Bendamustine combined with rituximab for patients with relapsed or refractory diffuse large B cell lymphoma

Patients with relapsed or refractory diffuse large B cell lymphoma (DLBCL) are treated with salvage regimens and may be considered for high-dose chemotherapy and autologous stem cell transplantation if disease is chemosensitive. Bendamustine is active in indolent B cell lymphomas and chronic lymphocytic leukemia but has not been extensively studied in aggressive lymphomas. This trial examines the combination of bendamustine and rituximab in patients with relapsed and refractory DLBCL. Patients received bendamustine at 90 mg/m2 (n = 2) or 120 mg/m2 (n = 57) on days 1 and 2 and rituximab at 375 mg/m2 on day 1 every 28 days for up to 6 cycles. The study evaluated objective response rate (ORR), duration of response (DOR), progression-free survival (PFS), and treatment safety. Fifty-nine patients were treated, and 48 were evaluable for response. Median age was 74; 89 % had stage III or IV disease, and 63 % had high revised International Prognostic Index scores; the median number of prior therapies was 1. Based on analysis using the intent-to-treat population, the ORR was 45.8 % (complete response, 15.3 %; partial response, 30.5 %). The median DOR was 17.3 months, and the median PFS was 3.6 months. Grade 3 or 4 hematological toxicities included neutropenia (36 %), leukopenia (29 %), thrombocytopenia (22 %), and anemia (12 %). The combination of bendamustine and rituximab showed modest activity in patients with relapsed and refractory DLBCL and has an acceptable toxicity profile

Adaptation to Variable Environments, Resilience to Climate Change: Investigating Land, Water and Settlement in Indus Northwest India

This paper explores the nature and dynamics of adaptation and resilience in the face of a diverse and varied environmental and ecological context using the case study of South Asia’s Indus Civilization (ca. 3000–1300 BC). Most early complex societies developed in regions where the climatic parameters faced by ancient subsistence farmers were varied but rain falls primarily in one season. In contrast, the Indus Civilization developed in a specific environmental context that spanned a very distinct environmental threshold, where winter and summer rainfall systems overlap. There is now evidence to show that this region was directly subject to climate change during the period when the Indus Civilization was at its height (ca. 2500–1900 BC). The Indus Civilization, therefore, provides a unique opportunity to understand how an ancient society coped with diverse and varied ecologies and change in the fundamental environmental parameters. This paper integrates research carried out as part of the Land, Water and Settlement project in northwest India between 2007 and 2014. Although coming from only one of the regions occupied by Indus populations, these data necessitate the reconsideration of several prevailing views about the Indus Civilization as a whole and invigorate discussion about human-environment interactions and their relationship to processes of cultural transformation

Investigating knowledge management factors affecting Chinese ICT firms performance: An integrated KM framework

This is an Author's Accepted Manuscript of an article published in the Journal of Information Systems Management, 28(1), 19 - 29, 2011, copyright Taylor & Francis, available online at: http://www.tandfonline.com/10.1080/10580530.2011.536107.This article sets out to investigate the critical factors of Knowledge Management (KM) which are considered to have an impact on the performance of Chinese information and communication technology (ICT) firms. This study confirms that the cultural environment of an enterprise is central to its success in the context of China. It shows that a collaborated, trusted, and learning environment within ICT firms will have a positive impact on their KM performance

Analysis of Neptune's 2017 Bright Equatorial Storm

We report the discovery of a large ($\sim$8500 km diameter) infrared-bright storm at Neptune's equator in June 2017. We tracked the storm over a period of 7 months with high-cadence infrared snapshot imaging, carried out on 14 nights at the 10 meter Keck II telescope and 17 nights at the Shane 120 inch reflector at Lick Observatory. The cloud feature was larger and more persistent than any equatorial clouds seen before on Neptune, remaining intermittently active from at least 10 June to 31 December 2017. Our Keck and Lick observations were augmented by very high-cadence images from the amateur community, which permitted the determination of accurate drift rates for the cloud feature. Its zonal drift speed was variable from 10 June to at least 25 July, but remained a constant $237.4 \pm 0.2$ m s$^{-1}$ from 30 September until at least 15 November. The pressure of the cloud top was determined from radiative transfer calculations to be 0.3-0.6 bar; this value remained constant over the course of the observations. Multiple cloud break-up events, in which a bright cloud band wrapped around Neptune's equator, were observed over the course of our observations. No "dark spot" vortices were seen near the equator in HST imaging on 6 and 7 October. The size and pressure of the storm are consistent with moist convection or a planetary-scale wave as the energy source of convective upwelling, but more modeling is required to determine the driver of this equatorial disturbance as well as the triggers for and dynamics of the observed cloud break-up events.Comment: 42 pages, 14 figures, 6 tables; Accepted to Icaru

Adaptation to Variable Environments, Resilience to Climate Change: Investigating Land, Water and Settlement in Indus Northwest India

This paper explores the nature and dynamics of adaptation and resilience in the face of a diverse and varied environmental and ecological context using the case study of South Asia’s Indus Civilization (ca. 3000–1300 BC). Most early complex societies developed in regions where the climatic parameters faced by ancient subsistence farmers were varied but rain falls primarily in one season. In contrast, the Indus Civilization developed in a specific environmental context that spanned a very distinct environmental threshold, where winter and summer rainfall systems overlap. There is now evidence to show that this region was directly subject to climate change during the period when the Indus Civilization was at its height (ca. 2500–1900 BC). The Indus Civilization, therefore, provides a unique opportunity to understand how an ancient society coped with diverse and varied ecologies and change in the fundamental environmental parameters. This paper integrates research carried out as part of the Land, Water and Settlement project in northwest India between 2007 and 2014. Although coming from only one of the regions occupied by Indus populations, these data necessitate the reconsideration of several prevailing views about the Indus Civilization as a whole and invigorate discussion about human-environment interactions and their relationship to processes of cultural transformation

Adaptation to Variable Environments, Resilience to Climate Change: Investigating Land, Water and Settlement in Indus Northwest India

This paper explores the nature and dynamics of adaptation and resilience in the face of a diverse and varied environmental and ecological context using the case study of South Asia’s Indus Civilization (ca. 3000–1300 BC). Most early complex societies developed in regions where the climatic parameters faced by ancient subsistence farmers were varied but rain falls primarily in one season. In contrast, the Indus Civilization developed in a specific environmental context that spanned a very distinct environmental threshold, where winter and summer rainfall systems overlap. There is now evidence to show that this region was directly subject to climate change during the period when the Indus Civilization was at its height (ca. 2500–1900 BC). The Indus Civilization, therefore, provides a unique opportunity to understand how an ancient society coped with diverse and varied ecologies and change in the fundamental environmental parameters. This paper integrates research carried out as part of the Land, Water and Settlement project in northwest India between 2007 and 2014. Although coming from only one of the regions occupied by Indus populations, these data necessitate the reconsideration of several prevailing views about the Indus Civilization as a whole and invigorate discussion about human-environment interactions and their relationship to processes of cultural transformation

Histological validation of a type 1 diabetes clinical diagnostic model for classification of diabetes

This is the final version. Available on open access from Wiley via the DOI in this recordAims: Misclassification of diabetes is common due to an overlap in the clinical features of type 1 and type 2 diabetes. Combined diagnostic models incorporating clinical and biomarker information have recently been developed that can aid classification, but they have not been validated using pancreatic pathology. We evaluated a clinical diagnostic model against histologically defined type 1 diabetes. Methods: We classified cases from the Network for Pancreatic Organ donors with Diabetes (nPOD) biobank as type 1 (n = 111) or non-type 1 (n = 42) diabetes using histopathology. Type 1 diabetes was defined by lobular loss of insulin-containing islets along with multiple insulin-deficient islets. We assessed the discriminative performance of previously described type 1 diabetes diagnostic models, based on clinical features (age at diagnosis, BMI) and biomarker data [autoantibodies, type 1 diabetes genetic risk score (T1D-GRS)], and singular features for identifying type 1 diabetes by the area under the curve of the receiver operator characteristic (AUC-ROC). Results: Diagnostic models validated well against histologically defined type 1 diabetes. The model combining clinical features, islet autoantibodies and T1D-GRS was strongly discriminative of type 1 diabetes, and performed better than clinical features alone (AUC-ROC 0.97 vs. 0.95; P = 0.03). Histological classification of type 1 diabetes was concordant with serum C-peptide [median < 17 pmol/l (limit of detection) vs. 1037 pmol/l in non-type 1 diabetes; P < 0.0001]. Conclusions: Our study provides robust histological evidence that a clinical diagnostic model, combining clinical features and biomarkers, could improve diabetes classification. Our study also provides reassurance that a C-peptide-based definition of type 1 diabetes is an appropriate surrogate outcome that can be used in large clinical studies where histological definition is impossible. Parts of this study were presented in abstract form at the Network for Pancreatic Organ Donors Conference, Florida, USA, 19–22 February 2019 and Diabetes UK Professional Conference, Liverpool, UK, 6–8 March 2019.Diabetes UKNational Institutes of Health (NIH)National Institute for Health Research (NIHR)JDRFHelmsley Charitable Trus

Ecological indicators to capture the effects of fishing on biodiversityand conservation status of marine ecosystems

IndiSeas (“Indicators for the Seas”) is a collaborative international working group that was established in2005 to evaluate the status of exploited marine ecosystems using a suite of indicators in a comparative framework. An initial shortlist of seven ecological indicators was selected to quantify the effects of fishing on the broader ecosystem using several criteria (i.e., ecological meaning, sensitivity to fishing, data avail-ability, management objectives and public awareness). The suite comprised: (i) the inverse coefficient of variation of total biomass of surveyed species, (ii) mean fish length in the surveyed community, (iii)mean maximum life span of surveyed fish species, (iv) proportion of predatory fish in the surveyed community, (v) proportion of under and moderately exploited stocks, (vi) total biomass of surveyed species,and (vii) mean trophic level of the landed catch. In line with the Nagoya Strategic Plan of the Convention on Biological Diversity (2011–2020), we extended this suite to emphasize the broader biodiversity and conservation risks in exploited marine ecosystems. We selected a subset of indicators from a list of empirically based candidate biodiversity indicators initially established based on ecological significance to complement the original IndiSeas indicators. The additional selected indicators were: (viii) mean intrinsic vulnerability index of the fish landed catch, (ix) proportion of non-declining exploited species in the surveyed community, (x) catch-based marine trophic index, and (xi) mean trophic level of the surveyed community. Despite the lack of data in some ecosystems, we also selected (xii) mean trophic level of the modelled community, and (xiii) proportion of discards in the fishery as extra indicators. These additional indicators were examined, along with the initial set of IndiSeas ecological indicators, to evaluate whether adding new biodiversity indicators provided useful additional information to refine our under-standing of the status evaluation of 29 exploited marine ecosystems. We used state and trend analyses,and we performed correlation, redundancy and multivariate tests. Existing developments in ecosystem-based fisheries management have largely focused on exploited species. Our study, using mostly fisheries independent survey-based indicators, highlights that biodiversity and conservation-based indicators are complementary to ecological indicators of fishing pressure. Thus, they should be used to provide additional information to evaluate the overall impact of fishing on exploited marine ecosystems