Overall survival after reirradiation of spinal metastases – independent validation of predictive models

Background: It is unknown if survival prediction tools (SPTs) sufficiently predict survival in patients who undergo palliative reirradiation of spinal metastases. We therefore set out to clarify if SPTs can predict survival in this patient population. Methods: We retrospectively analyzed spinal reirradiations performed (n = 58, 52 patients, 44 included in analysis). SPTs for patients with spinal metastases were identified and compared to a general palliative score and to a dedicated SPT to estimate prognosis in palliative reirradiation independent of site (SPT-Nieder). Results: Consistently in all tests, SPT-Nieder showed best predictive performance as compared to other tools. Items associated with survival were general condition (KPS), liver metastases, and steroid use. Other factors like primary tumor site, pleural effusion, and bone metastases were not correlated with survival. We adapted an own score to the data which performed comparable to SPT-Nieder but avoids the pleural effusion item. Both scores showed good performance in identifying long-term survivors with late recurrences. Conclusions: Survival prediction in case of spinal reirradiation is possible with sufficient predictive separation. Applying SPTs in case of reirradiation helps to identify patients with good life expectancy who might benefit from dose escalation or longer treatment courses

The Role of Methotrexate in Psoriatic Therapy in the Age of Biologic and Biosimilar Medication: Therapeutic Benefits versus Toxicology Emergencies

Used in the psoriasis therapy for over 30 years, methotrexate belongs to the non‐biological medication class. Its continued use must be studied in the context of the modern unprecedented powerful pharmacological and medical development, due to the particularly, even uniquely fast development of biologicals, which assume an extremely important role in cutting‐edge medicine. This status has turned biosimilars and all related matters into an outstanding challenge not only for researchers worldwide but also for other medicinal product‐associated fields such as development of regulatory standards and pharmacovigilance, to mention the most important. However, against a comparable high‐risk background, compounded by the additional danger of serious cumulative toxicity, methotrexate therapy continues to be recommended mainly for patients suffering from severe psoriasis, seriously affecting their quality of life

Automated VMAT planning for postoperative adjuvant treatment of advanced gastric cancer

Background: Postoperative/adjuvant radiotherapy of advanced gastric cancer involves a large planning target volume (PTV) with multi-concave shapes which presents a challenge for volumetric modulated arc therapy (VMAT) planning. This study investigates the advantages of automated VMAT planning for this site compared to manual VMAT planning by expert planners. Methods: For 20 gastric cancer patients in the postoperative/adjuvant setting, dual-arc VMAT plans were generated using fully automated multi-criterial treatment planning (autoVMAT), and compared to manually generated VMAT plans (manVMAT). Both automated and manual plans were created to deliver a median dose of 45 Gy to the PTV using identical planning and segmentation parameters. Plans were evaluated by two expert radiation oncologists for clinical acceptability. AutoVMAT and manVMAT plans were also compared based on dose-volume histogram (DVH) and predicted normal tissue complication probability (NTCP) analysis. Results: Both manVMAT and autoVMAT plans were considered clinically acceptable. Target coverage was similar (manVMAT: 96.6 ± 1.6%, autoVMAT: 97.4 ± 1.0%, p = 0.085). With autoVMAT, median kidney dose was reduced on average by > 25%; (for left kidney from 11.3 ± 2.1 Gy to 8.9 ± 3.5 Gy (p = 0.002); for right kidney from 9.2 ± 2.2 Gy to 6.1 ± 1.3 Gy (p <  0.001)). Median dose to the liver was lower as well (18.8 ± 2.3 Gy vs. 17.1 ± 3.6 Gy, p = 0.048). In addition, Dmax of the spinal cord was significantly reduced (38.3 ± 3.7 Gy vs. 31.6 ± 2.6 Gy, p <  0.001). Substantial improvements in dose conformity and integral dose were achieved with autoVMAT plans (4.2% and 9.1%, respectively; p <  0.001). Due to the better OAR sparing in the autoVMAT plans compared to manVMAT plans, the predicted NTCPs for the left and right kidney and the liver-PTV were significantly reduced by 11.3%, 12.8%, 7%, respectively (p ≤ 0.001). Delivery time and total number of monitor units were increased in autoVMAT plans (from 168 ± 19 s to 207 ± 26 s, p = 0.006) and (from 781 ± 168 MU to 1001 ± 134 MU, p = 0.003), respectively. Conclusions: For postoperative/adjuvant radiotherapy of advanced gastric cancer, involving a complex target shape, automated VMAT planning is feasible and can substantially reduce the dose to the kidneys and the liver, without compromising the target dose delivery

Profitability and Capital Structure: An Empirical Study of French and Hungarian Wine Producers in 2004-2013

Background: Profitability of the Hungarian wine industry has been a focus of numerous research studies due to the centuries-old history and the recent changes. Objectives: The aim of the study is to analyse the capital structure of the Hungarian and the French wine industries and demonstrate the benefits of the usage of an international company database. Methods/Approach: First, the database and the applied methods are described and then the descriptive statistical analysis of the industry is presented. The two set hypotheses are aimed at testing the main contradiction between the pecking order and the trade-off theory, which is related to profitability and the usage of external funds. Results: The analysis examines the differences between the funding policies applied in the two countries. This was carried out by means of a discriminant analysis, which indicates the financing characteristics of French and Hungarian wine producers. In order to confirm the results of the discriminant analysis we conducted a cluster analysis on the same sample where 3 out of 4 variables proved to be significant in classifying the two groups. Conclusions: The main conclusion of the study is that the behaviour of the factors explaining the development of the capital structure differs significantly in the two examined countries

ORBIS as a Research Tool: Examination of the Capital Structure of the Hungarian and French Wine Industry

ORBIS is a global database and financial analysis tool offering company statements, ownership, rating and scores, news and intelligence. Global means the current coverage exceeds 165 million entities which most of them are private companies. However also listed companies, banks (over 35.000), insurance companies are included. And all that taking into consideration how different the legislations in countries are sometimes not only giving the free choice to companies when it comes to publish the reports but also forbids to do so (some Islamic jurisdictions). Goal of the paper is to demonstrate the usage of ORBIS in the examination of the capital structure of the Hungarian and French wine industry. This work is licensed under a&nbsp;Creative Commons Attribution-NonCommercial 4.0 International License.</p

Identification of a novel PPARβ/δ/miR-21-3p axis in UV-induced skin inflammation.

Although excessive exposure to UV is widely recognized as a major factor leading to skin perturbations and cancer, the complex mechanisms underlying inflammatory skin disorders resulting from UV exposure remain incompletely characterized. The nuclear hormone receptor PPARβ/δ is known to control mouse cutaneous repair and UV-induced skin cancer development. Here, we describe a novel PPARβ/δ-dependent molecular cascade involving TGFβ1 and miR-21-3p, which is activated in the epidermis in response to UV exposure. We establish that the passenger miRNA miR-21-3p, that we identify as a novel UV-induced miRNA in the epidermis, plays a pro-inflammatory function in keratinocytes and that its high level of expression in human skin is associated with psoriasis and squamous cell carcinomas. Finally, we provide evidence that inhibition of miR-21-3p reduces UV-induced cutaneous inflammation in ex vivo human skin biopsies, thereby underlining the clinical relevance of miRNA-based topical therapies for cutaneous disorders

Sharing the Sacred: A Tradition of Mormon Public Education in Kirtland, Ohio

The Church of Jesus Christ of Latter-Day Saints (LDS) has a strong tradition of promoting formal education. This includes several initiatives detailing, preserving, and sharing church history at sites of significance, setting these sites apart as sacred space. In summer 2015 I conducted eight weeks of ethnographic fieldwork at the Kirtland Historic Village, a recreated 19th century town in northeast Ohio. Historic Kirtland’s status as a sacred LDS space, coupled with its high operating costs and low non-LDS visitor attendance, raises the question of why the site stays open to the general public and free of admission. The use of historical material at the site and its narrative interpretation by sister missionaries reveal LDS investment in this local community. Material culture and stories are used to perform a consistent narrative about a wealthy patriarch that transformed a rural town into a thriving small city. The Kirtland Historic Village illustrates a fundamental social fact about the religious life of Mormons: reliving the past through present actions

Prediction of Insolvency of Hungarian Micro Enterprises

The aim of the study is to establish insolvency forecast model with the usage of different statistical methods and compare their efficiency. Besides this the relation and direction between indebtedness and financial distress is also part of the examination. With different approaches we nearly reached the same efficiency, the main focus was on the independent testing sample where we did not apply any modification on the dataset supposing realistic circumstances for predicting the probability of default. The research is focusing on small companies, since their number in the economy is considered high, but for this segment such insolvency forecasts are very rare. This work is licensed under a&nbsp;Creative Commons Attribution-NonCommercial 4.0 International License.</p