Proceedings of the Conference on Globalization and Its Discontents

Recent studies on economic globalization have used various indicators, such as the ratio of trade-to-GDP and the ratio of FDI-to-GDP, to analyze the globalization performances of national economies. Although each indicator is useful in itself, our contention is that a single composite indicator (index) can provide more comprehensive information and would enable policy-makers and researchers to compare and rank the globalization performances of different countries, country groups and regions in a given year (or period) and over time. Accordingly, in this paper, we developed the economic globalization index to measure the extent of globalization of national economies. We have constructed the economic globalization index for the period 1975-2005. The overall results indicate that rich countries tend to be more globalized than poor countries. Furthermore, rich countries have improved their globalization –relative global integration level- from 1975 to 2005; however, many of poor countries’ relative levels of global integration have deteriorated during the same period. Our results seem to be in line with studies that characterize the recent situation in the world as “truncated globalization” or simply “triadization”.globalization, economic globalization index

Partial anomalous pulmonary venous return associated with vascular anomalies of the aorta: multidetector computed tomography findings

Partial anomalous pulmonary venous return (PAPVR) is a congenital anomaly that involves drainage of one to three pulmonary veins directly into the right heart or systemic venous system, creating a partial left-to-right shunt. This drainage is associated with cardiac abnormalities such as mitral stenosis and pulmonary stenosis, patent ductus arteriosus, and atrial septal defects. We report a case of PAPVR associated with vascular anomalies of the aorta by multidetector computed tomography in an adult female patient

Stereotactic body radiotherapy for recurrent hemoptysis due to chronic pulmonary aspergillosis: a case report and systematic review of the literature.

PURPOSE Chronic pulmonary aspergillosis (CPA) can manifest as fungus balls in preexisting cavities of lung parenchyma and recurrent hemoptysis is among the most frequent complications. Radiotherapy can be considered for treatment-refractory aspergilloma and severe hemoptysis. To the best of our knowledge, we present the first application of stereotactic body radiotherapy (SBRT) for a pulmonary aspergilloma in a patient with limited functional lung capacity. The topic was further expanded on with a systematic review of the literature addressing the implementation of radiotherapy in CPA patients. CASE REPORT A 52-year-old man presented with recurring and treatment-refractory hemoptysis caused by chronic cavitary aspergillosis localized in the left lower lobe. We applied SBRT on two consecutive days with a total dose of 16 Gy. Hemoptysis frequency decreased to a clinically insignificant level. SYSTEMATIC REVIEW We performed a systematic search of the literature in line with the PRISMA statement. The initial PubMed search resulted in 230 articles, of which 9 were included. RESULTS The available literature contained 35 patients with CPA who received radiotherapy. Dose fractionation usually ranged from 2 to 4 Gy per fraction, applied almost exclusively in conventional two-dimensional (2D) techniques. There is no report of SBRT usage in such a scenario. Most cases report a positive treatment response after irradiation. CONCLUSION The presented case demonstrates long-term clinical stability after SBRT for recurrent hemoptysis due to pulmonary aspergilloma. The systematic literature search revealed that concept definition is still uncertain, and further work is necessary to establish radiotherapy in clinical practice

Effect of dose to parotid ducts on Sticky Saliva and Xerostomia in radiotherapy of head and neck squamous cell carcinoma.

BACKGROUND Radiotherapy (RT) in head and neck squamous cell cancer (HNSCC) often leads to sticky saliva and xerostomia (SSX). Dose sparing of salivary glands (SG) reduces occurrence of SSX but few studies investigated the relationship between RT dose to SG substructures and SSX. We therefore investigated this hypothesis, focusing on the parotid duct (PD). METHODS Retrospective data was collected from 99 HNSCC patients treated at our center with (chemo-)radiotherapy (CRT). PD and other organs-at-risk (OAR) were (re-)contoured and DVHs were generated without re-planning. SSX was graded according to CTCAE v.4.03 and evaluated at acute, subacute, and two late timepoints. RESULTS Most patients presented with loco-regionally advanced disease. In 47% of patients, up-front neck dissection preceded CRT. Weighted mean dose was 28.6 Gy for bilateral parotid glands (PG), and 32.0 Gy for PD. Acute SSX presented as grades 0 (35.3%), I (41.4%), II (21.2%) and III (2.0%). There was no association of OARs and SSX ≥ grade 2 in univariable logistic regression (LR). Multivariable LR showed statistically significant relationship of acute SSX with: PG weighted mean dose (OR 0.84, p = 0.004), contralateral PG mean dose (OR 1.14, p = 0.02) and contralateral PD planning OAR (PD PRV) mean dose (OR 1.84, p = 0.03). CONCLUSIONS There was an association of acute SSX with dose exposure of PD PRV in multivariable regression, only. Due to statistical uncertainties and the retrospective nature of this analysis, further studies are required to confirm or reject the hypothesis

Influence of trace metal release from volcanic ash on growth of Thalassiosira pseudonana and Emiliania huxleyi

Recent studies demonstrate that volcanic ash has the potential to increase phytoplankton biomass in the open ocean. However, besides fertilizing trace metals such as Fe, volcanic ash contains a variety of potentially toxic metals such as Cd, Cu, Pb, and Zn. Especially in coastal regions closer to the volcanic eruption, where ash depositions can be very high, toxic effects are possible. Here we present the first results of laboratory experiments, showing that trace metal release from different volcanic materials can have both fertilizing and toxic effects on marine phytoplankton in natural coastal seawater. The diatom Thalassiosira pseudonana generally showed higher growth rates in seawater that was in short contact with volcanic ash compared to the controls without ash addition. In contrast to that, the addition of volcanic ash had either no effect or significantly decreased the growth rate of the coccolithophoride Emiliania huxleyi. It was not possible to attribute the effects to single trace metals, however, our results suggest that Mn plays an important role in regulating the antagonistic and synergistic effects of the different trace metals. This study shows that volcanic ash can lead to changes in the phytoplankton species composition in the high fall-out area of the surface ocean. Highlights: ► We tested the effect of volcanic ash on growth of T. pseudonana and E. huxleyi ► Volcanic ash increased growth of T. pseudonana but not of E. huxleyi ► Mn seems important to regulate the effects of different trace metals from the ash ► Volcanic eruptions have the potential to change phytoplankton community structure

Superior loco-regional control after primary surgery compared to chemo-radiotherapy for advanced stage laryngeal cancer.

OBJECTIVE The optimal strategy to treat loco-regionally advanced squamous cell carcinoma of the larynx (LSCC) remains to be defined. The goal of this single institution retrospective study was to report on oncologic outcome of advanced LSCC treated with curative intent. METHODS Patients diagnosed and treated for stage T3-T4a LSCC between 2001 and 2014 were retrospectively analyzed. Time-to-event endpoints were calculated beginning from the date of histologic diagnosis, which were analyzed with log-rank test and Cox proportional hazard models. RESULTS The cohort was divided into two subgroups: primary radiotherapy with concomitant cisplatin (CRT) (n=30, 38%) and primary surgery (n=48, 62%). Median follow-up was 56 months. Locoregional control (LRC) for the primary surgery and CRT were 95% and 50% in 5 years, respectively (p<0.01). Progression free survival (PFS) for the primary surgery and CRT were 61% and 38% in 5 years, respectively (p=0.23). The overall survival (OS) after primary surgery and CRT in 5 years were 63% vs. 65%, respectively (p=0.93). The 5-years LRC was significantly superior after surgery compared to RT for cT3 primaries (100% vs 50%, p= 0.0022). No significant differences were observed in the remaining subgroups regarding cT stage and PFS or OS. CONCLUSION Our series demonstrated superior LRC after primary surgery followed by risk-adapted adjuvant (C)RT compared to primary CRT in cT3 LSCC, but no significant difference in PFS or OS in locally-advanced LSCC. The optimal patient selection criteria for the ideal treatment for loco-regionally advanced LSCC still needs to be defined

Yalova İ linde Farkl ı Özelliklerdeki Seralar İçin Is ıtma Gereksinimlerinin Belirlenmesi

Bu çal ışmada, ülkemizin en yoğ un seracı l ı k bölgelerinden biri olan Yalova ilinde yayg ı n olarak görülen, 30 adet farkl ı boyut ve malzeme özelliklerine sahip seran ı n ı s ı tma gereksinimleri hesaplanm ışt ı r. Elde edilen sonuçlar grafiksel olarak değerlendirilmi ştir. Çal ışmada sera hacmine göre havaland ı rma yolu ile olu şan ı s ı kayb ı , sera örtü alan ı na göre kondüksiyon yolu ile olu şan ı s ı kayb ı ve sera taban alan ı na göre olu şan toplam ı s ı açığı aras ı nda doğrusal bir ilişki bulunduğ u belirlenmiştir. Havaland ı rma yoluyla olu şan ı s ı kayı plar ı , sera hacmindeki art ışa bağ l ı olarak % 10 - 17 oran ı nda azalma göstermi ştir. Kondüksiyon yoluyla olu şan ı s ı kay ı pları , örtü alan ı n ı n artmas ı ile cam seralarda %1 , plastik seralarda ise tek katl ı PE örtü malzemesinin kullan ı lmas ı durumunda çift katl ı PE malzemesine göre % 32 oran ı nda art ış göstermi ştir. Seralar ı n 1 m 2taban alan ı ndan kaybolan toplam ı s ı miktarları ise hacim art ışı na ve örtü malzemesinin cinsine göre cam seralarda % 1 - 2, plastik seralarda % 1 - 6 oran ı nda artmaktad ı r

Therapy-Associated Saliva and Taste change Evaluation (TASTE) in head & neck cancer patients undergoing radiotherapy: a study protocol

BACKGROUND One of the main side effects of radiation therapy to the head and neck region is altered taste sensation. This causes significant morbidity and has profound effects on the quality of life (QoL) of patients. While radiation-associated toxicities like xerostomia and dysphagia are part of large investigations, data on taste impairment is sparse. Small cohort sizes in the majority of studies and a variety of analysis methods limit our current understanding of the underlying processes. None of the studies published to date used a taste-specific QoL questionnaire with differentiation of the different taste qualities (e.g. sour, bitter). Furthermore, data regarding the correlation of taste impairment with radiation-associated change in saliva composition is currently not available. The aim of the TASTE study is to fill this gap. Based on the acquired data, a normal tissue complication probability (NTCP) model for late radiation-associated taste impairment will be developed. METHODS In this prospective, observational multicenter study 150 head and neck cancer patients undergoing radiation therapy will be recruited and undergo repetitive (semi-) objective and subjective assessment of their taste, smell and salivary function (questionnaires, taste and smell assessment, saliva analysis). Primary endpoint will be patient-reported taste impairment 12 months post radiation therapy using a standardized questionnaire. Secondary endpoints will include taste impairment measured using taste strips at 12 months and 2 years post radiation therapy. Differences between subgroups (radiation side, chemotherapy, etc.) and changes over time will be assessed while adjusting for confounding factors (e.g. age, sex, smoking history). DISCUSSION This study sets out to further our understanding of taste impairment in patients undergoing radiation therapy to the head and neck region with the goal to prevent this common side effect in future patients. The results of the study may be used to evaluate taste-preserving radiotherapy for patients with head and neck cancer, which may significantly reduce the long-term burden in this patient cohort

Therapy-Associated Saliva and Taste change Evaluation (TASTE) in head & neck cancer patients undergoing radiotherapy: a study protocol.

BACKGROUND One of the main side effects of radiation therapy to the head and neck region is altered taste sensation. This causes significant morbidity and has profound effects on the quality of life (QoL) of patients. While radiation-associated toxicities like xerostomia and dysphagia are part of large investigations, data on taste impairment is sparse. Small cohort sizes in the majority of studies and a variety of analysis methods limit our current understanding of the underlying processes. None of the studies published to date used a taste-specific QoL questionnaire with differentiation of the different taste qualities (e.g. sour, bitter). Furthermore, data regarding the correlation of taste impairment with radiation-associated change in saliva composition is currently not available. The aim of the TASTE study is to fill this gap. Based on the acquired data, a normal tissue complication probability (NTCP) model for late radiation-associated taste impairment will be developed. METHODS In this prospective, observational multicenter study 150 head and neck cancer patients undergoing radiation therapy will be recruited and undergo repetitive (semi-) objective and subjective assessment of their taste, smell and salivary function (questionnaires, taste and smell assessment, saliva analysis). Primary endpoint will be patient-reported taste impairment 12 months post radiation therapy using a standardized questionnaire. Secondary endpoints will include taste impairment measured using taste strips at 12 months and 2 years post radiation therapy. Differences between subgroups (radiation side, chemotherapy, etc.) and changes over time will be assessed while adjusting for confounding factors (e.g. age, sex, smoking history). DISCUSSION This study sets out to further our understanding of taste impairment in patients undergoing radiation therapy to the head and neck region with the goal to prevent this common side effect in future patients. The results of the study may be used to evaluate taste-preserving radiotherapy for patients with head and neck cancer, which may significantly reduce the long-term burden in this patient cohort