia lamppujen vaihtotarpeen pienentyessä.

The effect on prices of the attributes of holiday hotels: a hedonic prices approach

This article examines the effect on price of different characteristics of holiday hotels in the sun-and-beach segment. The effect on price is estimated under the hedonic function perspective by means of random effect models, known also as mixed or panel models. Some 82,000 prices were gathered between 1991 and 1998 from tour operator catalogues. The study reveals huge price differences between 4-star hotels and the rest, coupled with practically no difference between 1-star and 2-star hotels. Other attributes with a significant effect on price are town, hotel size, distance to the beach and availability of parking place. The results can assist hotel managers in shaping pricing and investment strategies

Integrating distributed generation and Smart Grids into single-family house

This study examines Smart Grids and distributed generation, which is connected to a single-family house. The distributed generation comprises small wind power plant and solar panels. The study is done from the consumer point of view and it is divided into two parts. The first part presents the theoretical part and the second part presents the research part. The theoretical part consists of the definition of distributed generation, wind power, solar energy and Smart Grids. The study examines what the Smart Grids will enable. New technology concerning Smart Grids is also examined. The research part introduces wind and sun conditions from two countries. The countries are Finland and Germany. According to the wind and sun conditions of these two countries, the annual electricity production from wind power plant and solar panels will be calculated. The costs of generating electricity from wind and solar energy are calculated from the results of annual electricity productions. The study will also deal with feed-in tariffs, which are supporting systems for renewable energy resources. It is examined in the study, if it is cost-effective for the consumers to use the produced electricity by themselves or sell it to the grid. Finally, figures for both countries are formed. The figures include the calculated cost of generating electricity from wind power plant and solar panels, retail and wholesale prices and feed-in tariffs. In Finland, it is not cost-effective to sell the produced electricity to the grid, before there are support systems. In Germany, it is cost-effective to sell the produced electricity from solar panels to the grid because of feed-in tariffs. On the other hand, in Germany it is cost-effective to produce electricity from wind to own use because the retail price is higher than the produced electricity from wind.

Intracellular membrane trafficking in Osteoclasts The role of direct Rab protein – Rac 1 interactions in the targeting of intracellular vesicles

Osteoclasts are cells responsible for bone resorption. These cells undergo extensive membrane re-organization during their polarization for bone resorption and form four distinct membrane domains, namely the ruffled border, the basolateral membrane, the sealing zone and the functional secretory domain. The endocytic/biosynthetic pathway and transcytotic route(s) are important for the resorption process, since the endocytic/biosynthetic pathway brings the specific vesicles to the ruffled border whereas the transcytotic flow is believed to transport the degraded bone matrix away from the resorption lacuna to the functional secretory domain. In the present study, we found a new transcytotic route from the functional secretory domain to the ruffled border, which may compensate membrane loss from the ruffled border during the resorption process. We also found that lipid rafts are essential for the ruffled border-targeted late endosomal pathways. A small GTP-binding protein, Rab7, has earlier been shown to regulate the late steps of the endocytic pathway. In bone-resorbing osteoclasts it is involved in the formation of the ruffled border, which displays several features of late endosomal membranes. Here we discovered a new Rab7-interacting protein, Rac1, which is another small GTP-binding protein and binds to the GTP-form of Rab7 in vitro. We demonstrated further that Rab7 colocalizes with Rac1 at the fusion zone of the ruffled border in bone-resorbing osteoclasts. In other cell types, such as fibroblast-like cells, this colocalization is mainly perinuclear. Because Rac1 is known to control the actin cytoskeleton through its effectors, we suggest that the Rab7-Rac1 interaction may mediate late endosomal transport between microtubules and microfilaments, thus enabling endosomal vesicles to switch tracks from microtubules to microfilaments before their fusion to the ruffled border. We then studied the role of Rab-Rac1 interaction in the slow recycling pathway. We revealed that Rac1 also binds directly to Rab11 and to some other but not all Rab-proteins, suggesting that Rab-Rac1 interaction could be a general regulatory mechanism to direct the intracellular vesicles from microtubule mediated transport to actin filament mediated transport and vice versa. On the basis of our results we thus propose a new hypothesis for these GTPases in the regulation of intracellular membrane flow.

A Method for Sky-Condition Classification from Ground-Based Solar Radiation Measurements

Identification of clouds from satellite images is now a routine task. Observation of clouds from the ground, however, is still needed to acquire a complete description of cloud conditions. Among the standard meteorologicalvariables, solar radiation is the most affected by cloud cover. In this note, a method for using global and diffuse solar radiation data to classify sky conditions into several classes is suggested. A classical maximum-likelihood method is applied for clustering data. The method is applied to a series of four years of solar radiation data and human cloud observations at a site in Catalonia, Spain. With these data, the accuracy of the solar radiation method as compared with human observations is 45% when nine classes of sky conditions are to be distinguished, and it grows significantly to almost 60% when samples are classified in only five different classes. Most errors are explained by limitations in the database; therefore, further work is under way with a more suitable database

Circumsolar energetic particle distribution on 2011 November 3

Late on 2011 November 3, STEREO-A, STEREO-B, MESSENGER, and near-Earth spacecraft observed an energetic particle flux enhancement. Based on the analysis of in situ plasma and particle observations, their correlation with remote sensing observations, and an interplanetary transport model, we conclude that the particle increases observed at multiple locations had a common single source active region and the energetic particles filled a very broad region around the Sun. The active region was located at the solar backside (as seen from Earth) and was the source of a large flare, a fast and wide coronal mass ejection, and an EIT wave, accompanied by type II and type III radio-emission. In contrast to previous solar energetic particle events showing broad longitudinal spread, this event showed clear particle anisotropies at three widely separated observation points at 1AU, suggesting direct particle injection close to the magnetic footpoint of each spacecraft, lasting for several hours.We discuss these observations and the possible scenarios explaining the extremely broad particle spread for this event.

Descrições de técnicas da química na produção de bens de acordo com os relatos dos naturalistas viajantes no Brasil colonial e imperial

European naturalists explored Brazil in long scientific expeditions and published accounts that make up a rich and still largely untapped historiographic source for the understanding of the history of chemistry. The production of indigo dye, the manufacture of limestone, extraction and purification of saltpeter and the production of salt are discussed. Lime was used to whitewash walls and, mixed with whale oil, as cement to glue stones in buildings of the colonial period. It was prepared by burning seashells in specifically designed ovens. Saltpeter was produced by reacting naturally occurring calcium and magnesium nitrate with potassium-rich wood ashes to yield KNO3. NaCl was obtained by evaporating seawater under the sun. Indigo, a native plant, was cultivated and processed to produce the renowned dye, which was exported to Europe.

Análisis de viabilidad técnica-económica del parque eólico Altos de Peralta

RESUMEN La energia eolica se considera una forma indirecta de energia solar. Entre el 1 y 2% de la energia proveniente del sol se convierte en viento, debido al movimiento del aire ocasionado por el desigual calentamiento de la superficie terrestre. La energia cinetica del viento puede transformarse en energia util, tanto mecanica como electrica. La energia eolica, transformada en energia mecanica ha sido historicamente aprovechada, pero su uso para la generacion de energia electrica es mas reciente, en respuesta a la crisis del petroleo y a los impactos ambientales derivados del uso de combustibles. El objetivo principal de este trabajo es hacer un analisis de viabilidad desde un punto de vista tecnico y economico de un parque eolico situado en el municipio de Barasoain (Navarra). Desde el punto de vista tecnico se han estudiado los aspectos constructivos del parque considerando sus diferentes infraestructuras de obra civil y electrica asi como los niveles de recurso eolico. En el ambito economico y financiero se han analizado los aspectos y ratios mas relevantes que definen un proyecto de estas caracteristicas asi como el modelo de financiacion elegida basada en el Project- Finance. Entre las conclusiones mas destacadas de este proyecto cabe destacar la contribucion de la construccion del parque al desarrollo social y economico de la zona donde queda ubicado contribuyendo a la creacion de puestos de trabajo, tanto en la fase de construccion como de explotacion y una perfecta armonia con condicionantes medioambientales de la zona. El analisis tecnico realizado nos indica la viabilidad tecnica del parque tanto desde el punto de vista de recurso eolico como la idoneidad para poder evacuar la energia producida. Por otro lado, los resultados obtenidos cumplen perfectamente con los estandares requeridos por los financiadores de los parques y resultando ser muy atractivos para sus accionistas

Multi-Eruption Solar Energetic Particle Events Observed by SOHO/ERNE

In the last two decades of studying the Solar Energetic Particle (SEP) phenomenon, intensive emphasis has been put on how and when and where these SEPs are injected into interplanetary space. It is well known that SEPs are related to solar flares and CMEs. However, the role of each in the acceleration of SEPs has been under debate since the major role was taken from flares ascribed to CMEs step by step after the skylab mission, which started the era of CME spaceborn observations. Since then, the shock wave generated by powerful CMEs in between 2-5 solar radii is considered the major accelerator. The current paradigm interprets the prolonged proton intensity-time profile in gradual SEP events as a direct effect of accelerated SEPs by shock wave propagating in the interplanetary medium. Thus the powerful CME is thought of as a starter for the acceleration and its shock wave as a continuing accelerator to result in such an intensity-time profile. Generally it is believed that a single powerful CME which might or might not be associated with a flare is always the reason behind such gradual events.

In this work we use the Energetic and Relativistic Nucleus and Electrons ERNE instrument on board Solar and Heliospheric Observatory SOHO to present an empirical study to show the possibility of multiple accelerations in SEP events. In the beginning we found 18 double-peaked SEP events by examining 88 SEP events. The peaks in the intensity-time profile were separated by 3-24 hours. We divided the SEP events according to possible multiple acceleration into four groups and in one of these groups we find evidence for multiple acceleration in velocity dispersion and change in the abundance ratio associated at transition to the second peak. Then we explored the intensity-time profiles of all SEP events during solar cycle 23 and found that most of the SEP events are associated with multiple eruptions at the Sun and we call those events as Multi-Eruption Solar Energetic Particles (MESEP) events. We use the data available by Large Angle and Spectrometric Coronograph LASCO on board SOHO to determine the CME associated with such events and YOHKOH and GOES satellites data to determine the flare associated with such events. We found four types of MESEP according to the appearance of the peaks in the intensity-time profile in large variation of energy levels. We found that it is not possible to determine whether the peaks are related to an eruption at the Sun or not, only by examining the anisotropy flux, He/p ratio and velocity dispersion. Then we chose a rare event in which there is evidence of SEP acceleration from behind previous CME. This work resulted in a conclusion which is inconsistent with the current SEP paradigm. Then we discovered through examining another MESEP event, that energetic particles accelerated by a second CME can penetrate a previous CME-driven decelerating shock. Finally, we report the previous two MESEP events with new two events and find a common basis for second CME SEPs penetrating previous decelerating shocks. This phenomenon is reported for the first time and expected to have significant impact on modification of the current paradigm of the solar energetic particle events.