A comparison between accelerated hypofractionation and stereotactic ablative radiotherapy (SABR) for early-stage non-small cell lung cancer (NSCLC): Results of a propensity score-matched analysis

BACKGROUND AND PURPOSE: Stereotactic ablative radiotherapy (SABR) has become standard for inoperable early-stage non-small cell lung cancer (NSCLC). However, there is no randomized evidence demonstrating benefit over more fractionated radiotherapy. We compared accelerated hypofractionation (AH) and SABR using a propensity score-matched analysis.

MATERIALS AND METHODS: From 1997-2007, 119 patients (T1-3N0M0 NSCLC) were treated with AH (48-60Gy, 12-15 fractions). Prior to SABR, this represented our institutional standard. From 2008-2012, 192 patients (T1-3N0M0 NSCLC) were treated with SABR (48-52Gy, 4-5 fractions). A total of 114 patients (57 per cohort) were matched (1:1 ratio, caliper: 0.10) using propensity scores.

RESULTS: Median follow-up (range) for the AH cohort was 36.3 (2.5-109.1) months, while that for the SABR group was 32.5 (0.3-62.6)months. Three-year overall survival (OS) and local control (LC) rates were 49.5% vs. 72.4% [p=0.024; hazard ratio (HR): 2.33 (1.28, 4.23), p=0.006] and 71.9% vs. 89.3% [p=0.077; HR: 5.56 (1.53, 20.2), p=0.009], respectively. On multivariable analysis, tumour diameter and PET staging were predictive for OS, while the only predictive factor for LC was treatment cohort.

CONCLUSIONS: OS and LC were improved with SABR, although OS is more closely related to non-treatment factors. This represents one of the few studies comparing AH to SABR for early-stage lung cancer.

Seven key actions to eradicate rheumatic heart disease in Africa: the Addis Ababa communiqué

Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) remain major causes of heart failure, stroke and death among African women and children, despite being preventable and imminently treatable. From 21 to 22 February 2015, the Social Cluster of the Africa Union Commission (AUC) hosted a consultation with RHD experts convened by the Pan-African Society of Cardiology (PASCAR) in Addis Ababa, Ethiopia, to develop a 'roadmap' of key actions that need to be taken by governments to eliminate ARF and eradicate RHD in Africa. Seven priority areas for action were adopted: (1) create prospective disease registers at sentinel sites in affected countries to measure disease burden and track progress towards the reduction of mortality by 25% by the year 2025, (2) ensure an adequate supply of high-quality benzathine penicillin for the primary and secondary prevention of ARF/RHD, (3) improve access to reproductive health services for women with RHD and other non-communicable diseases (NCD), (4) decentralise technical expertise and technology for diagnosing and managing ARF and RHD (including ultrasound of the heart), (5) establish national and regional centres of excellence for essential cardiac surgery for the treatment of affected patients and training of cardiovascular practitioners of the future, (6) initiate national multi-sectoral RHD programmes within NCD control programmes of affected countries, and (7) foster international partnerships with multinational organisations for resource mobilisation, monitoring and evaluation of the programme to end RHD in Africa. This Addis Ababa communiqué has since been endorsed by African Union heads of state, and plans are underway to implement the roadmap in order to end ARF and RHD in Africa in our lifetime.

Identification of diagnostic biomarkers for infection in premature neonates

Infection is a leading cause of neonatal morbidity and mortality worldwide. Premature neonates are particularly susceptible to infection because of physiologic immaturity, comorbidity, and extraneous medical interventions. Additionally premature infants are at higher risk of progression to sepsis or severe sepsis, adverse outcomes, and antimicrobial toxicity. Currently initial diagnosis is based upon clinical suspicion accompanied by nonspecific clinical signs and is confirmed upon positive microbiologic culture results several days after institution of empiric therapy. There exists a significant need for rapid, objective, in vitro tests for diagnosis of infection in neonates who are experiencing clinical instability. We used immunoassays multiplexed on microarrays to identify differentially expressed serum proteins in clinically infected and non-infected neonates. Immunoassay arrays were effective for measurement of more than 100 cytokines in small volumes of serum available from neonates. Our analyses revealed significant alterations in levels of eight serum proteins in infected neonates that are associated with inflammation, coagulation, and fibrinolysis. Specifically P- and E-selectins, interleukin 2 soluble receptor alpha, interleukin 18, neutrophil elastase, urokinase plasminogen activator and its cognate receptor, and C-reactive protein were observed at statistically significant increased levels. Multivariate classifiers based on combinations of serum analytes exhibited better diagnostic specificity and sensitivity than single analytes. Multiplexed immunoassays of serum cytokines may have clinical utility as an adjunct for rapid diagnosis of infection and differentiation of etiologic agent in neonates with clinical decompensation.

A ideia de Europa na imprensa desportiva portuguesa (1893-1945)

Pensar a Europa e Portugal, a partir da imprensa desportiva portuguesa, é o principal objectivo deste trabalho, que deve ser visto como uma espécie de "viagem" por um tempo conturbado (1893-1945), com os principais jornais desportivos a servirem de guia. Esta longa peregrinação de 52 anos — iniciada quando surge o primeiro jornal desportivo em Portugal e encerrada no ano em que termina a Segunda Guerra Mundial (altura em que este género de imprensa se consolida) — permitiu recuperar, simultaneamente, do baú do esquecimento, reflexões sobre a Europa e Portugal, e um pedaço da esquecida história da imprensa desportiva. /***Abstract - The main goal of this work is to think Europe and Portugal starting from the discourses produced in the portuguese spod press on the subject. This research must be seen as a “journey" through a troubled time (1893-1945), with the sport newspapers as guides. It's a long way of 52 years that started when the first portuguese sport newspaper born and finished at the end of the Second World War (period when Chis kind of press was already established) permitted, at the same time, a recovery, from the chests of forgetfulness, of reflections about Europe and Portugal and a piece of forgotten sport press history.

Graphic design and modernisation in Greece, 1945-1970

The primary aim of this work is to give voice to the silent history of graphic design in Greece, long uncharted and undocumented in both the international forum and the local design community. This study focuses on the professional modernisation of graphic design and its role in providing the means for change in Greek society. The research is supported by interdisciplinary analysis of commercial advertisements, posters, leaflets and magazines, as well as other supporting documentation, in the historical and cultural context of Athens, Greece from 1945 to 1970. The time examined was a transitional and vociferous period in the history of Greece, one of intense and rapid economic modernisation during the post-Second World War decades from the mid-1940s to 1970. This was a time when, along with broader changes in the social, economic and political life of Greece, important developments in design education, print technology, and professional organisation marked a new age for graphic design, as a profession emerging from the broader ‘graphic arts’ field (inclusive of both technological and creative processes) and claiming autonomy over the more established fine arts sector. All four chapters deal with modernisation in relation to the assumed divisions of traditional/modern, continuity/change, centre/periphery. Main areas of investigation are: trade organisation, graphic design education, advertising and urbanisation, electricity and tourism promotion. This research offers a view of the ways the ‘modern’ and the condition of modernity were experienced in the case of Greece through certain applications of graphic design and its agents of influence: graphic designers, artists, managers, publishers, the state and private entrepreneurs. The research benefited significantly from a number of interviews with design professionals and related individuals. The present endeavour has a modest aim: to enable understanding of how and why Greek graphic design at the time came to be, and to stress the validity of the visual as a means of historical documentation.

Letter, Greensboro, NC, to George Washington Spencer, Chesterfield, SC, 1890 January 11

This letter is from G. W. Winstead and A. M. Scales to G. W. Spencer regarding Reverend Dr. J. W. Blosser.

Letter, Redwine Jackson Parish, LA, to George Washington Spencer, Chesterfield, SC, 1887 February 21

This letter is from J. J. Spencer to G. W. Spencer.

Letter, Society Hill, SC, to George Washington Spencer, Chesterfield, SC, 1892 February 22

This letter is from the King Iron Bridge Manufacturing Company to G. W. Spencer.