Fostering a transport policy paradigm shift: comprehensiveness, sustainability and co-modality

This issue of the FAL Bulletin proposes a paradigm shift away from the traditional approach to transport policy in the region, so as to better address issues associated with development. It suggests working towards an integrated and sustainable infrastructure, logistics and mobility policy structure based on the principle of co- modality.

Convergence and divergence of transport and mobility policies in Latin America: Lack of urban co-modality

This issue of the FAL bulletin analyses transport and mobility policy in Latin America, where the lack of integrated public policies for urban mobility and the failure to take coordinated action over time make it difficult to prioritize investments and coordinate existing initiatives (both public and private).

Institutional framework, co-modality and sustainable transport services

This issue of the FAL bulletin focuses on the problems which public institutions encounter when formulating transport policies and the challenge of designing and implementing systemic, integrated, sustainable transport policies in the current institutional framework in the countries of Latin America.

The expressibility of modality in representational complement clauses in Brazilian Portuguese

This paper deals with the (im)possibility of expressing a variety of modal categories within the context of the layering approach to complementation in Functional Discourse Grammar (FDG).Our hypothesis is that modal expressions in complement clauses only pertain to operator or modifier classes of the highest layer relevant for that type of embedded construction and for all lower levels. In order to test this hypothesis, occurrences of complement clauses in two databases of spoken Brazilian Portuguese are analyzed. The investigation of this hypothesis is restricted to representational complement clauses.

Distinções entre modalidade deôntica objetiva e subjetiva no português falado: o caso do verbo 'dever'

The modal distinctions proposed by Hengeveld (2004), reexamined by Hengeveld and Mackenzie (2008) within the Functional Discourse Grammar (FDG), consider the existence of five types of modality: facultative, deontic, volitive, epistemic and evidential. Taking into special account the deontic modality, there are evidences that it can be subdivided into objective and subjective, as analyzed by Olbertz and Gasparini-Bastos (2013) in auxiliary constructions of spoken Spanish. This wok aims to investigate the contextual elements that favor the interpretation of these two values when they are expressed by the modal auxiliary verb “dever” (must) in spoken Portuguese data.

Beta therapy with 90 strontium as single modality therapy for canine squamous cell carcinoma in third eyelid

The purpose was to evaluate the effectiveness of beta-radiation with strontium-90 as single modality treatment of canine third eyelid squamous cell carcinoma (SCC). Nine dogs diagnosed with third eyelid SCC were treated with strontium-90. Radiation therapy was administered in four fractions of 100cGy per site every four days and at a depth of 0.2cm (Strontium-90 build' up) in each fraction. Radiation with beta therapy was well tolerated in all animals with no occurrence of radiation induced cataracts. In all cases, there were increased signs of conjunctival inflammation around the mass, which subsided with topical anti-inflammatory. Two dogs required surgical treatment for local tumor recurrence at 150 days and 352 days. In the remaining seven cases, disease free interval ranged from 1239 days to 2555 days. Beta therapy using 90Sr may be a valid alternative for the treatment of third eyelid SCC in dogs

Author stance in doctoral dissertations of native and non-native speakers of English: a corpus-based study on epistemic adverbs

[EN]Our study concentrates on the epistemic adverbs used in conveying author stance in academic English. The Contrastive Interlanguage Analysis (Granger, 1996) was run to three sets of corpora comprising doctoral dissertations written by native and non-native academic authors of English. Epistemic adverbs occurring in the dissertations were identified through a computer programme and their frequencies were separately computed for each corpus. Lastly, a log-likelihood test was administered to see whether there is a statistically significant difference across the groups in concern concerning the use of these adverbs.

Combined modality treatment improves tumor control and overall survival in patients with early stage Hodgkin's lymphoma: a systematic review

Combined modality treatment (CMT) of chemotherapy followed by localized radiotherapy is standard treatment for patients with early stage Hodgkin's lymphoma. However, the role of radiotherapy has been questioned recently and some clinical study groups advocate chemotherapy only for this indication. We thus performed a systematic review with meta-analysis of randomized controlled trials comparing chemotherapy alone with CMT in patients with early stage Hodgkin's lymphoma with respect to response rate, tumor control and overall survival (OS). We searched Medline, EMBASE and the Cochrane Library as well as conference proceedings from January 1980 to February 2009 for randomized controlled trials comparing chemotherapy alone versus the same chemotherapy regimen plus radiotherapy. Progression free survival and similar outcomes were analyzed together as tumor control. Effect measures used were hazard ratios for OS and tumor control as well as relative risks for complete response (CR). Meta-analyses were performed using RevMan5. Five randomized controlled trials involving 1,245 patients were included. The hazard ratio (HR) was 0.41 (95% confidence interval (CI) 0.25 to 0.66) for tumor control and 0.40 (95% CI 0.27 to 0.59) for OS for patients receiving CMT compared to chemotherapy alone. CR rates were similar between treatment groups. In sensitivity analyses another 6 trials were included that did not fulfill the inclusion criteria of our protocol but were considered relevant to the topic. These trials underlined the results of the main analysis. In conclusion, adding radiotherapy to chemotherapy improves tumor control and OS in patients with early stage Hodgkin's lymphoma.

Dual-modality PET/CT instrumentation-today and tomorrow

Positron emission tomography (PET) has proven to be a clinically valuable imaging modality, particularly for oncology staging and therapy follow-up. The introduction of combined PET/CT imaging has helped address challenging imaging situations when anatomical information on PET-only was inadequate for accurate lesion localization. After a decade of PET/CT these combined systems have matured technically. Today, whole-body oncology staging is available with PET/CT in 15 min, or less. This review details recent developments in combined PET/CT instrumentation and points to implications for major applications in clinical oncology.

Clinical outcomes of patients with severe aortic stenosis at increased surgical risk according to treatment modality

Objectives The aim of this study was to assess the role of transcatheter aortic valve implantation (TAVI) compared with medical treatment (MT) and surgical aortic valve replacement (SAVR) in patients with severe aortic stenosis (AS) at increased surgical risk. Background Elderly patients with comorbidities are at considerable risk for SAVR. Methods Since July 2007, 442 patients with severe AS (age: 81.7 ± 6.0 years, mean logistic European System for Cardiac Operative Risk Evaluation: 22.3 ± 14.6%) underwent treatment allocation to MT (n = 78), SAVR (n = 107), or TAVI (n = 257) on the basis of a comprehensive evaluation protocol as part of a prospective registry. Results Baseline clinical characteristics were similar among patients allocated to MT and TAVI, whereas patients allocated to SAVR were younger (p < 0.001) and had a lower predicted peri-operative risk (p < 0.001). Unadjusted rates of all-cause mortality at 30 months were lower for SAVR (22.4%) and TAVI (22.6%) compared with MT (61.5%, p < 0.001). Adjusted hazard ratios for death were 0.51 (95% confidence interval: 0.30 to 0.87) for SAVR compared with MT and 0.38 (95% confidence interval: 0.25 to 0.58) for TAVI compared with MT. Medical treatment (<0.001), older age (>80 years, p = 0.01), peripheral vascular disease (<0.001), and atrial fibrillation (p = 0.04) were significantly associated with all-cause mortality at 30 months in the multivariate analysis. At 1 year, more patients undergoing SAVR (92.3%) or TAVI (93.2%) had New York Heart Association functional class I/II as compared with patients with MT (70.8%, p = 0.003). Conclusions Among patients with severe AS with increased surgical risk, SAVR and TAVI improve survival and symptoms compared with MT. Clinical outcomes of TAVI and SAVR seem similar among carefully selected patients with severe symptomatic AS at increased risk.