Combined modality chemoradiation in elderly oesophageal cancer patients

We present a single institution experience with 5-FU, mitomycin-C based chemoradiation for the primary treatment of elderly patients with oesophageal cancer. Twenty-five patients with a median age of 77 years (range 66–88) with a diagnosis of stage II–III squamous cell or adenocarcinoma of the oesophagus were treated at Memorial Sloan Kettering from 1996 to 2001 with two cycles of concurrent 5-FU, mitomycin-C and 50.4 Gy. Owing to age and comorbidity, these patients were not considered surgical candidates. The Charlson comorbidity score was used to evaluate patient comorbidity. Nine patients (36%) experienced grade 3–4 haematologic toxicity. Of the 23 patients evaluable for response, 17 patients (68%) had a negative post-treatment endoscopy and CT scan without evidence of progressive disease. Eleven patients (44%) are alive and 10 (40%) remain without evidence of recurrent or progressive oesophageal cancer at a median follow-up of 35 months. The median overall survival was 35 months and 2-year survival 64%. There was no significant difference in overall survival between Charlson score ⩽2 and those with a score ⩾2 (P=0.10). Similar survival was observed for patients with adenocarcinoma or squamous carcinoma. Primary chemoradiation with two cycles of 5-FU, mitomycin-C, and 50.4 Gy in elderly patients is an active regimen with moderate toxicity, despite the advanced age and heavy comorbidity burden of this cohort. Patients with local/regional oesophageal cancer with adequate functional status should not be excluded from potentially curative treatment based on age alone

Advantages of a Polycentric Approach to Climate Change Policy

Lack of progress in global climate negotiations has led scholars to reconsider polycentric approaches to climate policy. Several examples of subglobal mechanisms to reduce greenhouse-gas emissions have been touted, but it remains unclear why they might achieve better climate outcomes than global negotiations alone. Decades of work conducted by researchers associated with the Vincent and Elinor Ostrom Workshop in Political Theory and Policy Analysis at Indiana University have emphasized two chief advantages of polycentric approaches over monocentric ones: they provide more opportunities for experimentation and learning to improve policies over time, and they increase communications and interactions — formal and informal, bilateral and multilateral — among parties to help build the mutual trust needed for increased cooperation. A wealth of theoretical, empirical and experimental evidence supports the polycentric approach

Comprehensive Axillary Evaluation in Neoadjuvant Chemotherapy Patients With Ultrasonography and Sentinel Lymph Node Biopsy

There is ongoing debate regarding the optimal sequence of sentinel lymph node (SLN) biopsy and neoadjuvant chemotherapy (CTX) for breast cancer. We report the accuracy of comprehensive pre–neoadjuvant CTX and post–neoadjuvant CTX axillary staging via ultrasound imaging, fine-needle aspiration (FNA) biopsy, and SLN biopsy.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41405/1/10434_2005_Article_6534.pd

Systematizing Policy Learning: From Monolith to Dimensions

notes: The authors wish to express their gratitude to the Norwegian Political Science Association Annual Conference, 6 January 2010, University of Agder, Kristiansand, participants of the ‘Establishing Causality in Policy Learning’ panel at the American Political Science Association (APSA) annual meeting,2–5 September 2010,Washington DC, and the European Consortium of Political Research (ECPR) Joint Sessions, St Gallen, 12–17 April 2011, workshop 2. Dunlop and Radaelli gratefully acknowledge the support of the European Research Council, grant on Analysis of Learning in Regulatory Governance, ALREG, http://centres.exeter.ac.uk/ceg/research/ALREG/index.php.publication-status: AcceptedThe definitive version is available at www.blackwell-synergy.com and also from DOI: 10.1111/j.1467-9248.2012.00982.xThe field of policy learning is characterised by concept stretching and lack of systematic findings. To systematize them, we combine the classic Sartorian approach to classification with the more recent insights on explanatory typologies. At the outset, we classify per genus et differentiam – distinguishing between the genus and the different species within it. By drawing on the technique of explanatory typologies to introduce a basic model of policy learning, we identify four major genera in the literature. We then generate variation within each cell by using rigorous concepts drawn from adult education research. Specifically, we conceptualize learning as control over the contents and goals of knowledge. By looking at learning through the lenses of knowledge utilization, we show that the basic model can be expanded to reveal sixteen different species. These types are all conceptually possible, but are not all empirically established in the literature. Up until now the scope conditions and connections among types have not been clarified. Our reconstruction of the field sheds light on mechanisms and relations associated with alternatives operationalizations of learning and the role of actors in the process of knowledge construction and utilization. By providing a comprehensive typology, we mitigate concept stretching problems and aim to lay the foundations for the systematic comparison across and within cases of policy learning.European Research Council, grant no 230267 on Analysis of Learning in Regulatory Governance, ALREG

Gravitational-wave research as an emerging field in the Max Planck Society. The long roots of GEO600 and of the Albert Einstein Institute

On the occasion of the 50th anniversary since the beginning of the search for gravitational waves at the Max Planck Society, and in coincidence with the 25th anniversary of the foundation of the Albert Einstein Institute, we explore the interplay between the renaissance of general relativity and the advent of relativistic astrophysics following the German early involvement in gravitational-wave research, to the point when gravitational-wave detection became established by the appearance of full-scale detectors and international collaborations. On the background of the spectacular astrophysical discoveries of the 1960s and the growing role of relativistic astrophysics, Ludwig Biermann and his collaborators at the Max Planck Institute for Astrophysics in Munich became deeply involved in research related to such new horizons. At the end of the 1960s, Joseph Weber's announcements claiming detection of gravitational waves sparked the decisive entry of this group into the field, in parallel with the appointment of the renowned relativist Juergen Ehlers. The Munich area group of Max Planck institutes provided the fertile ground for acquiring a leading position in the 1970s, facilitating the experimental transition from resonant bars towards laser interferometry and its innovation at increasingly large scales, eventually moving to a dedicated site in Hannover in the early 1990s. The Hannover group emphasized perfecting experimental systems at pilot scales, and never developed a full-sized detector, rather joining the LIGO Scientific Collaboration at the end of the century. In parallel, the Max Planck Institute for Gravitational Physics (Albert Einstein Institute) had been founded in Potsdam, and both sites, in Hannover and Potsdam, became a unified entity in the early 2000s and were central contributors to the first detection of gravitational waves in 2015.Comment: 94 pages. Enlarged version including new results from further archival research. A previous version appears as a chapter in the volume The Renaissance of General Relativity in Context, edited by A. Blum, R. Lalli and J. Renn (Boston: Birkhauser, 2020