The use of erythropoiesis-stimulating agents with ruxolitinib in patients with myelofibrosis in COMFORT-II: an open-label, phase 3 study assessing efficacy and safety of ruxolitinib versus best available therapy in the treatment of myelofibrosis

BACKGROUND: Anemia is considered a negative prognostic risk factor for survival in patients with myelofibrosis. Most patients with myelofibrosis are anemic, and 35-54 % present with anemia at diagnosis. Ruxolitinib, a potent inhibitor of Janus kinase (JAK) 1 and JAK2, was associated with an overall survival benefit and improvements in splenomegaly and patient-reported outcomes in patients with myelofibrosis in the two phase 3 COMFORT studies. Consistent with the ruxolitinib mechanism of action, anemia was a frequently reported adverse event. In clinical practice, anemia is sometimes managed with erythropoiesis-stimulating agents (ESAs). This post hoc analysis evaluated the safety and efficacy of concomitant ruxolitinib and ESA administration in patients enrolled in COMFORT-II, an open-label, phase 3 study comparing the efficacy and safety of ruxolitinib with best available therapy for treatment of myelofibrosis. Patients were randomized (2:1) to receive ruxolitinib 15 or 20 mg twice daily or best available therapy. Spleen volume was assessed by magnetic resonance imaging or computed tomography scan.

RESULTS: Thirteen of 146 ruxolitinib-treated patients had concomitant ESA administration (+ESA). The median exposure to ruxolitinib was 114 weeks in the +ESA group and 111 weeks in the overall ruxolitinib arm; the median ruxolitinib dose intensity was 33 mg/day for each group. Six weeks before the first ESA administration, 10 of the 13 patients had grade 3/4 hemoglobin abnormalities. These had improved to grade 2 in 7 of the 13 patients by 6 weeks after the first ESA administration. The rate of packed red blood cell transfusions per month within 12 weeks before and after first ESA administration remained the same in 1 patient, decreased in 2 patients, and increased in 3 patients; 7 patients remained transfusion independent. Reductions in splenomegaly were observed in 69 % of evaluable patients (9/13) following first ESA administration.

CONCLUSIONS: Concomitant use of an ESA with ruxolitinib was well tolerated and did not affect the efficacy of ruxolitinib. Further investigations evaluating the effects of ESAs to alleviate anemia in ruxolitinib-treated patients are warranted (ClinicalTrials.gov identifier, NCT00934544; July 6, 2009).

Finite-element investigation of cold-formed steel portal frames in fire

This paper presents the results of a full-scale site fire test performed on a cold-formed steel portal frame building with semi-rigid joints. The purpose of the study is to establish a performance-based approach for the design of such structures in fire boundary conditions. In the full-scale site fire test, the building collapsed asymmetrically at a temperature of 714°C. A non-linear elasto-plastic finite-element shell model is described and is validated against the results of the full-scale test. A parametric study is presented that highlights the importance of in-plane restraint from the side rails in preventing an outwards sway failure for both a single portal and full building geometry model. The study also demonstrates that the semi-rigidity of the joints should be taken into account in the design. The single portal and full building geometry models display a close match to site test results with failure at 682°C and 704°C, respectively. A design case is described in accordance with Steel Construction Institute design recommendations. The validated single portal model is tested with pinned bases, columns protected, realistic loading and rafters subject to symmetric uniform heating in accordance with the ISO 834 standard fire curve; failure occurs at 703°C.

Biocontrol agents promote growth of potato pathogens, depending on environmental conditions

There is a pressing need to understand and optimize biological control so as to avoid over-reliance on the synthetic chemical pesticides that can damage environmental and human health. This study focused on interactions between a novel biocontrol-strain, Bacillus sp. JC12GB43, and potato-pathogenic Phytophthora and Fusarium species. In assays carried out in vitro and on the potato tuber, the bacterium was capable of near-complete inhibition of pathogens. This Bacillus was sufficiently xerotolerant (water activity limit for growth = 0.928) to out-perform Phytophthora infestans (~0.960) and challenge Fusarium coeruleum (~0.847) and Fusarium sambucinum (~0.860) towards the lower limits of their growth windows. Under some conditions, however, strain JC12GB43 stimulated proliferation of the pathogens: for instance, Fusarium coeruleum growth-rate was increased under chaotropic conditions in vitro (132 mM urea) by >100% and on tubers (2-M glycerol) by up to 570%. Culture-based assays involving macromolecule-stabilizing (kosmotropic) compatible solutes provided proof-of-principle that the Bacillus may provide kosmotropic metabolites to the plant pathogen under conditions that destabilize macromolecular systems of the fungal cell. Whilst unprecedented, this finding is consistent with earlier reports that fungi can utilize metabolites derived from bacterial cells. Unless the antimicrobial activities of candidate biocontrol strains are assayed over a full range of field-relevant parameters, biocontrol agents may promote plant pathogen infections and thereby reduce crop yields. These findings indicate that biocontrol activity, therefore, ought to be regarded as a mode-of-behaviour (dependent on prevailing conditions) rather than an inherent property of a bacterial strain.

Risk-aware Planning in BDI Agents

The ability of an autonomous agent to select rational actions is vital in enabling it to achieve its goals. To do so effectively in a high-stakes setting, the agent must be capable of considering the risk and potential reward of both immediate and future actions. In this paper we provide a novel method for calculating risk alongside utility in online planning algorithms. We integrate such a risk-aware planner with a BDI agent, allowing us to build agents that can set their risk aversion levels dynamically based on their changing beliefs about the environment. To guide the design of a risk-aware agent we propose a number of principles which such an agent should adhere to and show how our proposed framework satisfies these principles. Finally, we evaluate our approach and demonstrate that a dynamically risk-averse agent is capable of achieving a higher success rate than an agent that ignores risk, while obtaining a higher utility than an agent with a static risk attitude.

Regulating Digital Financial Services Agents in Developing Countries to Promote Financial Inclusion

Limited access to bank branches excludes over one billion people from accessing financial services in developing countries. Digital financial services offered by banks and mobile money providers through agents can solve this problem without the need for complex and costly physical banking infrastructures. Delivering digital financial services through agents requires a legal framework to regulate liability. This article analyses whether vicarious liability of the principal is a more efficient regulatory approach than personal liability of the agent. Agent liability in Kenya, Fiji, and Malawi is analysed to demonstrate that vicarious liability of the principal, coupled to an explicit agreement as to agent rewards and penalties, is the more efficient regulatory approach.

Assessing the effect of reducing agents on the selective catalytic reduction of NOx over Ag/Al2O3 catalysts

The selective catalytic reduction (SCR) of NOx in the presence of different reducing agents over Ag/Al2O3 prepared by wet impregnation was investigated by probing catalyst activity and using NMR relaxation time analysis to probe the strength of surface interaction of the various reducing agent species and water. The results reveal that the strength of surface interaction of the reducing agent relative to water, the latter present in engine exhausts as a fuel combustion product and, in addition, produced during the SCR reaction, plays an important role in determining catalyst performance. Reducing agents with weak strength of interaction with the catalyst surface, such as hydrocarbons, show poorer catalytic performance than reducing agents with a higher strength of interaction, such as alcohols. This is attributed to the greater ability of oxygenated species to compete with water in terms of surface interaction with the catalyst surface, hence reducing the inhibiting effect of water molecules blocking catalyst sites. The results support the observations of earlier work in that the light off-temperature and maximum NOx conversion and temperature at which that occurs are sensitive to the reducing agent present during reaction, and the proposal that improved catalyst performance is caused by increased adsorption strength of the reducing agent, relative to water, at the catalyst surface. Importantly, the NMR relaxation time analysis approach to characterising the strength of adsorption more readily describes the trends in catalytic behaviour than does a straightforward consideration of the polarity (i.e., relative permittivity) of the reducing agents studied here. In summary, this paper describes a simple approach to characterising the interaction energy of water and reducing agent so as to aid the selection of reducing agent and catalyst to be used in SCR conversions.

Interacting agents on complex networks and stochastic processes in them

Nas últimas décadas, um grande número de processos têm sido descritos em termos de redes complexas. A teoria de redes complexas vem sendo utilizada com sucesso para descrever, modelar e caracterizar sistemas naturais, artificias e sociais, tais como ecossistemas, interações entre proteínas, a Internet, WWW, até mesmo as relações interpessoais na sociedade. Nesta tese de doutoramento apresentamos alguns modelos de agentes interagentes em redes complexas. Inicialmente, apresentamos uma breve introdução histórica (Capítulo 1), seguida de algumas noções básicas sobre redes complexas (Capítulo 2) e de alguns trabalhos e modelos mais relevantes a esta tese de doutoramento (Capítulo 3). Apresentamos, no Capítulo 4, o estudo de um modelo de dinâmica de opiniões, onde busca-se o consenso entre os agentes em uma população, seguido do estudo da evolução de agentes interagentes em um processo de ramificação espacialmente definido (Capítulo 5). No Capítulo 6 apresentamos um modelo de otimização de fluxos em rede e um estudo do surgimento de redes livres de escala a partir de um processo de otimização . Finalmente, no Capítulo 7, apresentamos nossas conclusões e perspectivas futuras.

Navigation in dynamic environments taking advantage of moving agents

Esta tese propõe uma forma diferente de navegação de robôs em ambientes dinâmicos, onde o robô tira partido do movimento de pedestres, com o objetivo de melhorar as suas capacidades de navegação. A ideia principal é que, ao invés de tratar as pessoas como obstáculos dinâmicos que devem ser evitados, elas devem ser tratadas como agentes especiais com conhecimento avançado em navegação em ambientes dinâmicos. Para se beneficiar do movimento de pedestres, este trabalho propõe que um robô os selecione e siga, de modo que possa mover-se por caminhos ótimos, desviar-se de obstáculos não detetados, melhorar a navegação em ambientes densamente populados e aumentar a sua aceitação por outros humanos. Para atingir estes objetivos, novos métodos são desenvolvidos na área da seleção de líderes, onde duas técnicas são exploradas. A primeira usa métodos de previsão de movimento, enquanto a segunda usa técnicas de aprendizagem por máquina, para avaliar a qualidade de candidatos a líder, onde o treino é feito com exemplos reais. Os métodos de seleção de líder são integrados com algoritmos de planeamento de movimento e experiências são realizadas para validar as técnicas propostas.

Stakeholder participation in sustainable forest management in fire-prone areas

Os incêndios florestais, associados ao abandono do espaço rural, a pequena propriedade florestal e o desinteresse e o absentismo dos proprietários florestais têm sido apontados como fatores que têm afetado a sustentabilidade das florestas em Portugal. Apesar da formulação de políticas e de instrumentos de planeamento e de gestão florestal para lidar com estes constrangimentos, são ainda escassos os progressos para uma Gestão Florestal Sustentável. A nível internacional e europeu, a participação dos agentes já representa um aspeto-chave no processo de definição e de implementação de estratégias que promovam a multifuncionalidade da floresta, mas também se adeqúem às necessidades e aos interesses dos agentes locais. A temática da tese esteve focada nesta discussão, argumentando que existe uma escassa participação dos agentes nos processos de tomada de decisão relativos ao setor florestal. O principal objetivo da investigação foi o desenvolvimento de uma metodologia participativa para a discussão e negociação de estratégias locais para a Gestão Florestal Sustentável, que maximizem o potencial produtivo e o papel sócio-ambiental das florestas, diminuam o risco de incêndio e promovam o crescente interesse e participação dos agentes locais na gestão florestal. A tese está estruturada em três partes. A primeira parte apresenta uma avaliação do sector florestal nacional, com base numa revisão bibliográfica e numa comparação de indicadores, políticas e instrumentos de planeamento e gestão florestal (Capítulo 2) e com base num estudo de perceção social desenvolvido numa área de estudo localizada na região Centro de Portugal. Este estudo analisa as perceções técnicas (decisores políticos e técnicos) e sociais (proprietários florestais e outros membros da comunidade local) sobre as florestas, a gestão florestal e os incêndios florestais (Capítulo 4). As ‘Zonas de Intervenção Florestal’, enquanto ferramenta recente para a cooperação e organização dos proprietários e produtores florestais, foram também analisadas (Capítulo 3). A segunda parte da tese é dedicada à análise de processos de participação pública, com base numa revisão bibliográfica sobre os benefícios, níveis, abordagens e métodos de participação (Capítulo 5) e numa avaliação de processos de participação pública desenvolvidos em Portugal (Capítulo 6). A terceira parte da tese foca-se no desenho e no teste da metodologia participativa proposta no âmbito desta tese (Capítulo 7) e na formulação de algumas orientações para melhoria dos processos participativos na gestão florestal (Capítulo 8). Os resultados confirmaram a centralidade dos incêndios florestais e dos fatores associados ao contexto socioeconómico (e.g. despovoamento e envelhecimento populacional, absentismo, falta de gestão florestal, estrutura fundiária) como os principais problemas que afetam a floresta na região Centro de Portugal. A organização e cooperação dos proprietários florestais emergiu como solução possível para lidar com estas ameaças e promover a multifuncionalidade da floresta, sendo essencial aumentar o conhecimento e a participação dos agentes nas decisões associadas à floresta. É proposta uma ferramenta para esta participação, centrada no contexto local e facilmente utilizável por todos os agentes. A implementação da metodologia participativa revelou o seu potencial no desenvolvimento de uma participação equitativa e inclusiva dos múltiplos agentes.

Phthalocyanines : interaction with carbon structures and as PDT agents

This dissertation describes the synthesis and characterization of different phthalocyanine (Pc) derivatives, as well as some porphyrins (Pors), for supramolecular interaction with different carbon nanostructures, to evaluate their potential application in electronic nanodevices. Likewise, it is also reported the preparation and biological evaluation of interesting phthalocyanine conjugates for cancer photodynamic therapy (PDT) and microorganisms photodynamic inactivation (PDI). The phthalonitrile precursors were prepared from commercial phthalonitriles by nucleophilic substitution of -NO2, -Cl, or -F groups, present in the phthalonitrile core, by thiol or pyridyl units. After the synthesis of these phthalonitriles, the corresponding Pcs were prepared by ciclotetramerization using a metallic salt as template at high temperatures. A second strategy involved the postfunctionalization of hexadecafluorophthalocyaninato zinc(II) through the adequate substituents of mercaptopyridine or cyclodextrin units on the macrocycle periphery. The different compounds were structurally characterized by diverse spectroscopic techniques, namely 1H, 13C and 19F nuclear magnetic resonance spectroscopies (attending the elemental composition of each structure); absorption and emission spectroscopy, and mass spectrometry. For the specific photophysical studies were also used electrochemical characterization, femtosecond and raman spectroscopy, transmission electron and atomic force microscopy. It was highlighted the noncovalent derivatisation of carbon nanostructures, mainly single wall carbon nanotubes (SWNT) and graphene nanosheets with the prepared Pc conjugates to study the photophysical properties of these supramolecular nanoassemblies. Also, from pyridyl-Pors and ruthenium phthalocyanines (RuPcs) were performed Por-RuPcs arrays via coordination chemistry. The results obtained of the novel supramolecular assemblies showed interesting electron donor-acceptor interactions and might be considered attractive candidates for nanotechnological devices. On the other hand, the amphiphilic phthalocyanine-cyclodextrin (Pc-CD) conjugates were tested in biological trials to assess their ability to inhibit UMUC- 3 human bladder cancer cells. The results obtained demonstrated that these photoactive conjugates are highly phototoxic against human bladder cancer cells and could be applied as promising PDT drugs.

Post-fire vegetation regeneration in Portugal : implications for management

This thesis aims at improving the knowledge on the post-fire vegetation regeneration. For that, forests and shrublands were studied, after forest fires and experimental fires. Maritime Pine (Pinus pinaster) recruitment after fire was studied. Fire severity was evidenced as a major effect on this process. High crown fire severity can combust the pines, destroying the seed bank and impeding post fire pine recruitment. However, crown combustion also influences the post-fire conditions on the soil surface, since high crown combustion (HCC) will decrease the postfire needle cast. After low crown combustion (LCC) (scorched rather than torched crowns), a considerable needle cover was observed, along with a higher density of pine seedlings. The overall trends of post-fire recruitment among LCC and HCC areas could be significantly attributed to cover by needles, as well by the estimation of fire severity using the diameters of the burned twigs (TSI). Fire increased the germination from the soil seed bank of a Pinus pinaster forest, and the effects were also related with fire severity. The densities of seedlings of the dominant taxa (genus Erica and Calluna vulgaris) were contrastingly affected in relation to the unburned situation, depending on fire severity, as estimated from the degree of fire-induced crown damage (LCC/HCC), as well as using a severity index based on the diameters of remaining twigs (TSI). Low severity patches had an increase in germination density relatively to the control, while high severity patches suffered a reduction. After an experimental fire in a heathland dominated by Pterospartum tridentatum, Erica australis and E. umbellata, no net differences in seedling emergence were observed, in relation to the pre-fire situation. However, rather than having no effect, the heterogeneity of temperatures caused by fire promoted caused divergent effects over the burned plot in terms of Erica australis germination – a progressive increased was observed in the plots were maximum temperature recorded ranged from 29 to 42.5ºC and decreased in plots with maximum temperature ranging from 51.5 to 74.5ºC. In this heathland, the seed density of two of the main species (E. australis and E. umbellata) was higher under their canopies, but the same was not true for P. tridentatum. The understory regeneration in pine and eucalypt stands, 5 to 6 years post fire, has been strongly associated with post-fire management practices. The effect of forest type was, comparatively, insignificant. Soil tilling, tree harvesting and shrub clearance, were linked to lower soil cover percentages. However, while all these management operations negatively affected the cover of resprouters, seeders were not affected by soil tilling. A strong influence of biogeographic region was identified, suggesting that more vulnerable regions may suffer higher effects of management, even under comparatively lower management pressure than more productive regions. This emphasizes the need to adequate post-fire management techniques to the target regions.

Environmental factors, clipping and fire: effects on cerrado (Brazilian savanna) native and invasive grasses

The Brazilian Cerrado houses a hugely diverse biota and is considered a conservation hotspot. One of the greatest threats to the integrity of this ecosystem is introduced African grasses, which can competitively exclude native grasses and cause changes in the microclimate and other disturbances. The Cerrado is a mosaic vegetation that provides different combinations, both spatially and temporally, of conditions that can become natural stressors to the herbaceous vegetation (water, nutrient and light availability). These mosaics are reflected in differences in relationships among native and invasive species, affecting competition and creating situations (place/season) that are more, or less, susceptible to invasion. The present study aimed to identify the different biological responses of native (Aristida recurvata, Aristida setifolia, Axonopus barbigerus, Echinolaena inflexa, Gymnopogon spicatus, Paspalum gardnerianum, Paspalum stellatum, Schizachyrium microstachyum, Schizachyrium sanguineum) and invasive (Melinis minutiflora and Andropogon gayanus) grasses to variations in natural stressors and to disturbance (fire and clipping), in order to understand changes in ecosystem functioning and competition processes between the grasses, and to understand invasion dynamics in this ecosystem. The presence of invasive species proved to affect the ecosystem functioning by increasing soil feeding activity. These differences were no longer observed in the dry season or when fires were frequent, showing that water availability and fire are more detrimental to soil feeding activity than is the vegetation. Laboratory experiments showed that both drought and flood simulated scenarios damaged both species, although the invasive species performed better under all watering conditions and responded better to fertilization. Underlying mechanisms such as the efficiency of photosynthesis and antioxidant mechanisms helped to explain this behavior. The invasive species grew faster and showed less cellular damage and a healthier photosystem, reflected in higher assimilation rates under stress. These differences between the native and invasive species were reduced with clipping, especially in dry soil with no fertilization, where the native species recovered better in relation to the pre-clipping levels. Flooding was as stressful as drought, but the invasive species can bypass this issue by growing an extensive root system, especially in the better-drained soils. Fire is more detrimental than clipping, with a slower recovery, while post-fire temperatures affect the germination of both invasive and native seeds and may be an important factor influencing the persistence of a diverse biota. This approach will finally contribute to the choice of the appropriate management techniques to preserve the Cerrado’s biodiversity.

Exploring Consumer Opportunism Conundrum in the Insurance Industry: The Role of Marketing

Drawing from the extant literature, this paper explores the prevalent consumer opportunism in the insurance transactions, its links to consumers’ perception, and the relevance of marketing strategies in curbing the menace. It shows that insurance opportunism could be perpetrated by any party in the insurance transaction system and at any stage of the process involved. Among factors identified as prompting this conundrum are economic motive, resentment towards the insurance companies, laxity in the application processing/asymmetric information, and insiders’ collaborations. Nonetheless, the paper suggests that strong commitment of insurance marketers to creating and delivering value to the customers more robustly through a proactive and all-embracing implementation of marketing strategies vis-àvis relationship marketing could significantly enhance consumers’ positive perception of insurance business and consequently result in a healthier insurance industry.