Afatinib versus cisplatin-based chemotherapy for EGFR mutation-positive lung adenocarcinoma (LUX-Lung 3 and LUX-Lung 6): analysis of overall survival data from two randomised, phase 3 trials

Background We aimed to assess the effect of afatinib on overall survival of patients with EGFR mutation-positive lung adenocarcinoma through an analysis of data from two open-label, randomised, phase 3 trials. Methods Previously untreated patients with EGFR mutation-positive stage IIIB or IV lung adenocarcinoma were enrolled in LUX-Lung 3 (n=345) and LUX-Lung 6 (n=364). These patients were randomly assigned in a 2:1 ratio to receive afatinib or chemotherapy (pemetrexed-cisplatin [LUX-Lung 3] or gemcitabine-cisplatin [LUX-Lung 6]), stratified by EGFR mutation (exon 19 deletion [del19], Leu858Arg, or other) and ethnic origin (LUX-Lung 3 only). We planned analyses of mature overall survival data in the intention-to-treat population after 209 (LUX-Lung 3) and 237 (LUX-Lung 6) deaths. These ongoing studies are registered with ClinicalTrials.gov, numbers NCT00949650 and NCT01121393. Findings Median follow-up in LUX-Lung 3 was 41 months (IQR 35–44); 213 (62%) of 345 patients had died. Median follow-up in LUX-Lung 6 was 33 months (IQR 31–37); 246 (68%) of 364 patients had died. In LUX-Lung 3, median overall survival was 28·2 months (95% CI 24·6–33·6) in the afatinib group and 28·2 months (20·7–33·2) in the pemetrexed-cisplatin group (HR 0·88, 95% CI 0·66–1·17, p=0·39). In LUX-Lung 6, median overall survival was 23·1 months (95% CI 20·4–27·3) in the afatinib group and 23·5 months (18·0–25·6) in the gemcitabine-cisplatin group (HR 0·93, 95% CI 0·72–1·22, p=0·61). However, in preplanned analyses, overall survival was significantly longer for patients with del19-positive tumours in the afatinib group than in the chemotherapy group in both trials: in LUX-Lung 3, median overall survival was 33·3 months (95% CI 26·8–41·5) in the afatinib group versus 21·1 months (16·3–30·7) in the chemotherapy group (HR 0·54, 95% CI 0·36–0·79, p=0·0015); in LUX-Lung 6, it was 31·4 months (95% CI 24·2–35·3) versus 18·4 months (14·6–25·6), respectively (HR 0·64, 95% CI 0·44–0·94, p=0·023). By contrast, there were no significant differences by treatment group for patients with EGFR Leu858Arg-positive tumours in either trial: in LUX-Lung 3, median overall survival was 27·6 months (19·8–41·7) in the afatinib group versus 40·3 months (24·3–not estimable) in the chemotherapy group (HR 1·30, 95% CI 0·80–2·11, p=0·29); in LUX-Lung 6, it was 19·6 months (95% CI 17·0–22·1) versus 24·3 months (19·0–27·0), respectively (HR 1·22, 95% CI 0·81–1·83, p=0·34). In both trials, the most common afatinib-related grade 3–4 adverse events were rash or acne (37 [16%] of 229 patients in LUX-Lung 3 and 35 [15%] of 239 patients in LUX-Lung 6), diarrhoea (33 [14%] and 13 [5%]), paronychia (26 [11%] in LUX-Lung 3 only), and stomatitis or mucositis (13 [5%] in LUX-Lung 6 only). In LUX-Lung 3, neutropenia (20 [18%] of 111 patients), fatigue (14 [13%]) and leucopenia (nine [8%]) were the most common chemotherapy-related grade 3–4 adverse events, while in LUX-Lung 6, the most common chemotherapy-related grade 3–4 adverse events were neutropenia (30 [27%] of 113 patients), vomiting (22 [19%]), and leucopenia (17 [15%]). Interpretation Although afatinib did not improve overall survival in the whole population of either trial, overall survival was improved with the drug for patients with del19 EGFR mutations. The absence of an effect in patients with Leu858Arg EGFR mutations suggests that EGFR del19-positive disease might be distinct from Leu858Arg-positive disease and that these subgroups should be analysed separately in future trials.

Sångöversättning – någonstans mellan respekt och slagkraft

Abstract (Song translation. Balancing between respect and hit capacity): The article discusses song translation by posing questions relevant to the study, practice, and assessment of translating/translated song: Is song translation really translation? Do non-singable translations count? Can we distinguish between free and faithful song translation? Are there untranslatable (aspects of) songs? etc. Three song translations between Finnish and Swedish are analyzed in the discussion: one made for a booklet to a recording, which in spite of the evident documentary purpose is fairly singable, one that is a national transplantation, which moves the sung story to the target country but even so is fairly faithful, and one that is considered respectful to its source, became a target culture hit, but perhaps because of the subtle changes in content. Changes can be seen as caused by a particular translation brief, as manipulations negotiating a cultural difference, or as examples of how (liberally) the craft of song translation is exercised. An amateur translation of the same song, made by the article’s author, is deemed dysfunctional for having put emphasis merely on semantic accuracy and rhymes, neglecting other aspects of the craft. The article suggests that singability is a relative concept, that stylistic/intertextual values matter a great deal in song and exert significant influence on song translation, and that source and target attentions in this area can be discussed as a much variable vacillation between a stance of respect and an aim for hit capacity.

Words as Events : Cretan Mantinádes in Performance and Composition

Words as Events introduces the tradition of short, communicative rhyming couplets, the mantinádes, which are still sung and recited in a variety of performance situations on the island of Crete. The local focus on communicative economy and artistry is further examined in an in-depth analysis of the processes and ideals of composition. Short genres of oral poetry have been widely neglected in folklore research; however, their demand for structural and semantic coherence as well as their dialogic nature appeals to very different human needs from those of the longer poems. In contemporary Crete, poems also appear in written contexts, they are submitted to modern mass media, and people widely exchange them as text messages. By striving to understand the tradition during a period of change, this study analyzes the larger principles that ground the communication, self-expression and creativity in the genre. The aim of this research is thus twofold: to present this specific register of dialogic oral poetry as well as to create a theoretical approach sensitive to the creativity of such short registers. The study is based on long-term ethnographic fieldwork conducted in Crete between the years 1997 2009. An important aspect of the methodology was to create long-term ties with a number of key-informants who composed mantinádes. The interdisciplinary theoretical and methodological basis for this analysis is in the contemporary Finnish and international research on oral poetry and on anthropological research on communicative speech genres. These theoretical insights are extended by addressing questions of spontaneity and individual agency. Since mantinádes are at the same time a model for composition and a reserve of poems in fixed form, the aesthetics and objectives of performance and composition are also plural. In a traditional singing event, the basic motivation for the singers is to provide a meaningful contribution to a selected theme, which is the shared topic of the poetic dialogue. Consequently, similar topics giving rise to poetic associations can be encountered during various moments of everyday life: the dialogic nature is embodied in the tradition to such degree that it also arises in the performances and composition of single poems and outside of any institutionalized performance arenas. Therefore, as this study discusses in detail, even the apparently non-contextualized poems recited between locals or occurring in the contemporary mass media arenas, are understood and evaluated as utterances that provide an individual perspective within a certain dialogue.

A speech-music discriminator using HILN model based features

We propose a simple speech music discriminator that uses features based on HILN(Harmonics, Individual Lines and Noise) model. We have been able to test the strength of the feature set on a standard database of 66 files and get an accuracy of around 97%. We also have tested on sung queries and polyphonic music and have got very good results. The current algorithm is being used to discriminate between sung queries and played (using an instrument like flute) queries for a Query by Humming(QBH) system currently under development in the lab.

Predicting the Timing of Spikes Evoked by Tactile Stimulation of the Hand

Kim SS, Sripati AP, Bensmaia SJ. Predicting the timing of spikes evoked by tactile stimulation of the hand. J Neurophysiol 104: 1484-1496, 2010. First published July 7, 2010; doi: 10.1152/jn.00187.2010. What does the hand tell the brain? Tactile stimulation of the hand evokes remarkably precise patterns of neural activity, suggesting that the timing of individual spikes may convey information. However, many aspects of the transformation of mechanical deformations of the skin into spike trains remain unknown. Here we describe an integrate-and-fire model that accurately predicts the timing of individual spikes evoked by arbitrary mechanical vibrations in three types of mechanoreceptive afferent fibers that innervate the hand. The model accounts for most known properties of the three fiber types, including rectification, frequency-sensitivity, and patterns of spike entrainment as a function of stimulus frequency. These results not only shed light on the mechanisms of mechanotransduction but can be used to provide realistic tactile feedback in upper-limb neuroprostheses.

A Deterministic Optimization Approach to Protein Sequence Design Using Continuous Models

Determining the sequence of amino acid residues in a heteropolymer chain of a protein with a given conformation is a discrete combinatorial problem that is not generally amenable for gradient-based continuous optimization algorithms. In this paper we present a new approach to this problem using continuous models. In this modeling, continuous "state functions" are proposed to designate the type of each residue in the chain. Such a continuous model helps define a continuous sequence space in which a chosen criterion is optimized to find the most appropriate sequence. Searching a continuous sequence space using a deterministic optimization algorithm makes it possible to find the optimal sequences with much less computation than many other approaches. The computational efficiency of this method is further improved by combining it with a graph spectral method, which explicitly takes into account the topology of the desired conformation and also helps make the combined method more robust. The continuous modeling used here appears to have additional advantages in mimicking the folding pathways and in creating the energy landscapes that help find sequences with high stability and kinetic accessibility. To illustrate the new approach, a widely used simplifying assumption is made by considering only two types of residues: hydrophobic (H) and polar (P). Self-avoiding compact lattice models are used to validate the method with known results in the literature and data that can be practically obtained by exhaustive enumeration on a desktop computer. We also present examples of sequence design for the HP models of some real proteins, which are solved in less than five minutes on a single-processor desktop computer Some open issues and future extensions are noted.

An Efficient Simulated Annealing With a Valid Solution Mechanism For TDMA Brodcast Scheduling problem

This paper presents an efficient Simulated Annealing with valid solution mechanism for finding an optimum conflict-free transmission schedule for a broadcast radio network. This is known as a Broadcast Scheduling Problem (BSP) and shown as an NP-complete problem, in earlier studies. Because of this NP-complete nature, earlier studies used genetic algorithms, mean field annealing, neural networks, factor graph and sum product algorithm, and sequential vertex coloring algorithm to obtain the solution. In our study, a valid solution mechanism is included in simulated annealing. Because of this inclusion, we are able to achieve better results even for networks with 100 nodes and 300 links. The results obtained using our methodology is compared with all the other earlier solution methods.

{C}^0$ penalty methods for the fully nonlinear Monge-Ampère equation

In this paper, we develop and analyze C(0) penalty methods for the fully nonlinear Monge-Ampere equation det(D(2)u) = f in two dimensions. The key idea in designing our methods is to build discretizations such that the resulting discrete linearizations are symmetric, stable, and consistent with the continuous linearization. We are then able to show the well-posedness of the penalty method as well as quasi-optimal error estimates using the Banach fixed-point theorem as our main tool. Numerical experiments are presented which support the theoretical results.

Multigrid algorithms for symmetric discontinuous Galerkin methods on graded meshes

We study a class of symmetric discontinuous Galerkin methods on graded meshes. Optimal order error estimates are derived in both the energy norm and the L 2 norm, and we establish the uniform convergence of V-cycle, F-cycle and W-cycle multigrid algorithms for the resulting discrete problems. Numerical results that confirm the theoretical results are also presented.

Location Area Planning Using Simulated Annealing With A New Solution Representation

Location area planning problem is to partition the cellular/mobile network into location areas with the objective of minimizing the total cost. This partitioning problem is a difficult combinatorial optimization problem. In this paper, we use the simulated annealing with a new solution representation. In our method, we can automatically generate different number of location areas using Compact Index (CI) to obtain the optimal/best partitions. We compare the results obtained in our method with the earlier results available in literature. We show that our methodology is able to perform better than earlier methods.

A QUADRATIC C degrees INTERIOR PENALTY METHOD FOR LINEAR FOURTH ORDER BOUNDARY VALUE PROBLEMS WITH BOUNDARY CONDITIONS OF THE CAHN-HILLIARD TYPE

We develop a quadratic C degrees interior penalty method for linear fourth order boundary value problems with essential and natural boundary conditions of the Cahn-Hilliard type. Both a priori and a posteriori error estimates are derived. The performance of the method is illustrated by numerical experiments.

Enhancing the high temperature plasticity of a Cu-containing austenitic stainless steel through grain boundary strengthening

The addition of 3 wt% Cu to heat-resistant SUS 304H austenitic steel enhances its high temperature mechanical properties. To further improve the properties, particularly the creep resistance and ductility at high temperatures, a post-solutionizing heat-treatment method that involves an intermediated annealing either at 700 or 800 degrees C after solutionizing for durations up to 180 min was employed. The purpose this heat-treatment is to precipitate planar Cr23C6 at the grain boundaries, which results in the boundaries getting serrated. Detailed microstructural analyses of these `grain boundary engineered' alloys was conducted and their mechanical performance, both at room temperature and at 750 degrees C, was evaluated. While the grain size and texture are unaffected due to the high temperature hold, the volume fraction of Sigma 3 twin boundaries was found to increase significantly. While the strength enhancement was only marginal, the ductility was found to increase significantly, especially at high temperature. A marked increase in the creep resistance was also noted, which is attributed to the reduction of the grain boundary sliding by the grain boundary serrations and the suppression of grain boundary cavitation through the optimization of the volume fraction and spacing of the Cr23C6 precipitates. The special heat-treatment performed with holding time of 3 h at 700 degrees C resulted in the optimum combination of strength, ductility and creep resistance at high temperature. (C) 2014 Elsevier B.V. All rights reserved.

Organic-inorganic hybrid PtCo nanoparticle with high electrocatalytic activity and durability for oxygen reduction

In Pt-transition metal (TM) alloy catalysts, the electron transfer from the TM to Pt is retarded owing to the inevitable oxidation of the TM surface by oxygen. In addition, acidic electrolytes such as those employed in fuel cells accelerate the dissolution of the surface TM oxide, which leads to catalyst degradation. Herein, we propose a novel synthesis strategy that selectively modifies the electronic structure of surface Co atoms with N-containing polymers, resulting in highly active and durable PtCo nanoparticle catalysts useful for the oxygen reduction reaction (ORR). The polymer, which is functionalized on carbon black, selectively interacts with the Co precursor, resulting in Co-N bond formation on the PtCo nanoparticle surface. Electron transfer from Co to Pt in the PtCo nanoparticles modified by the polymer is enhanced by the increase in the difference in electronegativity between Pt and Co compared with that in bare PtCo nanoparticles with the TM surface oxides. In addition, the dissolution of Co and Pt is prevented by the selective passivation of surface Co atoms and the decrease in the O-binding energy of surface Pt atoms. As a result, the catalytic activity and durability of PtCo nanoparticles for the ORR are significantly improved by the electronic ensemble effects. The proposed organic/inorganic hybrid concept will provide new insights into the tuning of nanomaterials consisting of heterogeneous metallic elements for various electrochemical and chemical applications.

An Experimental Study of Kerosene Combustion in a Supersonic Model Combustor Using Effervescent Atomization

Investigation of kerosene combustion in a Mach 2.5 flow was carried out using a model supersonic combustor with cross-section area of 51 mm × 70 mm and different integrated fuel injector/flameholder cavity modules. Experiments with pure liquid atomization and with effervescent atomization were characterized and compared. Direct photography, Schlieren imaging, and planar laser induced fluorescence (PLIF) imaging of OH radical were utilized to examine the cavity characteristics and spray structure. Schlieren images illustrate the effectiveness of gas barbotage in facilitating atomization and the importance of secondary atomization when kerosene sprays interacting with a supersonic crossflow. OH PLIF images further substantiate our previous finding that there exists a local high-temperature radical pool within the cavity flameholder, and this radical pool plays a crucial role in promoting kerosene combustion in a supersonic combustor. Under the same operation conditions, comparison of the measured static pressure distributions along the combustor also shows that effervescent atomization generally leads to better combustion performance than the use of pure liquid atomization. Furthermore, the present results demonstrate that the cavity characteristics can be different in non-reacting and reacting supersonic flows. As such, the conventional definition of cavity characteristics based on non-reacting flows needs to be revised.

Investigation of Vaporized Kerosene Injection and Combustion in a Supersonic Model Combustor

Injection and combustion of vaporized kerosene was experimentally investigated in a Mach 2.5 model combustor at various fuel temperatures and injection pressures. A unique kerosene heating and delivery system, which can prepare heated kerosene up to 820 K at a pressure of 5.5 MPa with negligible fuel coking, was developed. A three-species surrogate was employed to simulate the thermophysical properties of kerosene. The calculated thermophysical properties of surrogate provided insight into the fuel flow control in experiments. Kerosene jet structures at various preheat temperatures injecting into both quiescent environment and a Mach 2.5 crossflow were characterized. It was shown that the use ofvaporized kerosene injection holds the potential of enhancing fuel-air mixing and promoting overall burning. Supersonic combustion tests further confirmed the preceding conjecture by comparing the combustor performances of supercritical kerosene with those of liquid kerosene and effervescent atomization with hydrogen barbotage. Under the similar flow conditions and overall kerosene equivalence ratios, experimental results illustrated that the combustion efficiency of supercritical kerosene increased approximately 10-15% over that of liquid kerosene, which was comparable to that of effervescent atomization.