Intravenous Busulfan for Autologous Stem Cell Transplantation in Adult Patients with Acute Myeloid Leukemia: a Survey of 952 Patients on Behalf of the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation

Oral busulfan is the historical backbone of the busulfan+cyclophosphamide regimen for autologous stem cell transplantation. However intravenous busulfan has more predictable pharmacokinetics and less toxicity than oral busulfan; we, therefore, retrospectively analyzed data from 952 patients with acute myeloid leukemia who received intravenous busulfan for autologous stem cell transplantation. Most patients were male (n=531, 56%), and the median age at transplantation was 50.5 years. Two-year overall survival, leukemia-free survival, and relapse incidence were 67±2%, 53±2%, and 40±2%, respectively. The non-relapse mortality rate at 2 years was 7±1%. Five patients died from veno-occlusive disease. Overall leukemia-free survival and relapse incidence at 2 years did not differ significantly between the 815 patients transplanted in first complete remission (52±2% and 40±2%, respectively) and the 137 patients transplanted in second complete remission (58±5% and 35±5%, respectively). Cytogenetic risk classification and age were significant prognostic factors: the 2-year leukemia-free survival was 63±4% in patients with good risk cytogenetics, 52±3% in those with intermediate risk cytogenetics, and 37 ± 10% in those with poor risk cytogenetics (P=0.01); patients ≤50 years old had better overall survival (77±2% versus 56±3%; P<0.001), leukemia-free survival (61±3% versus 45±3%; P<0.001), relapse incidence (35±2% versus 45±3%; P<0.005), and non-relapse mortality (4±1% versus 10±2%; P<0.001) than older patients. The combination of intravenous busulfan and high-dose melphalan was associated with the best overall survival (75±4%). Our results suggest that the use of intravenous busulfan simplifies the autograft procedure and confirm the usefulness of autologous stem cell transplantation in acute myeloid leukemia. As in allogeneic transplantation, veno-occlusive disease is an uncommon complication after an autograft using intravenous busulfan.

Financial reporting by European foundations

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Finance from the NOVA – School of Business and Economics

A simulation model for lean, agile, resilient and green supply chain management: practices and interoperability assessment

Dissertação para obtenção do Grau de Mestre em Engenharia e Gestão Industrial

Popular music exhibitions in Portugal: practices of representation from 2007 to 2013

This thesis focuses on the representation of Popular Music in museums by mapping, analyzing, and characterizing its practices in Portugal at the beginning of the 21st century. Now that museums' ability to shape public discourse is acknowledged, the examination of popular music's discourses in museums is of the utmost importance for Ethnomusicology and Popular Music Studies as well as for Museum Studies. The concept of 'heritage' is at the heart of this processes. The study was designed with the aim of moving the exhibiting of popular music in museums forward through a qualitative inquiry of case studies. Data collection involved surveying pop-rock music exhibitions as a qualitative sampling of popular music exhibitions in Portugal from 2007 to 2013. Two of these exhibitions were selected as case studies: No Tempo do Gira-Discos: Um Percurso pela Produção Fonográfica Portuguesa at the Museu da Música in Lisbon in 2007 (also Faculdade de Letras, 2009), and A Magia do Vinil, a Música que Mudou a Sociedade at the Oficina da Cultura in Almada in 2008 (and several other venues, from 2009 to 2013). Two specific domains were observed: popular music exhibitions as instances of museum practice and museum professionals. The first domain encompasses analyzing the types of objects selected for exhibition; the interactive museum practices fostered by the exhibitions; the concepts and narratives used to address popular music discursively, as well as the interpretative practices they allow. The second domain, focuses museum professionals and curators of popular music exhibitions as members of a group, namely their goals, motivations and perspectives. The theoretical frameworks adopted were drawn from the fields of ethnomusicology, popular music studies, and museum studies. The written materials of the exhibitions were subjected of methods of discourse analysis methods. Semi-structured interviews with curators and museum professional were also conducted and analysed. From the museum studies perspective, the study research suggests that the practice adopted by popular music museums largely matches that of conventional museums. From the ethnomusicological and popular music studies stand point, the two case studies reveal two distinct conceptual worlds: the first exhibition, curated by an academic and an independent researcher, points to a mental configuration where popular music is explained through a framework of genres supported by different musical practices. Moreover, it is industry actors such as decision makers and gatekeepers that govern popular music, which implies that the visitors' romantic conception of the musician is to some extent dismantled; the second exhibition, curated by a record collector and specialist, is based on a more conventional process of the everyday historical speech that encodes a mismatch between “good” and “bad music”. Data generated by a survey shows that only one curator, in fact that of my first case study, has an academic background. The backgrounds of all the others are in some way similar to the curator of the second case study. Therefore, I conclude that the second case study best conveys the current practice of exhibiting Popular Music in Portugal.

Cultural journalism in a digital environment : new models, practices and possibilities

Both culture coverage and digital journalism are contemporary phenomena that have undergone several transformations within a short period of time. Whenever the media enters a period of uncertainty such as the present one, there is an attempt to innovate in order to seek sustainability, skip the crisis or find a new public. This indicates that there are new trends to be understood and explored, i.e., how are media innovating in a digital environment? Not only does the professional debate about the future of journalism justify the need to explore the issue, but so do the academic approaches to cultural journalism. However, none of the studies so far have considered innovation as a motto or driver and tried to explain how the media are covering culture, achieving sustainability and engaging with the readers in a digital environment. This research examines how European media which specialize in culture or have an important cultural section are innovating in a digital environment. Specifically, we see how these innovation strategies are being taken in relation to the approach to culture and dominant cultural areas, editorial models, the use of digital tools for telling stories, overall brand positioning and extensions, engagement with the public and business models. We conducted a mixed methods study combining case studies of four media projects, which integrates qualitative web features and content analysis, with quantitative web content analysis. Two major general-interest journalistic brands which started as physical newspapers – The Guardian (London, UK) and Público (Lisbon, Portugal) – a magazine specialized in international affairs, culture and design – Monocle (London, UK) – and a native digital media project that was launched by a cultural organization – Notodo, by La Fábrica – were the four case studies chosen. Findings suggest, on one hand, that we are witnessing a paradigm shift in culture coverage in a digital environment, challenging traditional boundaries related to cultural themes and scope, angles, genres, content format and delivery, engagement and business models. Innovation in the four case studies lies especially along the product dimensions (format and content), brand positioning and process (business model and ways to engage with users). On the other hand, there are still perennial values that are crucial to innovation and sustainability, such as commitment to journalism, consistency (to the reader, to brand extensions and to the advertiser), intelligent differentiation and the capability of knowing what innovation means and how it can be applied, since this thesis also confirms that one formula doesn´t suit all. Changing minds, exceeding cultural inertia and optimizing the memory of the websites, looking at them as living, organic bodies, which continuously interact with the readers in many different ways, and not as a closed collection of articles, are still the main challenges for some media.

An investigation of safety design practices of metal machines

BACKGROUND: Machinery safety issues are a challenge facing manufacturers who are supposed to create and provide products in a better and faster way. In spite of their construction and technological advance, they still contribute to many potential hazards for operators and those nearby. OBJECTIVE: The aim of this study is to investigate safety aspects of metal machinery offered for sale on Internet market according to compliance with minimum and fundamental requirements. METHODS: The study was carried out with the application of a checklist prepared on the basis of Directive 2006/42/EC and Directive 2009/104/EC and regulations enforcing them into Polish law. RESULTS: On the basis of the study it was possible to reveal the safety aspects that were not met in practice. It appeared that in the case of minimum requirements the most relevant problems concerned information, signal and control elements, technology and machinery operations, whereas as far as fundamental aspects are concerned it was hard to assure safe work process. CONCLUSIONS: In spite of the fact that more and more legal acts binding in the Member Countries of the European Union are being introduced to alleviate the phenomenon, these regulations are often not fulfilled.

Seismic-resistant building practices resulting from local seismic culture

Considering that vernacular architecture may bear important lessons on hazard mitigation, this chapter focuses on the European Mediterranean countries and studies traditional seismic-resistant architectural elements and techniques that local populations developed to prevent or repair earthquake damage. This area was selected as a case study because, as a highly seismic region, it has suffered the effect of many earthquakes along the history and, thus, regions within this area are prone to have developed a Local Seismic Culture. After reviewing seismic resistant construction concepts, a wide range of traditional construction solutions that, in many cases, have shown to improve the seismic performance of vernacular constructions of these regions is presented, as a contribution to the general overview of retrofitting building systems provided in this book. The main motivation is that most of these techniques can be successfully applied to preserve and to retrofit surviving examples without prejudice for their identity.

Introduction to special Issue: future priorities in European media and communication research

(Excerto) The European Journal of Communication seeks to present the best in current research in the broad field of media and communication research. Irregularly, we seek to take stock by inviting a small group of leading scholars to present their work at a symposium on a common theme, which then forms the basis for a Special Issue of the Journal. In 2014, the European Science Foundation (ESF) published one of their ‘Forward Looks’ entitled Media in Europe: New Questions for Research and Policy. We subsequently invited several of the Forward Look’s authors to meet and discuss their work with us at a symposium hosted by the European University Cyprus, and the discussion and revised papers that resulted are published here.

Evaluation system in the European Commission : DEVCO’S evaluation methodology

Mestrado em Economia e Políticas Públicas

Effects of selected post harvest processes on brown crab (Cancerpagurus L.) and European lobster (Homarus gammarus L.) from Irish Crustacean Fisheries

The crustacean fishery is important to the socio economics of rural and island communities around Ireland; with brown crab (Cancer pagurus) and European lobster (.Homarus gammarus) being the most valuable shellfish species. Brown crab and lobster are marketed live with the majority being exported from Ireland to southern Europe. Post capture processes used in Ireland are very subjective but promote fresh, live products. Common practices used in the crustacean fishery include nicking of brown crab and long term storage of lobster. This study showed that nicking resulted in elevated mean lactate levels of 17.90% (StDev ± 1.74) and elevated mean glucose levels of 120.55 % (StDev ± 0.26) with mean circulating bacteria levels 9 times greater in nicked crab. Nicking resulted in 96.3% increase in tissue necrosis and a subsequent reduction in product quality. These factors possibly compromise the host’s defense system, which may ultimately reduce the animal’s ability to cope with additional stressors caused by post-harvest processes. Long term storage allows lobster to be stored until the market is less saturated and prices are higher. This investigation found that some lobsters contracted bacterial biofilms as a result of long term storage. Bacteria isolated from biofilms were identified as Arcobacter and Campylobacterales with identity and alignment scores of 80% andd 88% respectively.

When is the Best Time for the Second Antiplatelet Agent in Non-St Elevation Acute Coronary Syndrome?

Abstract Dual antiplatelet therapy is a well-established treatment in patients with non-ST elevation acute coronary syndrome (NSTE-ACS), with class I of recommendation (level of evidence A) in current national and international guidelines. Nonetheless, these guidelines are not precise or consensual regarding the best time to start the second antiplatelet agent. The evidences are conflicting, and after more than a decade using clopidogrel in this scenario, benefits from the routine pretreatment, i.e. without knowing the coronary anatomy, with dual antiplatelet therapy remain uncertain. The recommendation for the upfront treatment with clopidogrel in NSTE-ACS is based on the reduction of non-fatal events in studies that used the conservative strategy with eventual invasive stratification, after many days of the acute event. This approach is different from the current management of these patients, considering the established benefits from the early invasive strategy, especially in moderate to high-risk patients. The only randomized study to date that specifically tested the pretreatment in NSTE-ACS in the context of early invasive strategy, used prasugrel, and it did not show any benefit in reducing ischemic events with pretreatment. On the contrary, its administration increased the risk of bleeding events. This study has brought the pretreatment again into discussion, and led to changes in recent guidelines of the American and European cardiology societies. In this paper, the authors review the main evidence of the pretreatment with dual antiplatelet therapy in NSTE-ACS.

Overuse and underuse of colonoscopy in a European primary care setting.

BACKGROUND: Efforts to decrease overuse of health care may result in underuse. Overuse and underuse of colonoscopy have never been simultaneously evaluated in the same patient population. METHODS: In this prospective observational study, the appropriateness and necessity of referral for colonoscopy were evaluated by using explicit criteria developed by a standardized expert panel method. Inappropriate referrals constituted overuse. Patients with necessary colonoscopy indications who were not referred constituted underuse. Consecutive ambulatory patients with lower gastrointestinal (GI) symptoms from 22 general practices in Switzerland, a country with ready access to colonoscopy, were enrolled during a 4-week period. Follow-up data were obtained at 3 months for patients who did not undergo a necessary colonoscopy. RESULTS: Eight thousand seven hundred sixty patient visits were screened for inclusion; 651 patients (7.4%) had lower GI symptoms (mean age 56.4 years, 68% women). Of these, 78 (12%) were referred for colonoscopy. Indications for colonoscopy in 11 patients (14% of colonoscopy referrals or 1.7% of all patients with lower GI symptoms) were judged inappropriate. Among 573 patients not referred for the procedure, underuse ranged between 11% and 28% of all patients with lower GI symptoms, depending on the criteria used. CONCLUSIONS: Applying criteria from an expert panel of nationally recognized experts indicates that underuse of referral for colonoscopy exceeds overuse in primary care in Switzerland. To improve quality of care, both overuse and underuse of important procedures must be addressed.

The value of selected in vitro and in silico methods to predict acute oral toxicity in a regulatory context: results from the European Project ACuteTox.

ACuteTox is a project within the 6th European Framework Programme which had as one of its goals to develop, optimise and prevalidate a non-animal testing strategy for predicting human acute oral toxicity. In its last 6 months, a challenging exercise was conducted to assess the predictive capacity of the developed testing strategies and final identification of the most promising ones. Thirty-two chemicals were tested blind in the battery of in vitro and in silico methods selected during the first phase of the project. This paper describes the classification approaches studied: single step procedures and two step tiered testing strategies. In summary, four in vitro testing strategies were proposed as best performing in terms of predictive capacity with respect to the European acute oral toxicity classification. In addition, a heuristic testing strategy is suggested that combines the prediction results gained from the neutral red uptake assay performed in 3T3 cells, with information on neurotoxicity alerts identified by the primary rat brain aggregates test method. Octanol-water partition coefficients and in silico prediction of intestinal absorption and blood-brain barrier passage are also considered. This approach allows to reduce the number of chemicals wrongly predicted as not classified (LD50>2000 mg/kg b.w.).

Best practice in the management of mild-to-moderately active ulcerative colitis and achieving maintenance of remission using mesalazine.

Optimizing treatment goals in ulcerative colitis requires recognizing the needs of patients. It is increasingly recognized that adapting treatment strategies aligned with patient needs can improve patient compliance and consequently minimize relapse rates. Tailoring of treatment strategies can improve not only patient quality of life, and decrease the number harmed by adverse events from more potent drugs, but can also save valuable healthcare costs by avoiding high-cost treatment interventions associated with acute ulcerative colitis. This review will consider several elements of mesalazine management from the patient perspective based on a range of clinical and patient-focused evidence. By highlighting patient preferences in disease management it is envisaged that this review will aid physicians to optimize treatment decisions with the different mesalazine preparations available.