Fluorescence-guided imaging for resection margin evaluation in head and neck cancer patients using cetuximab-800CW:A quantitative dose-escalation study

Tumor-positive resection margins are present in up to 23% of head and neck cancer (HNC) surgeries, as intraoperative techniques for real-time evaluation of the resection margins are lacking. In this study, we investigated the safety and potential clinical value of fluorescence-guided imaging (FGI) for resection margin evaluation in HNC patients. We determined the optimal cetuximab-800CW dose by quantification of intrinsic fluorescence values using multi-diameter single-fiber reflectance, single-fiber fluorescence (MDSFR/SFF) spectroscopy. Methods: Five cohorts of three HNC patients received cetuximab-800CW systemically: three single dose cohorts (10, 25, 50 mg) and two cohorts pre-dosed with 75 mg unlabeled cetuximab (15 or 25 mg). Fluorescence visualization and MDSFR/SFF spectroscopy quantification was performed and were correlated to histopathology. Results: There were no study-related adverse events higher than Common Terminology Criteria for Adverse Events grade-II. Quantification of intrinsic fluorescence values showed a dose-dependent increase in background fluorescence in the single dose cohorts (p<0.001, p<0.001), which remained consistently low in the pre-dosed cohorts (p=0.6808). Resection margin status was evaluated with a sensitivity of 100% (4/4 tumor-positive margins) and specificity of 91% (10/11 tumor-negative margins). Conclusion: A pre-dose of 75 mg unlabeled cetuximab followed by 15 mg cetuximab-800CW was considered the optimal dose based on safety, fluorescence visualization and quantification of intrinsic fluorescence values. We were able to use a lower dose cetuximab-800CW than previously described, while remaining a high sensitivity for tumor detection due to application of equipment optimized for IRDye800CW detection, which was validated by quantification of intrinsic fluorescence values

Serviços de intermediação para crianças-testemunhas que depõem em tribunais criminais da África do Sul

Publicado em português, espanhol e inglês.Título em espanhol: Servicios de mediación para los testigos menores de edad que atestiguan ante tribunales penales sudafricanos. -- Título em inglês: Intermediary services for child witnesses testifying in south african criminal courts.Destaca que os crimes contra crianças e os subseqüentes procedimentos criminais nos quais se exige que a criança participe como testemunha ocorrem com suficiente freqüência para que se garantam serviços de intermediação a todas as crianças-testemunhas. Ele destaca as implicações práticas a fim de melhorar o processo corrente de intermediação, em nível regional, provincial e nacional. Primeiramente, o artigo faz uma reflexão sobre os serviços de intermediação oferecidos a crianças-testemunhas em algumas áreas dos subúrbios da região oeste de Johannesburgo; em segundo lugar, discute experiências práticas e literatura de apoio, assim como a experiência da Bethany House com o projeto Child in Crisis Foundation (SA)

The Lemon Car Game Across Cultures: Evidence of Relational Rationality

In cross-cultural business negotiation, culture is known to influence negotiation processes. As a lens to study this effect we deployed the Lemon Car Game, an online negotiation game developed for this purpose (Hofstede et al. in: Proceedings of 39th international simulation and gaming association conference (ISAGA). Technologia, Kaunas, pp 39–46, 2009a; Hofstede et al. in: David, Sichman (eds) Multi-agent-based simulation IX, international workshop, MABS 2008, revised selected papers, LNAI 5269. Springer, Berlin, pp 1–16, 2009b). In this article we report the results from the game, obtained from over 800 players from more than 70 countries. We employ several complementary analyses in a mixed-methods approach. Our findings show that to make sense of the players’ actions during negotiation, economic rationality falls short. A pan-cultural individual-level analysis of actions and stated intentions also fails to yield a coherent picture. Within countries, however, actions and intentions do cohere, as shown by an ecological country-level factor analysis, from which three factors emerge for the sellers at country level: trustworthiness, opportunism, and fairness. We conclude from these findings that, in this game, players are driven by what we call relational rationality: they are rational from the perspective of the social world in which they live, with interpersonal relationships weighing heavily. Relational rationality changes players’ perspective of economic rationality, and thus their observed behaviour in negotiation. Based on this evidence, we extrapolate that relational rationality significantly influences negotiation processes in all cultures.greenInteractive IntelligenceAlgorithmic