Neuropsychological Sequelae of Carotid Angioplasty with Stent Placement: Correlation with Ischemic Lesions in Diffusion Weighted Imaging

BACKGROUND AND PURPOSE: Few studies investigated the neuropsychological outcome after carotid angioplasty with stent placement (CAS), yielding partially inconsistent results. The present investigation evaluated the effect of CAS in patients with high-grade stenosis and assessed the predictive value of ischemic lesion number for postinterventional cognitive deterioration. METHODS: 22 patients were tested neuropsychologically before and six weeks after CAS. Cerebral ischemic changes were assessed with diffusion weighted imaging (DWI) prior to and after angioplasty. RESULTS: Pre- to postinterventional cognitive performance improved significantly in terms of verbal memory (t = -2.30; p<0.05), whereas significant deterioration was noted regarding verbal memory span (t = 2.31; p<0.05). 8 (36%) persons conformed to the criteria of cognitive improvement. 6 patients (27%) were postinterventionally classified as having deficits. Analysis yielded no statistically significant correlations between lesion quantity and cognitive change. CONCLUSION: Both improvement and deterioration of cognitive functioning was observed in our collective of patients, leaving the neuropsychological outcome after percutaneous transluminal angioplasty unpredictable in individual cases. The presence of acute ischemic lesions on DWI was found to be not tightly associated with cognitive dysfunction after CAS

Induction therapy with Erlotinib (E) and Gemcitabine/Platinum (GP) in stage III NSCLC

Background: In 2004 we started a phase II trial in non-small lung cancer (NSCLC), stage III, with erlotinib followed by a combination with a platinum-based doublet in unselected patients to identify molecular subgroups benefitting from an EGFR targeting approach. Patients and methods: Induction with erlotinib (E, 150 mg, d1-42) was followed by three cycles of gemcitabine (G, 1250 mg/m&sup2;, d1+d8, q3w) and cisplatin (P, 80 mg/m&sup2;, d1, q3w). Patients with at least stable disease after E were treated with a GP + E combination. Induction was followed by surgery and radiation. The trial was conducted as a prospective, multi-center, open label, exploratory phase II study to determine pathological response rate (pRR), as well as secondary endpoints disease free survival (DFS) and overall survival (OS). Results: Of 38 prescreened patients 16 were included in the main study. Due to slow recruitment the study had to be terminated early. Combination of E and GP was well tolerated, surgery was feasible after induction therapy in 12 of 16 patients, 7/12 (58%) patients had a major pathological response (MPR). Median overall survival for patients with MPR was 57.7 months (confidence interval (CI), 37.4 to 78.0; n = 7) and for patients without MPR 11.9 months (CI, 6.4 to 17.4; n = 5). 2/16 patients had an epidermal growth factor receptor (EGFR) mutation. Conclusion: Before discovery of distinct molecular mechanisms in NSCLC our study was an attempt to identify clinical and pathological subgroups that would benefit from E induction. Two patients with an EGFR mutation were identified. MPR was a predictor of long term disease free and overall survival

Against the Grain? Assessing Graduate Labour Market Trends in Germany Through a Task-Based Indicator of Graduate Jobs

Applying work by Green and Henseke (in IZA J Labor Policy 5(1):14, 2016a), this study examines changes in the German graduate labour market in the twenty-first century. To do so, it deploys a new statistically derived indicator of graduate jobs, based on job skill requirements obtained from worker-reported task data in the German Employment Surveys 2006 and 2012. As in previous work, the resulting classifier explains differences in graduate labour market outcomes better than existing methods and can be applied in a range of contexts where intelligence on graduate destinations is desired. It is supplied in the appendix of this study. Despite the expansion of higher educational attainment between 1999 and 2012, my analysis indicates a rising excess demand for graduate labour. Following key findings emerge: •Graduate skills are required beyond the narrow range of professions. Work tasks associated with cognitive skills use are key determinants of higher education requirements on the job. •The proportion of graduates in the age bracket 25–34 has risen among men from 14.7 to 18.9% and from 13.3 to 22.5% among women between 1999 and 2012. Young women have become the group with greatest level of higher education in the labour market. •The growing supply of graduate labour in the age bracket 25–34 was surpassed by the expansion of employment in graduate jobs. The employment share of graduate jobs shifted by 17 percentage points to almost 30% among young women and by 11 percentage points to 28% among young men. •Among young female graduates, the incidence of underemployment fell to 22% between 1999 and 2012; roughly comparable to the level among males at the same ages. Prime aged female graduates, however, experience above average rates of underemployment. •A sharp rise of the pay premium associated with higher education among men contrasts with stagnating wage differentials among women. •The pay penalty associated with underemployment has not changed statistically significantly