Bevacizumab plus oxaliplatin-based chemotherapy as adjuvant treatment for colon cancer (AVANT): a phase 3 randomised controlled trial

Background: Bevacizumab improves the efficacy of oxaliplatin-based chemotherapy in metastatic colorectal cancer. Our aim was to assess the use of bevacizumab in combination with oxaliplatin-based chemotherapy in the adjuvant treatment of patients with resected stage III or high-risk stage II colon carcinoma. Methods: Patients from 330 centres in 34 countries were enrolled into this phase 3, open-label randomised trial. Patients with curatively resected stage III or high-risk stage II colon carcinoma were randomly assigned (1: 1: 1) to receive FOLFOX4 (oxaliplatin 85 mg/m(2), leucovorin 200 mg/m(2), and fluorouracil 400 mg/m(2) bolus plus 600 mg/m(2) 22-h continuous infusion on day 1; leucovorin 200 mg/m(2) plus fluorouracil 400 mg/m(2) bolus plus 600 mg/m(2) 22-h continuous infusion on day 2) every 2 weeks for 12 cycles; bevacizumab 5 mg/kg plus FOLFOX4 (every 2 weeks for 12 cycles) followed by bevacizumab monotherapy 7.5 mg/kg every 3 weeks (eight cycles over 24 weeks); or bevacizumab 7.5 mg/kg plus XELOX (oxaliplatin 130 mg/m(2) on day 1 every 2 weeks plus oral capecitabine 1000 mg/m(2) twice daily on days 1-15) every 3 weeks for eight cycles followed by bevacizumab monotherapy 7.5 mg/kg every 3 weeks (eight cycles over 24 weeks). Block randomisation was done with a central interactive computerised system, stratified by geographic region and disease stage. Surgery with curative intent occurred 4-8 weeks before randomisation. The primary endpoint was disease-free survival, analysed for all randomised patients with stage III disease. This study is registered with ClinicalTrials.gov, number NCT00112918. Findings: Of the total intention-to-treat population (n=3451), 2867 patients had stage III disease, of whom 955 were randomly assigned to receive FOLFOX4, 960 to receive bevacizumab-FOLFOX4, and 952 to receive bevacizumab-XELOX. After a median follow-up of 48 months (range 0-66 months), 237 patients (25%) in the FOLFOX4 group, 280 (29%) in the bevacizumab-FOLFOX4 group, and 253 (27%) in the bevacizumab-XELOX group had relapsed, developed a new colon cancer, or died. The disease-free survival hazard ratio for bevacizumab-FOLFOX4 versus FOLFOX4 was 1.17 (95% CI 0.98-1.39; p=0.07), and for bevacizumab-XELOX versus FOLFOX4 was 1.07 (0.90-1.28; p=0.44). After a minimum follow-up of 60 months, the overall survival hazard ratio for bevacizumab-FOLFOX4 versus FOLFOX4 was 1.27 (1.03-1.57; p=0.02), and for bevacizumab-XELOX versus FOLFOX4 was 1.15 (0.93-1.42; p=0.21). The 573 patients with high-risk stage II cancer were included in the safety analysis. The most common grade 3-5 adverse events were neutropenia (FOLFOX4: 477 [42%] of 1126 patients, bevacizumab-FOLFOX4: 416 [36%] of 1145 patients, and bevacizumab-XELOX: 74 [7%] of 1135 patients), diarrhoea (110 [10%], 135 [12%], and 181 [16%], respectively), and hypertension (12 [1%], 122 [11%], and 116 [10%], respectively). Serious adverse events were more common in the bevacizumab groups (bevacizumab-FOLFOX4: 297 [26%]; bevacizumab-XELOX: 284 [25%]) than in the FOLFOX4 group (226 [20%]). Treatment-related deaths were reported in one patient receiving FOLFOX4, two receiving bevacizumab-FOLFOX4, and five receiving bevacizumab-XELOX. Interpretation: Bevacizumab does not prolong disease-free survival when added to adjuvant chemotherapy in resected stage III colon cancer. Overall survival data suggest a potential detrimental effect with bevacizumab plus oxaliplatin-based adjuvant therapy in these patients. On the basis of these and other data, we do not recommend the use of bevacizumab in the adjuvant treatment of patients with curatively resected stage III colon cancer.

U-Pb dating by zircon dissolution method using chemical abrasion

Chemical abrasion was carried out on zircons grains of the Temora II standard for U-Pb dating prior to analyses using in situ Laser Ablation-MultiCollector Ion Coupled Plasma Mass Spectrometer (LA-ICPMS) followed by the Isotope Dissolution Thermal Ionization Mass Spectrometer (ID-TIMS) method. The proposed methodology was herein applied in order to reduce primarily the effects of secondary Pb loss, the presence of common lead and/or silicate impurities. Nine Temora II zircon grains were analyzed by the laser ablation method yielding an age of 418.3±4.3 Ma. Zircon grains of a same population were separated for chemical abrasion before dissolution and mass spectrometry analyses. Six fractions of them were separated for isotope dissolution using 235U-205Pb mixed spike after we have checked and assured the laboratory conditions of low blank values for total Pb of less than 2 pg/g. The obtained U-Pb zircon age by the ID-TIMS method was 415.7±1.8 Ma (error 0.43 %) based on four successful determinations. The results are consistent with the published ages for the Temora diorite (Temora I â 416.75±1.3 Ma; Temora II â 416.78±0.33 Ma) and established as 416±0.33 Ma. The technique is thus recommended for high precision U-Pb zircon analyses (error < 1 %), mainly for high resolution stratigraphic studies of Phanerozoic sequences.

Equilíbrio estático e dinâmico no indivíduo com espondilite anquilosante: revisão da literatura

Com o objetivo de analisar as alterações musculoesqueléticas dos indivíduos com espondilite anquilosante (EA) e suas repercussões sobre o controle postural, realizou-se uma revisão bibliográfica nas bases de dados da BIREME e EBSCO HOTS e no site Pubmed com as palavras-chave: "ankylosing spondylitis", "postural balance" e "posture". Foram selecionados artigos envolvendo seres humanos e que analisavam o controle postural e a biomecânica dos indivíduos com EA, nos idiomas inglês e português, publicados no período entre 1999 e 2010. Do total de artigos encontrados, apenas quatro preencheram os requisitos. Desses, três compararam os resultados de pacientes com EA com os dados obtidos de indivíduos saudáveis, e um analisou apenas indivíduos com EA. Nenhum artigo continha o mesmo método de análise postural. Para avaliação do equilíbrio foram utilizadas a Escala de Equilíbrio de Berg, a Plataforma de Força e a Magnometria. Os principais desvios posturais encontrados foram aumento da cifose torácica e flexão do quadril, que levam a uma anteriorização do centro de gravidade corporal, apresentando flexão do joelho e plantiflexão do tornozelo como compensação para manter o equilíbrio. Apenas um autor encontrou piora do equilíbrio funcional nos sujeitos com EA. Todos os métodos de avaliação utilizados foram considerados capazes de mensurar o equilíbrio, não havendo uma escala específica para pacientes com EA.

QUALIDADE AMBIENTAL DE ÁREAS VERDES: ANÁLISE SONORA DA PRAÇA DA LUZ – SÃO PAULO

A proposta deste artigo é questionar a qualidade ambiental das áreas verdes inseridas no contexto urbano de uma grande cidade. Primeiro, apresenta-se o papel dos parques e praças públicas na cidade contemporânea, ou seja, como esses espaços são benéficos para a população, e de que forma podem melhorar a qualidade de vida. É necessário compreender a importância desses locais para os habitantes, e com esse intuito, busca-se analisar os aspectos que agregam qualidade a um espaço verde. Depois apresenta-se um breve histórico do Jardim da Luz, que se tratada área verde mais antiga da cidade de São Paulo. Através da descrição de sua história, pode-se perceber a mudança da compreensão do papel das áreas verdes para a cidade, e as mudanças no meio de utilização da mesma. Dentre todos os aspectos ambientais que podem caracterizar uma área verde, este artigo irá se aprofundar no impacto dos ruídos urbanos sobre a mesma. Segundo a Organização Mundial de Saúde (OMC), “a poluição sonora é hoje, depois da poluição do ar e da água, o problema ambiental que afeta o maior número de pessoas” (LACERDA, 2005). Em razão da abrangência do problema, é necessário pesquisar formas de avaliar corretamente as paisagens sonoras urbanas, e seu impacto na qualidade de vida da população. Por essa razão, demonstra-se como avaliar acusticamente os espaços públicos, através da comparação dos resultados obtidos em medições in loco com sonômetros com os critérios para avaliação de áreas verdes propostos pela metodologia de avaliação de Antônio Pedro Carvalho, professor na Faculdade de Engenharia da Universidade do Porto, em Portugal.

The nature of extremely red galaxies in the local universe

We investigate the nature of extremely red galaxies (ERGs), objects whose colours are redder than those found in the red sequence present in colour–magnitude diagrams of galaxies. We selected from the Sloan Digital Sky Survey Data Release 7 a volume-limited sample of such galaxies in the redshift interval 0.010 < z < 0.030, brighter than Mr = −17.8 (magnitudes dereddened, corrected for the Milky Way extinction) and with (g − r) colours larger than those of galaxies in the red sequence. This sample contains 416 ERGs, which were classified visually. Our classification was cross-checked with other classifications available in the literature. We found from our visual classification that the majority of objects in our sample are edge-on spirals (73 per cent). Other spirals correspond to 13 per cent, whereas elliptical galaxies comprise only 11 per cent of the objects. After comparing the morphological mix and the distributions of Hα/Hβ and axial ratios of ERGs and objects in the red sequence, we suggest that dust, more than stellar population effects, is the driver of the red colours found in these extremely red galaxies.

Inhibition of human platelet aggregation by eosinophils

AIMS: The relationship between the activity of eosinophils and platelets has been observed in recent decades by many scientists. These observations include increased numbers of eosinophils associated with platelet disorders, including changes in the coagulation cascade and platelet aggregation. Based on these observations, the interaction between eosinophils and platelets in platelet aggregation was analyze. MAIN METHODS: Human platelets were incubated with eosinophil cytosolic fraction, promyelocytic human HL-60 clone 15 cell lineage, and eosinophil cationic protein (ECP). Platelet rich plasma (PRP) aggregation was induced by adenosine diphosphate, platelet activating factor, arachidonic acid, and collagen, and washed platelets (WP) were activated by thrombin. KEY FINDINGS: Aggregation induced by all agonists was dose dependently inhibited by eosinophil cytosolic fraction. This inhibition was only partially reversed by previous incubation of the eosinophils with l-Nitro-Arginine-Methyl-Ester (l-NAME). Previous incubation with indomethacin did not prevent the cytosolic fraction induced inhibition. The separation of eosinophil cytosolic fraction by gel filtration on Sephadex G-75 showed that the inhibitory activity was concentrated in the lower molecular weight fraction. HL-60 clone 15 cells differentiated into eosinophils for 5 and 7 day were able to inhibit platelet aggregation. The ECP protein inhibited the platelet aggregation on PRP and WP. This inhibition was more evident in WP, and the citotoxicity MTT assay proved the viability of tested platelets, showing that the observed inhibition by the ECP protein does not occur simply by cell death. SIGNIFICANCE: Our results indicate that eosinophils play a fundamental role in platelet aggregation inhibition

Psychometric properties of the Beck Depression Inventory-II: a comprehensive review

OBJECTIVE: To review the psychometric properties of the Beck Depression Inventory-II (BDI-II) as a self-report measure of depression in a variety of settings and populations. METHODS: Relevant studies of the BDI-II were retrieved through a search of electronic databases, a hand search, and contact with authors. Retained studies (k = 118) were allocated into three groups: non-clinical, psychiatric/institutionalized, and medical samples. RESULTS: The internal consistency was described as around 0.9 and the retest reliability ranged from 0.73 to 0.96. The correlation between BDI-II and the Beck Depression Inventory (BDI-I) was high and substantial overlap with measures of depression and anxiety was reported. The criterion-based validity showed good sensitivity and specificity for detecting depression in comparison to the adopted gold standard. However, the cutoff score to screen for depression varied according to the type of sample. Factor analysis showed a robust dimension of general depression composed by two constructs: cognitive-affective and somatic-vegetative. CONCLUSIONS: The BDI-II is a relevant psychometric instrument, showing high reliability, capacity to discriminate between depressed and non-depressed subjects, and improved concurrent, content, and structural validity. Based on available psychometric evidence, the BDI-II can be viewed as a cost-effective questionnaire for measuring the severity of depression, with broad applicability for research and clinical practice worldwide.

Model of vessels for the 3D reconstruction

[EN] In this paper, we present a vascular tree model made with synthetic materials and which allows us to obtain images to make a 3D reconstruction. In order to create this model, we have used PVC tubes of several diameters and lengths that will let us evaluate the accuracy of our 3D reconstruction. We have made the 3D reconstruction from a series of images that we have from our model and after we have calibrated the camera. In order to calibrate it we have used a corner detector. Also we have used Optical Flow techniques to follow the points through the images going and going back. Once we have the set of images where we have located a point, we have made the 3D reconstruction choosing by chance a couple of images and we have calculated the projection error. After several repetitions, we have found the best 3D location for the point.

Biometanazione della frazione organica di rifiuti solidi urbani da raccolta indifferenziata mediante codigestione con refluo zootecnico o addizione di solfuro di sodio

Il presente elaborato è stato finalizzato allo sviluppo di un processo di digestione anaerobica della frazione organica dei rifiuti solidi urbani (FORSU oppure, in lingua inglese OFMSW, Organic Fraction of Municipal Solid Waste) provenienti da raccolta indifferenziata e conseguente produzione di biogas da impiegarsi per il recupero energetico. Questo lavoro rientra nell’ambito di un progetto, cofinanziato dalla Regione Emilia Romagna attraverso il Programma Regionale per la Ricerca Industriale, l’Innovazione e il Trasferimento Tecnologico (PRRIITT), sviluppato dal Dipartimento di Chimica Applicata e Scienza dei Materiali (DICASM) dell’Università di Bologna in collaborazione con la Facoltà di Ingegneria dell’Università di Ferrara e con la società Recupera s.r.l. che applicherà il processo nell’impianto pilota realizzato presso il proprio sito di biostabilizzazione e compostaggio ad Ostellato (FE). L’obiettivo è stato la verifica della possibilità di impiegare la frazione organica dei rifiuti indifferenziati per la produzione di biogas, e in particolare di metano, attraverso un processo di digestione anaerobica previo trattamento chimico oppure in codigestione con altri substrati organici facilmente fermentabili. E’ stata inoltre studiata la possibilità di impiego di reattori con biomassa adesa per migliorare la produzione specifica di metano e diminuire la lag phase. Dalla sperimentazione si può concludere che è possibile giungere allo sviluppo di metano dalla purea codigerendola assieme a refluo zootecnico. Per ottenere però produzioni significative la quantità di solidi volatili apportati dal rifiuto non deve superare il 50% dei solidi volatili complessivi. Viceversa, l’addizione di solfuri alla sola purea si è dimostrata ininfluente nel tentativo di sottrarre gli agenti inibitori della metanogenesi. Inoltre, l’impiego di supporti di riempimento lavorando attraverso processi batch sequenziali permette di eliminare, nei cicli successivi al primo, la lag phase dei batteri metanogeni ed incrementare la produzione specifica di metano.