Accelerated partial irradiation for breast cancer: Systematic review and meta-analysis of 8653 women in eight randomized trials

Background and purpose: Accelerated partial breast irradiation (APBI) is the strategy that allows adjuvant treatment delivery in a shorter period of time in smaller volumes. This study was undertaken to assess the effectiveness and outcomes of APBI in breast cancer compared with whole-breast irradiation (WBI). Material and methods: Systematic review and meta-analysis of randomized controlled trials of WBI versus APBI. Two authors independently selected and assessed the studies regarding eligibility criteria. Results: Eight studies were selected. A total of 8653 patients were randomly assigned for WBI versus APBI. Six studies reported local recurrence outcomes. Two studies were matched in 5 years and only one study for different time of follow-up. Meta-analysis of two trials assessing 1407 participants showed significant difference in the WBI versus APBI group regarding the 5-year local recurrence rate (HR = 4.54, 95% CI: 1.78-11.61, p = 0.002). Significant difference in favor of WBI for different follow-up times was also found. No differences in nodal recurrence, systemic recurrence, overall survival and mortality rates were observed. Conclusions: APBI is associated with higher local recurrence compared to WBI without compromising other clinical outcomes. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

Jam To-morrow and Jam Yesterday, but Never Jam To-day: The of Theology Libraries Planning the Twenty-first Century

The future of theology libraries is far from clear. Since the nineteenth century, theology libraries have evolved to support the work of theological education. This article briefly reviews the development of theology libraries in North America and examines the contextual changes impacting theology libraries today. Three significant factors that will shape theology libraries in the coming decade are collaborative models of pedagogy and scholarship, globalization and rapid changes in information technology, and changes in the nature of scholarly publishing including the digitization of information. A large body of research is available to assist those responsible for guiding the direction of theology libraries in the next decade, but there are significant gaps in what we know about the impact of technology on how people use information that must be filled in order to provide a solid foundation for planning.

Reading Scripture in Conflicts

sermon text; MS Word document

Evangelicals, Islamists and the globalisation of apocalyptic discourse

After 9/11, it has become increasingly obvious that strongly held religious convictions about the end of the world cannot be dismissed as the predictable consequences of deprivation, as several generations of social scientists once claimed. Instead, it has become clear that these kinds of ideas, having a life of their own, may establish discourses which may have extraordinary capacity to cross nations, cultures and even religions, encouraging passive withdrawal from the political world as well as inspiring vicious and sometimes violent attempts at its subjugation, underwriting the ‘war on terror’ as well as inspiring some of those intent on the destruction of the United States. This article describes one of Ireland’s most successful intellectual exports – a very specific system of thinking about the end of the world known as ‘dispensational premillennialism.’ And the article will move from county Wicklow in the early nineteenth century, through the troubled decades of American modernity, to arrive, perhaps unexpectedly, in the company of the soldiers of radical jihad. The article will describe the globalisation of a discourse which was developed among the most privileged classes of early nineteenth-century Ireland to explain and justify their attempt to withdraw from the world, and which has more recently been used to explain and justify sometimes violent political interventions by both prominent Western politicians and some of the most marginalised and desperate inhabitants of our broken twenty-first century.

A highly efficient sensor platform using simply manufactured nanodot patterned substrates

Block copolymer (BCP) self-assembly is a low-cost means to nanopattern surfaces. Here, we use these nanopatterns to directly print arrays of nanodots onto a conducting substrate (Indium Tin Oxide (ITO) coated glass) for application as an electrochemical sensor for ethanol (EtOH) and hydrogen peroxide (H

Interleukin 10 reduces the incidence of pancreatitis after therapeutic endoscopic retrograde cholangiopancreatography.

BACKGROUND & AIMS: Prophylactic administration of interleukin (IL)-10 decreases the severity of experimental pancreatitis. Prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis in humans is a unique model to study the potential role of IL-10 in this setting. METHODS: In a single-center, double-blind, randomized, placebo-controlled study, the effect of a single injection of 4 microg/kg (group 1) or 20 microg/kg (group 2) IL-10 was compared with that of placebo (group 0), all administered 30 minutes before therapeutic ERCP. The primary endpoint was the effect of IL-10 on serum levels of amylases and lipases measured 4, 24, and 48 hours after ERCP. The secondary objective was to evaluate changes in plasma cytokines (IL-6, IL-8, tumor necrosis factor) at the same time points and the incidence of acute pancreatitis in the 3 groups. Subjects undergoing a first therapeutic ERCP were eligible for inclusion. RESULTS: A total of 144 patients were included. Seven were excluded based on intention to treat (n = 1) or per protocol (n = 6). Forty-five, 48, and 44 patients remained in groups 0, 1, and 2, respectively. The 3 groups were comparable for age, sex, underlying disease, indication for treatment, type of treatment, and plasma levels of C-reactive protein (CRP), cytokines, and hydrolases at baseline. No significant difference was observed in CRP, cytokine, and hydrolase plasma levels after ERCP. Forty-three patients developed hyperhydrolasemia (18 in group 0, 14 in group 1, and 11 in group 2; P = 0.297), and 19 patients developed acute clinical pancreatitis (11 in group 0, 5 in group 1, 3 in group 2; P = 0.038). Two severe cases were observed in the placebo group. No mortality related to ERCP was observed. Logistic regression identified 3 independent risk factors for post-therapeutic ERCP pancreatitis: IL-10 administration (odds ratio [OR], 0.46; 95% confidence interval [95% CI], 0.22-0.96; P = 0.039), pancreatic sphincterotomy (OR, 5.04; 95% CI, 1.53-16.61; P = 0.008), and acinarization (OR, 8.19; 95% CI, 1.83-36.57; P = 0.006). CONCLUSIONS: A single intravenous dose of IL-10, given 30 minutes before the start of the procedure, independently reduces the incidence of post-therapeutic ERCP pancreatitis.

Neural network analysis identifies scaffold properties necessary for in vitro chondrogenesis in elastin-like polypeptide biopolymer scaffolds.

The successful design of biomaterial scaffolds for articular cartilage tissue engineering requires an understanding of the impact of combinations of material formulation parameters on diverse and competing functional outcomes of biomaterial performance. This study sought to explore the use of a type of unsupervised artificial network, a self-organizing map, to identify relationships between scaffold formulation parameters (crosslink density, molecular weight, and concentration) and 11 such outcomes (including mechanical properties, matrix accumulation, metabolite usage and production, and histological appearance) for scaffolds formed from crosslinked elastin-like polypeptide (ELP) hydrogels. The artificial neural network recognized patterns in functional outcomes and provided a set of relationships between ELP formulation parameters and measured outcomes. Mapping resulted in the best mean separation amongst neurons for mechanical properties and pointed to crosslink density as the strongest predictor of most outcomes, followed by ELP concentration. The map also grouped formulations together that simultaneously resulted in the highest values for matrix production, greatest changes in metabolite consumption or production, and highest histological scores, indicating that the network was able to recognize patterns amongst diverse measurement outcomes. These results demonstrated the utility of artificial neural network tools for recognizing relationships in systems with competing parameters, toward the goal of optimizing and accelerating the design of biomaterial scaffolds for articular cartilage tissue engineering.

Progress in intra-articular therapy.

Diarthrodial joints are well suited to intra-articular injection, and the local delivery of therapeutics in this fashion brings several potential advantages to the treatment of a wide range of arthropathies. Possible benefits over systemic delivery include increased bioavailability, reduced systemic exposure, fewer adverse events, and lower total drug costs. Nevertheless, intra-articular therapy is challenging because of the rapid egress of injected materials from the joint space; this elimination is true of both small molecules, which exit via synovial capillaries, and of macromolecules, which are cleared by the lymphatic system. In general, soluble materials have an intra-articular dwell time measured only in hours. Corticosteroids and hyaluronate preparations constitute the mainstay of FDA-approved intra-articular therapeutics. Recombinant proteins, autologous blood products and analgesics have also found clinical use via intra-articular delivery. Several alternative approaches, such as local delivery of cell and gene therapy, as well as the use of microparticles, liposomes, and modified drugs, are in various stages of preclinical development.

Participant, rater, and computer measures of coherence in posttraumatic stress disorder.

We examined the coherence of trauma memories in a trauma-exposed community sample of 30 adults with and 30 without posttraumatic stress disorder. The groups had similar categories of traumas and were matched on multiple factors that could affect the coherence of memories. We compared the transcribed oral trauma memories of participants with their most important and most positive memories. A comprehensive set of 28 measures of coherence including 3 ratings by the participants, 7 ratings by outside raters, and 18 computer-scored measures, provided a variety of approaches to defining and measuring coherence. A multivariate analysis of variance indicated differences in coherence among the trauma, important, and positive memories, but not between the diagnostic groups or their interaction with these memory types. Most differences were small in magnitude; in some cases, the trauma memories were more, rather than less, coherent than the control memories. Where differences existed, the results agreed with the existing literature, suggesting that factors other than the incoherence of trauma memories are most likely to be central to the maintenance of posttraumatic stress disorder and thus its treatment.

Conocimiento del contenido sobre polígonos de estudiantes para profesor de matemáticas

En este trabajo analizamos el conocimiento geométrico sobre polígonos de estudiantes para profesor peruano. Este conocimiento se describe en función de las capacidades que evidencian. Hemos determinado dichas capacidades con base en el modelo de razonamiento de Van Hiele y en consideraciones sobre el aprendizaje geométrico. Mostramos los resultados generales del grupo de alumnos, así como el estudio de dos casos.

An open shop scheduling problem with a non-bottleneck machine

This paper considers the problem of processing n jobs in a two-machine non-preemptive open shop to minimize the makespan, i.e., the maximum completion time. One of the machines is assumed to be non-bottleneck. It is shown that, unlike its flow shop counterpart, the problem is NP-hard in the ordinary sense. On the other hand, the problem is shown to be solvable by a dynamic programming algorithm that requires pseudopolynomial time. The latter algorithm can be converted into a fully polynomial approximation scheme that runs in time. An O(n log n) approximation algorithm is also designed whi finds a schedule with makespan at most 5/4 times the optimal value, and this bound is tight.