A Conceptual Model for Planning and Management of Areas of Public Space and Meeting in Colombia

A refined investigation of new trends in urban analysis assuming a sustainable design of Areas of Public Space and Meeting (APSM) is a fundamental response to the challenges of inclusive and efficient cities. Even though the APSM are districts regarded as urban structuring systems, there is a lack of territorial planning instruments and conceptual models aimed at explaining their long-term dynamics. Based on these premises, we developed a conceptual model that articulates relevant variables of interest for the planning and management of APSM. The construction of the model includes the review and analysis of the literature and the validation process based on a consultation with a panel of experts on the subject. Our findings demonstrate that the existing research does not address the APSM issue adequately, and the methodologies proposed so far do not lead to accurate and comprehensive analyses of urban complexity in light of sustainability targets. There are only isolated, disjointed, and partial approaches to variables of interest, making it difficult to carry out holistic studies. Our technical and scientific proposal offers a framework for an exhaustive evaluation of these areas. The model has been structured according to the assumptions of urban sustainability and can be applied to diverse urban environments in South America

Coupled dark matter-dark energy in light of near Universe observations

Cosmological analysis based on currently available observations are unable to rule out a sizeable coupling among the dark energy and dark matter fluids. We explore a variety of coupled dark matter-dark energy models, which satisfy cosmic microwave background constraints, in light of low redshift and near universe observations. We illustrate the phenomenology of different classes of dark coupling models, paying particular attention in distinguishing between effects that appear only on the expansion history and those that appear in the growth of structure. We find that while a broad class of dark coupling models are effectively models where general relativity (GR) is modified --and thus can be probed by a combination of tests for the expansion history and the growth of structure--, there is a class of dark coupling models where gravity is still GR, but the growth of perturbations is, in principle modified. While this effect is small in the specific models we have considered, one should bear in mind that an inconsistency between reconstructed expansion history and growth may not uniquely indicate deviations from GR. Our low redshift constraints arise from cosmic velocities, redshift space distortions and dark matter abundance in galaxy voids. We find that current data constrain the dimensionless coupling to be |xi|<0.2, but prospects from forthcoming data are for a significant improvement. Future, precise measurements of the Hubble constant, combined with high-precision constraints on the growth of structure, could provide the key to rule out dark coupling models which survive other tests. We shall exploit as well weak equivalence principle violation arguments, which have the potential to highly disfavour a broad family of coupled models.Comment: 34 pages, 6 figures; changes to match published versio

Neratinib after trastuzumab-based adjuvant therapy in HER2-positive breast cancer (ExteNET): 5-year analysis of a randomised, double-blind, placebo-controlled, phase 3 trial

Background: ExteNET showed that 1 year of neratinib, an irreversible pan-HER tyrosine kinase inhibitor, significantly improves 2-year invasive disease-free survival after trastuzumab-based adjuvant therapy in women with HER2-positive breast cancer. We report updated efficacy outcomes from a protocol-defined 5-year follow-up sensitivity analysis and long-term toxicity findings. Methods: In this ongoing randomised, double-blind, placebo-controlled, phase 3 trial, eligible women aged 18 years or older (≥20 years in Japan) with stage 1–3c (modified to stage 2–3c in February, 2010) operable breast cancer, who had completed neoadjuvant and adjuvant chemotherapy plus trastuzumab with no evidence of disease recurrence or metastatic disease at study entry. Patients who were eligible patients were randomly assigned (1:1) via permuted blocks stratified according to hormone receptor status (hormone receptor-positive vs hormone receptor-negative), nodal status (0 vs 1–3 vs or ≥4 positive nodes), and trastuzumab adjuvant regimen (given sequentially vs concurrently with chemotherapy), then implemented centrally via an interactive voice and web-response system, to receive 1 year of oral neratinib 240 mg/day or matching placebo. Treatment was given continuously for 1 year, unless disease recurrence or new breast cancer, intolerable adverse events, or consent withdrawal occurred. Patients, investigators, and trial funder were masked to treatment allocation. The predefined endpoint of the 5-year analysis was invasive disease-free survival, analysed by intention to treat. ExteNET is registered with ClinicalTrials.gov, number NCT00878709, and is closed to new participants. Findings: Between July 9, 2009, and Oct 24, 2011, 2840 eligible women with early HER2-positive breast cancer were recruited from community-based and academic institutions in 40 countries and randomly assigned to receive neratinib (n=1420) or placebo (n=1420). After a median follow-up of 5·2 years (IQR 2·1–5·3), patients in the neratinib group had significantly fewer invasive disease-free survival events than those in the placebo group (116 vs 163 events; stratified hazard ratio 0·73, 95% CI 0·57–0·92, p=0·0083). The 5-year invasive disease-free survival was 90·2% (95% CI 88·3–91·8) in the neratinib group and 87·7% (85·7–89·4) in the placebo group. Without diarrhoea prophylaxis, the most common grade 3–4 adverse events in the neratinib group, compared with the placebo group, were diarrhoea (561 [40%] grade 3 and one [<1%] grade 4 with neratinib vs 23 [2%] grade 3 with placebo), vomiting (grade 3: 47 [3%] vs five [<1%]), and nausea (grade 3: 26 [2%] vs two [<1%]). Treatment-emergent serious adverse events occurred in 103 (7%) women in the neratinib group and 85 (6%) women in the placebo group. No evidence of increased risk of long-term toxicity or long-term adverse consequences of neratinib-associated diarrhoea were identified with neratinib compared with placebo. Interpretation: At the 5-year follow-up, 1 year of extended adjuvant therapy with neratinib, administered after chemotherapy and trastuzumab, significantly reduced the proportion of clinically relevant breast cancer relapses—ie, those that might lead to death, such as distant and locoregional relapses outside the preserved breast—without increasing the risk of long-term toxicity. An analysis of overall survival is planned after 248 events