Contribution of Case Reports to Brain Metastases Research: Systematic Review and Analysis of Pattern of Citation

Research activity related to different aspects of prevention, prediction, diagnosis and treatment of brain metastases has increased during recent years. One of the major databases (Scopus) contains 942 scientific articles that were published during the 5-year time period 2006–2010. Of these, 195 (21%) reported on single patient cases and 12 (1%) were reports of 2 cases. Little is known about their influence on advancement of the field or scientific merits. Do brain metastases case reports attract attention and provide stimuli for further research or do they go largely unrecognized? Different measures of impact, visibility and quality of published research are available, each with its own pros and cons. For the present evaluation, article citation rate was chosen. The median number of citations overall and stratified by year of publication was 0, except for the year 2006 when it was 2. As compared to other articles, case reports remained more often without citation (p<0.05 except for 2006 data). All case reports with 10 or more citations (n = 6) reported on newly introduced anticancer drugs, which commonly are prescribed to treat extracranial metastases, and the responses observed in single patients with brain metastases. Average annual numbers of citations were also calculated. The articles with most citations per year were the same six case reports mentioned above (the only ones that obtained more than 2.0 citations per year). Citations appeared to gradually increase during the first two years after publication but remained on a generally low or modest level. It cannot be excluded that case reports without citation provide interesting information to some clinicians or researchers. Apparently, case reports describing unexpected therapeutic success gain more attention, at least in terms of citation, than others

A review of clinical trials of cetuximab combined with radiotherapy for non-small cell lung cancer

Treatment of non-small cell lung cancer (NSCLC) is challenging in many ways. One of the problems is disappointing local control rates in larger volume disease. Moreover, the likelihood of both nodal and distant spread increases with primary tumour (T-) stage. Many patients are elderly and have considerable comorbidity. Therefore, aggressive combined modality treatment might be contraindicated or poorly tolerated. In many cases with larger tumour volume, sufficiently high radiation doses can not be administered because the tolerance of surrounding normal tissues must be respected. Under such circumstances, simultaneous administration of radiosensitizing agents, which increase tumour cell kill, might improve the therapeutic ratio. If such agents have a favourable toxicity profile, even elderly patients might tolerate concomitant treatment. Based on sound preclinical evidence, several relatively small studies have examined radiotherapy (RT) with cetuximab in stage III NSCLC. Three different strategies were pursued: 1) RT plus cetuximab (2 studies), 2) induction chemotherapy followed by RT plus cetuximab (2 studies) and 3) concomitant RT and chemotherapy plus cetuximab (2 studies). Radiation doses were limited to 60-70 Gy. As a result of study design, in particular lack of randomised comparison between cetuximab and no cetuximab, the efficacy results are difficult to interpret. However, strategy 1) and 3) appear more promising than induction chemotherapy followed by RT and cetuximab. Toxicity and adverse events were more common when concomitant chemotherapy was given. Nevertheless, combined treatment appears feasible. The role of consolidation cetuximab after RT is uncertain. A large randomised phase III study of combined RT, chemotherapy and cetuximab has been initiated

Emotional problems in preadolescents in Norway: the role of gender, ethnic minority status, and home- and school-related hassles

<p>Abstract</p> <p>Background</p> <p>"The gender gap" refers to a lifelong higher rate of emotional problems in girls, as compared to boys, that appears during adolescence. The gender gap is a well-replicated finding among older adolescents and is assumed to be a cross-cultural phenomenon. However, these cross-cultural studies have not investigated the gender gap in ethnic minorities but sampled ethnic majority adolescents in different countries. Some studies that investigated the gender gap across ethnic groups indirectly (by presenting emotional problem scores stratified by gender and ethnic group) indicate that the gender gap is less prominent or even absent among minorities. The aims of this study were to assess whether the gender gap is found in both majority and minority preadolescents, and to investigate whether a possible (gender and ethnic) group difference can be accounted for by differences in home or school hassles.</p> <p>Methods</p> <p>Participants were 902 preadolescent students (aged 10 to 12) from two cities in Norway. We collected self-report measures of emotional problems and home and school hassles. Using mediated moderation analysis we tested whether the interaction effect between gender and ethnic minority background on emotional problems was mediated by home or school hassles.</p> <p>Results</p> <p>The gender gap in emotional problems was restricted to ethnic majority preadolescents. School hassles but not home hassles accounted in part for this effect.</p> <p>Conclusions</p> <p>The absence of the gender gap among minority as opposed to majority preadolescents may indicate that social circumstances may postpone or hamper the emergence and magnitude of the gender gap in ethnic minority preadolescents. In this study, school hassles partly accounted for the combined gender and ethnic group differences on emotional problems. This indicates that school hassles may play a role in the higher levels of emotional problems in preadolescent minority boys and consequently the absence of a gender gap found in our minority sample.</p

Imperializing Norden

The two pre-Napoleonic Nordic polities are best understood as empires. Drawing on recent analytical and historical scholarship on empires, I argue that 17th and 18th century Denmark, on which the piece concentrates, was very much akin to the other European empires existing at the time. Read in this light, national identities within the fragments of the empire appear similar. Nationalisms are all shaped directly on the Danish model, having at the same time Denmark as their constitutive cultural other. The introduction notes that, where all European imperial experiences are concerned, overseas territories had the most wounds inflicted upon them. We would not know this if we considered Faroese, Icelandic and Norwegian nationalism in isolation. These polities, Norway in particular, participated in and benefited from the colonial policies of the empire. This notwithstanding, their national identities insist that these nations were on the receiving – as opposed to the imposing – end of imperialism. This is a historically unwarranted and ethically problematic stance requiring further discussion

Can conditions experienced during migration limit the population levels of birds?

Populations of migratory birds are usually considered to be limited by conditions in breeding or wintering areas, but some might be limited by conditions encountered on migration. This could occur at stopover sites where competition for restricted food supplies can reduce subsequent survival or breeding success, or during the flights themselves, when adverse weather can occasionally kill large numbers of individuals. Competition for food could act in a density-dependent manner and help to regulate populations, whereas weather effects are more likely to act in a density-independent manner. The evidence for these views is explored in this paper. When preparing for migration, birds must normally obtain more food per day than usual, in order to accumulate the body reserves that fuel their flights. Birds often concentrate in large numbers at particular stopover sites, where food can become scarce, thus affecting migratory performance. Rates of weight gain, departure weights, and stopover durations often correlate with food supplies at stopover sites, sometimes influencing the subsequent survival and reproductive success of individuals, which can in turn affect subsequent breeding numbers. Many studies have provided evidence for interference and depletion competition at stopover sites, relatively few for migration conditions influencing the subsequent breeding or survival of individuals, and even fewer for effects on subsequent breeding numbers. Migrants in flight occasionally suffer substantial mortality in storms, especially over water, sometimes involving many thousands of birds at a time. Other mass mortalities have resulted from atypical ‘winter-like’ weather, occurring soon after the arrival of summer migrants in their breeding areas or just before their departure in autumn. Again, many thousands of birds at a time have been killed in such incidents, causing reductions of 30–90% in local breeding densities. In some bird species, migration-related events can at times have substantial effects on the year-to-year changes in breeding population levels. Nonetheless, the difficulties involved in investigating migrating birds at different points on their migration routes have so far limited the number of studies on the influence of events during migration periods on population level