Bevacizumab, Pemetrexed, and Cisplatin, or Bevacizumab and Erlotinib for Patients With Advanced Non-Small-Cell Lung Cancer Stratified by Epidermal Growth Factor Receptor Mutation: Phase II Trial SAKK19/09.

OBJECTIVE: The goal was to demonstrate that tailored therapy, according to tumor histology and epidermal growth factor receptor (EGFR) mutation status, and the introduction of novel drug combinations in the treatment of advanced non-small-cell lung cancer are promising for further investigation. METHODS: We conducted a multicenter phase II trial with mandatory EGFR testing and 2 strata. Patients with EGFR wild type received 4 cycles of bevacizumab, pemetrexed, and cisplatin, followed by maintenance with bevacizumab and pemetrexed until progression. Patients with EGFR mutations received bevacizumab and erlotinib until progression. Patients had computed tomography scans every 6 weeks and repeat biopsy at progression. The primary end point was progression-free survival (PFS) ≥ 35% at 6 months in stratum EGFR wild type; 77 patients were required to reach a power of 90% with an alpha of 5%. Secondary end points were median PFS, overall survival, best overall response rate (ORR), and tolerability. Further biomarkers and biopsy at progression were also evaluated. RESULTS: A total of 77 evaluable patients with EGFR wild type received an average of 9 cycles (range, 1-25). PFS at 6 months was 45.5%, median PFS was 6.9 months, overall survival was 12.1 months, and ORR was 62%. Kirsten rat sarcoma oncogene mutations and circulating vascular endothelial growth factor negatively correlated with survival, but thymidylate synthase expression did not. A total of 20 patients with EGFR mutations received an average of 16 cycles. PFS at 6 months was 70%, median PFS was 14 months, and ORR was 70%. Biopsy at progression was safe and successful in 71% of the cases. CONCLUSIONS: Both combination therapies were promising for further studies. Biopsy at progression was feasible and will be part of future SAKK studies to investigate molecular mechanisms of resistance.

Blood pressure levels and haematoma growth in patients with Intracerebral Haemorrhage (ICH) A retrospective observational study

Intracerebral haemorrhage (ICH) is a spontaneous extravasation of blood into brain parenchyma. Although ICH represents approximately only 15% of all strokes, it is one of the major causes of stroke-related death and disability. One of the causes of poor outcome is the haematoma growth. The association between elevated blood pressure (BP) and haematoma enlargement in acute ICH has not been clarified. Our objective is to try to identify this relationship that may suggest an immediate target for intervention to possibly improve outcomes in patients with spontaneous ICH and might settle the controversy surrounding the optimal management of blood pressure.We propose a retrospective revision using a sample present in our database of approximately 250 patients with primary ICH and less than 12h from symptoms onset. Systolic blood pressure levels (SBP) are assessed at baseline, at 6h, at 12h, at 24h and at 72h, being these last four the average levels of the different recordings during those time intervals. Haematoma growth will be defined as an increase in the volume of intraparenchymal haemorrhage of >33% as measured by image analysis on the 24-hour CT or 72-hour CT compared with the baseline CT scan. A qualified neuroradiologist not informed of the aim of the study, will review the CT images. The secondary objective will be to correlate the BP levels in the acute phase of ICH with clinical outcome. We will evaluate early neurologic deterioration at 72h by using the National Institutes of Health Stroke Scale (NIHSS); outcome at 90 days by using the modified Rankin scale and mortality at 72h and 90 days. The statistical analysis will be adjusted by possibly confounding variables

Understanding the in vitro dissolution rate of glasses with respect to future clinical applications

Glass is a unique material with a long history. Several glass products are used daily in our everyday life, often unnoticed. Glass can be found not only in obvious applications such as tableware, windows, and light bulbs, but also in tennis rackets, windmill turbine blades, optical devices, and medical implants. The glasses used at present as implants are inorganic silica-based melt-derived compositions mainly for hard-tissue repair as bone graft substitute in dentistry and orthopedics. The degree of glass reactivity desired varies according to implantation situation and it is vital that the ion release from any glasses used in medical applications is controlled. Understanding the in vitro dissolution rate of glasses provides a first approximation of their behavior in vivo. Specific studies concerning dissolution properties of bioactive glasses have been relatively scarce and mostly concentrated to static condition studies. The motivation behind this work was to develop a simple and accurate method for quantifying the in vitro dissolution rate of highly different types of glass compositions with interest for future clinical applications. By combining information from various experimental conditions, a better knowledge of glass dissolution and the suitability of different glasses for different medical applications can be obtained. Thus, two traditional and one novel approach were utilized in this thesis to study glass dissolution. The chemical durability of silicate glasses was tested in water and TRIS-buffered solution at static and dynamic conditions. The traditional in vitro testing with a TRISbuffered solution under static conditions works well with bioactive or with readily dissolving glasses, and it is easy to follow the ion dissolution reactions. However, in the buffered solution no marked differences between the more durable glasses were observed. The hydrolytic resistance of the glasses was studied using the standard procedure ISO 719. The relative scale given by the standard failed to provide any relevant information when bioactive glasses were studied. However, the clear differences in the hydrolytic resistance values imply that the method could be used as a rapid test to get an overall idea of the biodegradability of glasses. The standard method combined with the ion concentration and pH measurements gives a better estimate of the hydrolytic resistance because of the high silicon amount released from a glass. A sensitive on-line analysis method utilizing inductively coupled plasma optical emission spectrometer and a flow-through micro-volume pH electrode was developed to study the initial dissolution of biocompatible glasses. This approach was found suitable for compositions within a large range of chemical durability. With this approach, the initial dissolution of all ions could be measured simultaneously and quantitatively, which gave a good overall idea of the initial dissolution rates for the individual ions and the dissolution mechanism. These types of results with glass dissolution were presented for the first time during the course of writing this thesis. Based on the initial dissolution patterns obtained with the novel approach using TRIS, the experimental glasses could be divided into four distinct categories. The initial dissolution patterns of glasses correlated well with the anticipated bioactivity. Moreover, the normalized surface-specific mass loss rates and the different in vivo models and the actual in vivo data correlated well. The results suggest that this type of approach can be used for prescreening the suitability of novel glass compositions for future clinical applications. Furthermore, the results shed light on the possible bioactivity of glasses. An additional goal in this thesis was to gain insight into the phase changes occurring during various heat treatments of glasses with three selected compositions. Engineering-type T-T-T curves for glasses 1-98 and 13-93 were stablished. The information gained is essential in manufacturing amorphous porous implants or for drawing of continuous fibers of the glasses. Although both glasses can be hot worked to amorphous products at carefully controlled conditions, 1-98 showed one magnitude greater nucleation and crystal growth rate than 13-93. Thus, 13-93 is better suited than 1-98 for working processes which require long residence times at high temperatures. It was also shown that amorphous and partially crystalline porous implants can be sintered from bioactive glass S53P4. Surface crystallization of S53P4, forming Na2O∙CaO∙2SiO2, was observed to start at 650°C. The secondary crystals of Na2Ca4(PO4)2SiO4, reported for the first time in this thesis, were detected at higher temperatures, from 850°C to 1000°C. The crystal phases formed affected the dissolution behavior of the implants in simulated body fluid. This study opens up new possibilities for using S53P4 to manufacture various structures, while tailoring their bioactivity by controlling the proportions of the different phases. The results obtained in this thesis give valuable additional information and tools to the state of the art for designing glasses with respect to future clinical applications. With the knowledge gained we can identify different dissolution patters and use this information to improve the tuning of glass compositions. In addition, the novel online analysis approach provides an excellent opportunity to further enhance our knowledge of glass behavior in simulated body conditions.

Pamidronate for the treatment of osteoporosis secondary to chronic cholestatic liver disease in Wistar rats

Osteoporosis is a major complication of chronic cholestatic liver disease (CCLD). We evaluated the efficacy of using disodium pamidronate (1.0 mg/kg body weight) for the prevention (Pr) or treatment (Tr) of cholestasis-induced osteoporosis in male Wistar rats: sham-operated (Sham = 12); bile duct-ligated (Bi = 15); bile duct-ligated animals previously treated with pamidronate before and 1 month after surgery (Pr = 9); bile duct-ligated animals treated with pamidronate 1 month after surgery (Tr = 9). Rats were sacrificed 8 weeks after surgery. Immunohistochemical expression of IGF-I and GH receptor was determined in the proximal growth plate cartilage of the left tibia. Histomorphometric analysis was performed in the right tibia and the right femur was used for biomechanical analysis. Bone material volume over tissue volume (BV/TV) was significantly affected by CCLD (Sham = 18.1 ± 3.2 vs Bi = 10.6 ± 2.2%) and pamidronate successfully increased bone volume. However, pamidronate administered in a preventive regimen presented no additional benefit on bone volume compared to secondary treatment (BV/TV: Pr = 39.4 ± 12.0; Tr = 41.2 ± 12.7%). Moreover, the force on the momentum of fracture was significantly reduced in Pr rats (Sham = 116.6 ± 23.0; Bi = 94.6 ± 33.8; Pr = 82.9 ± 22.8; Tr = 92.5 ± 29.5 N; P < 0.05, Sham vs Pr). Thus, CCLD had a significant impact on bone histomorphometric parameters and pamidronate was highly effective in increasing bone mass in CCLD; however, preventive therapy with pamidronate has no advantage regarding bone fragility.

The nature of the highly artistic student in visual arts at secondary school /

This qualitative investigation examined the nature of 7 highly artistic visual arts students at 2 secondary schools in southcentral Ontario. Through interviews, questionnaires, observations, and artwork documents, this study attempted to understand these highly artistic students in terms of creativity, motivation, social and emotional perspectives, and cognitive processes. Data collection occuned over a 3-monlh period. and the data analysis program NVivo 7 was used for coding to develop themes and categories for organizing data. The findings of this study illustrate the significant place that \ isual arts can lake in the growth and development for the youth of today. Participants idcniificd dcxclopnig critical thinking and problem-solving skills, taking risks, and meeting challenges ilirouuh their engagement in the creative process. The transferability of these skills \\ as referenced to numerous aspects of their lives. By enhancing individual perspectives through the study of visual arts, their local and world connections were extended, and environmental and societal concerns evolved. In addition, the communicative opportunities that visual arts provided for these students in terms of personal expression provided emotional health and paths of personal discovery. Through the participants' production of artwork with the many stages this involves, combined with insight into their needs, the participants relayed miportant suggestions for programming enhancements and educational settmgs lor \ isiial arts classrooms. These suggestions are meaningful for educators and curriculum developers of the future.

Test of Hockman and Oldham's job characteristics model in a post-secondary educational setting

One hundred and seventy-two subj ects participated in this quantitative, correlational survey which tested Hackman and Oldham's Job Characteristics Model in an educational setting. Subjects were Teaching Masters, Chairmen and Deans from an Ontario community college. The data were collected via mailed questionnaire, on all variables of the model. Several reliable, valid instruments were used to test the variables. Data analysis through Pearson correlation and stepwise multiple regression analyses revealed that core job characteristics predicted certain critical psychological states and that these critical psychological states, in turn were able to predict various personal and work outcomes but not absenteeism. The context variable, Satisfaction with Co-workers, was the only consistent moderating variable between core characteristics and critical psychological states; however, individual employee differences did moderate the relationship between critical psychological states and all of the personal and work outcomes except Internal Work Motivation. Two other moderator variables, Satisfaction with Context and Growth Need Strength, demonstrated an ability to predict the outcome General Job Satisfaction. The research suggests that this model may be used for job design and redesign purposes within the community college setting.

Defence of Agaricus bisporus against toxic secondary metabolites from Trichoderma aggressivum.

Trichoderma spp are effective competitors against other fungi because they are mycoparasitic and produce hydrolytic enzymes and secondary metabolites that inhibit the growth of their competitors. Inhibitory compounds produced by Trichoderma aggressivum, the causative agent of green mold disease, are more toxic to the hybrid off-white strains of Agaricus bisporus than the commercial brown strains, consistent with the commercial brown strain’s increased resistance to the disease. This project looked at the response of hybrid off-white and commercial brown strains of A. bisporus to the presence of T. aggressivum metabolites with regard to three A. bisporus genes: laccase 1, laccase 2, and manganese peroxidase. The addition of T. aggressivum toxic metabolites had no significant effect on MnP or lcc1 transcript abundance. Alternatively, laccase 2 appears to be involved in resistance to T. aggressivum because the presence of T. aggressivum metabolites results in higher lcc2 transcript abundance and laccase activity, especially in the commercial brown strain. The difference in laccase expression and activity between A. bisporus strains was not a result of regulatory or coding sequence differences. Alteration of laccase transcription by RNAi resulted in transformants with variable levels of laccase transcript abundance. Transformants with a low number of lcc transcripts were very sensitive to T. aggressivum toxins, while those with a high number of lcc transcripts had increased resistance. These results indicated that laccase activity, in particular that encoded by lcc2, serves as a defense response of A. bisporus to T. aggressivum toxins and contributes to green mold disease resistance in commercial brown strains.

Metaphorical Interpretation: Measuring and Facilitating Growth.

Abstract A total of 378 grade 9 students participated in this study to address the problem that although metaphorical literacy and thought are expected and necessary for success in junior and senior high school and beyond, metaphorical concepts and thought are not required to be explicitly taught to these students. The students were from 20 different classes from 4 levels: English language learners (ELL), school to work (SSTW), applied, and academic. All were from 7 secondary schools within a board in southern Ontario. Nine classes made up the control group and 11 classes made up the treatment group. All classes were given 3 pretests and the posttest. The treatment group was given Socratic lessons and direct instruction on metaphorical thought and expressions during 1 semester and in conjunction with their other classroom material. The pretest scores (TOLD, Peabody, preproverbs concrete, and preproverbs abstract) did not reveal any effect of gender, but the academic students had higher scores than the applied students. The SSTW student results are more variable: (a) for the TOLD test, SSTW scores were between those of the academic and applied students; (b) for Peabody scores, SSTW students’ scores are the same as academic and are greater than applied; (c) for preproverbs concrete and preproverbs abstract, the SSTW scores are not different from the applied scores. The postproverbs concrete and postproverbs abstract scores for the treatment groups also showed no effect of gender but revealed that all students who received the treatment did better on their post scores. The positive changes of the treatment group illustrate a measured movement from literal understanding to abstract understanding using direct Socratic instruction and proverbs as a medium.

Posttraumatic Growth: A Mediated-Moderation Model

The primary goal was to test a mediated-moderation model in which dispositional optimism was the moderator and its role was mediated by problem-focused coping. A secondary goal was to demonstrate that posttraumatic growth could be differentiated from maturation and normal development. Two groups of participants were recruited and completed questionnaires twice with a 60-day interval: One group (Trauma), described a traumatic experience and the second group (Non-trauma), described a significant experience. Contrary to the hypothesis, only problem-focused coping and deliberate rumination predicted posttraumatic growth, and these findings were only observed in concurrent analyses. Furthermore, the results indicated that there was no significant difference between groups on growth scores at either Time 1 or Time 2. The findings suggest that the term “posttraumatic growth” may refer to the context in which growth occurs rather than to some developmental process that uniquely follows trauma.

L’effet du vieillissement sur les cellules souches neurales adultes

La neurogenèse persiste à l’âge adulte dans deux régions du système nerveux central (SNC) des mammifères : la zone sous-ventriculaire (SVZ) du cerveau antérieur et la zone sous-granulaire (SGZ) de l’hippocampe. Cette neurogenèse est possible grâce à la capacité de prolifération des cellules souches présentes dans les niches de la SVZ et la SGZ, mais en vieillissant, le cerveau subit une diminution dramatique du nombre de cellules souches neurales adultes (CSNa), une diminution de la prolifération cellulaire et une altération des niches de neurogenèse. Cependant, une importante question reste sans réponse : comment la perte tardive des CSNa est temporellement reliée aux changements de l’activité de prolifération et de la structure de la principale niche de neurogenèse (la SVZ)? Afin d’avoir un aperçu sur les événements initiaux, nous avons examiné les changements des CSNa et de leur niche dans la SVZ entre le jeune âge et l’âge moyen. La niche de la SVZ des souris d’âge moyen (12 mois) subit une réduction de l’expression des marqueurs de plusieurs sous-populations de précurseurs neuraux en comparaison avec les souris jeunes adultes (2 mois). Anatomiquement, cela est associé avec des anomalies cytologiques, incluant une atrophie générale de la SVZ, une perte de la couche de cellules sousépendymaires par endroit et l’accumulation de gouttelettes lipidiques de grande taille dans l’épendyme. Fonctionnellement, ces changements sont corrélés avec une diminution de l’activité de la SVZ et une réduction du nombre de nouveaux neurones arrivant aux bulbes olfactifs. Pour déterminer si les CSNa de la SVZ ont subi des changements visibles, nous avons évalué les paramètres clés des CSNa in vivo et in vitro. La culture cellulaire montre qu’un nombre équivalent de CSNa ayant la capacité de former des neurosphères peut être isolé du cerveau du jeune adulte et d’âge moyen. Cependant, à l’âge moyen, les précurseurs neuraux semblent moins sensibles aux facteurs de croissance durant leur différenciation in vitro. Les CSNa donnent des signes de latence in vivo puisque leur capacité d’incorporation et de rétention du BrdU diminue. Ensemble, ces données démontrent que, tôt dans le processus du vieillissement, les CSNa et leur niche dans la SVZ subissent des changements significatifs, et suggèrent que la perte de CSNa liée au vieillissement est secondaire à ces événements.

The role of PPARgamma in cartilage growth and development using cartilage-specific PPARgamma knockout mice

Le cartilage est un tissu conjonctif composé d’une seule sorte de cellule nommée chondrocytes. Ce tissu offre une fondation pour la formation des os. Les os longs se développent par l'ossification endochondral. Ce processus implique la coordination entre la prolifération, la différenciation et l'apoptose des chondrocytes, et résulte au remplacement du cartilage par l'os. Des anomalies au niveau du squelette et des défauts liés à l’âge tels que l’arthrose (OA) apparaissent lorsqu’il y a une perturbation dans l’équilibre du processus de développement. À ce jour, les mécanismes exacts contrôlant la fonction et le comportement des chondrocytes pendant la croissance et le développement du cartilage sont inconnus. Le récepteur activateur de la prolifération des peroxysomes (PPAR) gamma est un facteur de transcription impliqué dans l'homéostasie des lipides. Plus récemment, son implication a aussi été suggérée dans l'homéostasie osseuse. Cependant, le rôle de PPARγ in vivo dans la croissance et le développement du cartilage est inconnu. Donc, pour la première fois, cette étude examine le rôle spécifique de PPARγ in vivo dans la croissance et le développement du cartilage. Les souris utilisées pour l’étude avaient une délétion conditionnelle au cartilage du gène PPARγ. Ces dernières ont été générées en employant le système LoxP/Cre. Les analyses des souris ayant une délétion au PPARγ aux stades embryonnaire et adulte démontrent une réduction de la croissance des os longs, une diminution des dépôts de calcium dans l’os, de la densité osseuse et de la vascularisation, un délai dans l’ossification primaire et secondaire, une diminution cellulaire, une perte d’organisation colonnaire et une diminution des zones hypertrophiques, une désorganisation des plaques de croissance et des chondrocytes déformés. De plus, la prolifération et la différenciation des chondrocytes sont anormales. Les chondrocytes et les explants isolés du cartilage mutant démontrent une expression réduite du facteur de croissance endothélial vasculaire (VEGF)-A et des éléments de production de la matrice extracellulaire. Une augmentation de l’expression de la métalloprotéinase matricielle (MMP)-13 est aussi observée. Dans les souris âgées ayant une délétion au PPARγ, y est aussi noté des phénotypes qui ressemblent à ceux de l’OA tel que la dégradation du cartilage et l'inflammation de la membrane synoviale, ainsi qu’une augmentation de l’expression de MMP-13 et des néoépitopes générés par les MMPs. Nos résultats démontrent que le PPARγ est nécessaire pour le développement et l’homéostasie du squelette. PPARγ est un régulateur essentiel pour la physiologie du cartilage durant les stades de croissance, de développement et de vieillissement.

Investing Online: Concerns about the Evolving Use of the Internet as an Investment Tool in the Secondary Market Context

La croissance dramatique du commerce électronique des titres cache un grand potentiel pour les investisseurs, de même que pour l’industrie des valeurs mobilières en général. Prenant en considération ses risques particuliers, les autorités réglementaires vivent un défi important face à l’Internet en tant que nouveau moyen d’investir. Néanmoins, malgré l’évolution technologique, les objectifs fondamentaux et l’approche des autorités réglementaires restent similaires à ce qui se produit présentement. Cet article analyse l’impact de l’Internet sur le commerce des valeurs mobilières en se concentrant sur les problèmes soulevés par l’utilisation de ce nouveau moyen de communication dans le contexte du marché secondaire. Par conséquent, son objectif est de dresser le portrait des plaintes typiques des investisseurs, de même que celui des activités frauduleuses en valeurs mobilières propres au cyberespace. L’auteur fait une synthèse des développements récents en analysant l’approche des autorités réglementaires, les études doctrinales, la jurisprudence et les cas administratifs. L'auteure désire remercier la professeure Raymonde Crête pour ses précieux commentaires et conseils.

Development of plant tissue culture of Plumbago rosea Linn. for enhanced production of secondary metabolites

P rosea syn. Indica belong to the family of plumbaginaceae, is an important medicinal plant, cultivated widely in India. The roots of these plant are generally used for medicinal purposes mainly as diuretic, germicidal, vessicant, and abortifacient. It is also used for anaemia, diarrhea, leprosy and common wart. The bark of the root contains orange yellow pigment named plumbagin, a crystalline substance, belongs to the class of naphthoquinone. Its chemical structure is 5-hydroxy 2-methyl 1,4naphthoquinone. Apart from P rosea, P zeylanica, P europea, Drosera and Drosophyllum also contains plumbagin. The most exploited source of plumbagin is, of course, P. rosea roots. The roots contain O.9mg/ g D.Wt. of plumbagin in the roots. These plants grow very slowly and the roots suitable for plumbagin extraction can be obtained only after several years of growth. The productivity of the plant is also rather poor. The focus of the present study was to develop alternative strategies to obtain plumbagin. The tissue culture of P rosea for micropropagation has been studied

Effects of shoot pruning and inflorescence thinning on plant growth, yield and fruit quality of greenhouse tomatoes in a tropical climate

The combined effects of shoot pruning (one or two stems) and inflorescence thinning (five or ten flowers per inflorescence) on greenhouse tomato yield and fruit quality were studied during the dry season (DS) and rainy season (RS) in Central Thailand. Poor fruit set, development of undersized (mostly parthenocarpic) fruits, as well as the physiological disorders blossom-end rot (BER) and fruit cracking (FC) turned out to be the prevailing causes deteriorating fruit yield and quality. The proportion of marketable fruits was less than 10% in the RS and around 65% in the DS. In both seasons, total yield was significantly increased when plants were cultivated with two stems, resulting in higher marketable yields only in the DS. While the fraction of undersized fruits was increased in both seasons when plants were grown with a secondary stem, the proportions of BER and FC were significantly reduced. Restricting the number of flowers per inflorescence invariably resulted in reduced total yield. However, in neither season did fruit load considerably affect quantity or proportion of the marketable yield fraction. Inflorescence thinning tended to promote BER and FC, an effect which was only significant for BER in the RS. In conclusion, for greenhouse tomato production under climate conditions as they are prevalent in Central Thailand, the cultivation with two stems appears to be highly recommendable whereas the measures to control fruit load tested in this study did not proof to be advisable.

Revisiting the Relationship between Income Distribution and Economic Growth

La mayoría de los modelos que exploran la relación entre la desigualdad en la distribución del ingreso y el crecimiento económico, postulan la existencia de una correlación negativa entre las dos que es generada a través de diferentes mecanismos. Paralelamente a los modelos teóricos, un número importante de estudios empíricos han tratado de evaluar esta relación. De este esfuerzo ha surgido un consenso amplio que valida la existencia de dicha relación negativa. No obstante, estudios recientes basados en el uso de datos de panel han producido el resultado contrario, documentando la presencia de una relación positiva entre desigualdad y crecimiento. El examen del debate generado a partir de estos resultados, así como el trabajo empírico adelantado en este estudio, indican que las estimaciones obtenidas en diversos trabajos pueden no ser tan robustas como se creía En consecuencia, se sugiere que la realización de estudios de caso por país puede ser una mejor vía para explorar este tema.