Financial Openness and Financial Development: Evidence from Emerging Countries

We investigate the potential relation between financial openness and financial development for 27 emerging countries for the period between 1996 and 2016. We focus on three dimensions of financial openness: capital account openness, trade openness, and stock-market openness. In this study, we propose alternative measures for capital account and trade openness. Moreover, we offer capital flow and valuation-based measures for stock-market openness as a potential determinant of financial development. Our findings indicate that capital account openness and trade openness are the key drivers of financial development. These results are not sensitive to the use of alternative financial openness and financial development measures, and are robust after being controlled for institutional quality and its components. Our results have implications for policymakers in emerging countries who try to increase the depth of their financial markets for an easier and cheaper access to funds

Case report of radiation-induced lung injury with trastuzumab emtansine: the lung also matters

With an increase in the number of agents used concurrently with radiotherapy (RT), a new research area has emerged regarding toxicity. Here, we present a case of a 47-year-old woman presenting with radiation-induced lung injury (RILI) that occurred six months after the end of RT with concomitant and sequential use of trastuzumab-emtansine (T-DM1) with RT. The patient’s T-DM1 treatment was discontinued because of RILI. Antibiotic and methylprednisolone treatments were started. The steroid dose was gradually tapered and completely discontinued after full recovery. If new agents are used concurrently with RT, the toxicity profile of new agents should be kept in mind

Leptomeningeal metastasis in primary uterine cervical cancer: a rare case and review of the literature

Objectives. Leptomeningeal metastasis (LM) of primary uterine cervical cancer is rare and treatment options are limited. In this case report and literature review, we aimed to present a patient with cervical cancer with LM and discuss previously reported cases in the literature.  Case presentation. Our case was a 58-year-old patient who was initially diagnosed with metastatic primary uterine cervical cancer and treated with chemotherapy and chemoradiotherapy. During follow-up, she developed neurological symptoms, and LM was detected in the craniospinal regions. Cerebrospinal fluid cytology examination has confirmed metastatic disease. The patient was treated with concurrent intrathecal methotrexate and whole-brain radiotherapy (WBRT). A good clinical and cytological response was obtained. However, while intrathecal methotrexate was being continued after WBRT, she succumbed to hematological toxicity before the radiological response could be evaluated. Conclusions. LM is an extremely rare and catastrophic distant spread pattern in patients with cervical cancer. In the literature, a total of 26 patients were reported up to date. Median survival after detection of LM was nine weeks, including our case. Multimodal treatment combinations such as systemic and intrathecal chemotherapy and radiotherapy (RT) were used. However, most of these reports did not have detailed information about toxicity. Despite the combined use of aggressive treatment modalities, patients have limited survival and very high risks of hematologic toxicity. Concurrent use of intrathecal chemotherapy and radiotherapy should be avoided due to increased risk of morbidity

Radiotherapy for pediatric adrenocortical carcinoma – review of the literature

none13Background and purpose Pediatric adrenocortical carcinoma (pACC) is a rare disease with poor prognosis. Publications on radiotherapy (RT) are scarce. This review summarizes the current data on RT for pACC and possibly provides first evidence to justify its use in this setting. Materials and methods We searched the PubMed and Embase database for manuscripts regarding RT for pACC. Results We included 17 manuscripts reporting on 76 patients treated with RT, after screening 2961 references and 269 full articles. In addition, we added data of 4 unreported pACC patients treated by co-authors. All reports based on retrospective data. Median age at first diagnosis was 11.1 years (70% female); 78% of patients presented with hormonal activity. RT was mostly performed for curative intent (78%). 88% of RT were administered during primary therapy. The site of RT was predominantly the local tumor bed (76%). Doses of RT ranged from 15 to 62 Gy (median 50 Gy). Information on target volumes or fractionation were lacking. Median follow-up was 6,9 years and 64% of the patients died of disease, with 33% alive without disease. In 16 of 48 patients with available follow-up data after adjuvant RT (33%) no recurrence was reported and in 3 of 9 patients palliative RT seemed to induce some benefit for the patient. Conclusions Our first systematic review on RT for pACC provides too few data for any general recommendation, but adjuvant RT in patients with high risk might be considered. International collaborative studies are urgently needed to establish better evidence on the role of RT in this rare malignancy.noneWiegering, Verena; Riedmeier, Maria; Thompson, Lester D.R.; Virgone, Calogero; Redlich, Antje; Kuhlen, Michaela; Gultekin, Melis; Yalcin, Bilgehan; Decarolis, Boris; Härtel, Christoph; Schlegel, Paul-Gerhardt; Fassnacht, Martin; Timmermann, BeateWiegering, Verena; Riedmeier, Maria; Thompson, Lester D. R.; Virgone, Calogero; Redlich, Antje; Kuhlen, Michaela; Gultekin, Melis; Yalcin, Bilgehan; Decarolis, Boris; Härtel, Christoph; Schlegel, Paul-Gerhardt; Fassnacht, Martin; Timmermann, Beat

PTPA variants and impaired PP2A activity in early-onset parkinsonism with intellectual disability

The protein phosphatase 2A complex (PP2A), the major Ser/Thr phosphatase in the brain, is involved in a number of signalling pathways and functions, including the regulation of crucial proteins for neurodegeneration, such as alpha-synuclein, tau and LRRK2. Here, we report the identification of variants in the PTPA/PPP2R4 gene, encoding a major PP2A activator, in two families with early-onset parkinsonism and intellectual disability. We carried out clinical studies and genetic analyses, including genome-wide linkage analysis, whole-exome sequencing, and Sanger sequencing of candidate variants. We next performed functional studies on the disease-associated variants in cultured cells and knock-down of ptpa in Drosophila melanogaster. We first identified a homozygous PTPA variant, c.893T&gt;G (p.Met298Arg), in patients from a South African family with early-onset parkinsonism and intellectual disability. Screening of a large series of additional families yielded a second homozygous variant, c.512C&gt;A (p.Ala171Asp), in a Libyan family with a similar phenotype. Both variants co-segregate with disease in the respective families. The affected subjects display juvenile-onset parkinsonism and intellectual disability. The motor symptoms were responsive to treatment with levodopa and deep brain stimulation of the subthalamic nucleus. In overexpression studies, both the PTPA p.Ala171Asp and p.Met298Arg variants were associated with decreased PTPA RNA stability and decreased PTPA protein levels; the p.Ala171Asp variant additionally displayed decreased PTPA protein stability. Crucially, expression of both variants was associated with decreased PP2A complex levels and impaired PP2A phosphatase activation. PTPA orthologue knock-down in Drosophila neurons induced a significant impairment of locomotion in the climbing test. This defect was age-dependent and fully reversed by L-DOPA treatment. We conclude that bi-allelic missense PTPA variants associated with impaired activation of the PP2A phosphatase cause autosomal recessive early-onset parkinsonism with intellectual disability. Our findings might also provide new insights for understanding the role of the PP2A complex in the pathogenesis of more common forms of neurodegeneration.</p

Cervix Cancer Brachytherapy: Target Volume Determination

Concurrent chemoradiotherapy followed by brachytherapy (BRT) is the standard treatment for patients with locally advanced cervical cancer. Today, three-dimensional (3D) image-guided BRT (3D-IGBT) is the new standard. It improves local control, increases overall survival, and minimizes toxicity. Magnetic resonance imaging (MRI), ultrasound (US), computed tomography (CT), and positron emission tomography (PET)/CT can be performed in 3D-IGBT. In cervical cancers, MRI is considered the gold standard imaging modality. It also has been implemented into the cervix 3D-IGBT . because of the excellent soft tissue contrast with clear definition of target volumes and easily identified organs al risk (OARs). This review summarizes imaging and volume definitions in 3D-IGBT of cervical cancer.WoSScopu

Production and characterization of ZrO2 ceramics and composites to be used for hip prosthesis

Tetragonal ZrO2 polycrystalline (TZP) ceramics with varying yttria and ceria content (2-3 mol%) and distribution (coated or co-precipitated), and varying second phase content Al2O3 were prepared and investigated by means of microstructural analysis, mechanical properties, and hydrothermal stability, and ZrO2-based composites with 35-60 vol% of electrical conductive TiN particles were developed. The effects of stabilizer content and means of addition, powder preparation, sintering conditions, and grain size have been systematically investigated. Fully dense Y-TZP ceramics, stabilized with 2-3 mol% Y2O3, 2 wt% Al2O3 can be achieved by hot pressing at 1,450 degrees C for 1 h. The hydrothermal stability increased with increasing overall yttria content. The jet-milled TiN powder was used to investigate the ZrO2-TiN composites as function of the TiN content. The experimental work revealed that fully dense ZrO2-TiN composites, stabilized with 1.75 mol% Y2O3, 0.75 wt% Al2O3, and a jet-milled TiN content ranging from 35 to 60 vol% could be achieved by hot pressing at 1,550 degrees C for 1 h. Transformation toughening was found as the primary toughening mechanism. The decreasing hardness and strength could be attributed to an increasing TiN grain size with increasing TiN content, whereas the decreasing toughness might be due to the decreasing contribution of transformation toughening from the tetragonal to monoclinic ZrO2 phase transformation. The E modulus increases linearly with increasing TiN content, whereas the hydrothermal stability increases with addition of TiN content.status: publishe

Definitive Treatment For Locally Advanced Cervical Cancer: A Retrospective Analysis From A Singe Institution

The primary aim of this study was to evaluate the long-term treatment outcomes of definitive chemoradiotherapy (CRT) of locally advanced cervical cancer and beside this to identify prognostic factors and related toxicities. Between February 2001 and September 2013, 327 patients were retrospectively evaluated. The median age was 56 years (range, 24-82 years). Ninety-five percent of patients had >= Stage IIB disease. External pelvic radiotherapy (RT) (45-50.4 Gy) and concomitant chemotherapy followed by 28 Gy in 4 fractions high dose rate brachytherapy was administered. Boost doses of 10-15 Gy were administered to < 2 cm lymph nodes (LNs) or distal parametrial involved sites. The median follow-up time was 68 months (range, 45-90 months). Two-, 5- and 10-year cancer specific survival (CSS) rates were 80%, 68%, and 65%; disease-free survival (DFS) rates were 73%, 66%, and 64%; local recurrence-free survival (LRFS) rates were 94%, 92%, and 91%; loco-regional recurrence-free survival (LRRFS) were 92%, 89%, and 86%; distant metastases-free survival (DMFS) were 81%, 76%, 75%, respectively. In multivariate analysis, age, clinical stage and LN metastasis at diagnosis were independent prognostic factors for both CSS and DFS. Third month response to treatment was the most important prognostic factor for all end points in univariate and multivariate analysis. With the aggressive radiotherapeutic approach, it seems that distant metastases rather than locoregional recurrence determines the survival rates. Consolidation chemotherapy may be a good option after definitive CRT which needs to be supported with future phase III studies.WoSScopu

Dosimetric Comparison Of Three‐Dimensional Conformal Radiotherapy And Intensity‐Modulated Radiotherapy For Left‐Sided Chest Wall And Lymphatic Irradiation

Introduction The aim of this study was to compare five different techniques for chest wall (CW) and lymphatic irradiation in patients with left‐sided breast carcinoma. Methods Three‐dimensional conformal radiotherapy (3DCRT), forward‐planned intensity‐modulated radiotherapy (FP‐IMRT), inverse‐planned IMRT (IP‐IMRT; 7‐ or 9‐field), and hybrid IP‐/FP‐IMRT were compared in 10 patients. Clinical target volume (CTV) included CW and internal mammary (IM), supraclavicular (SC), and axillary nodes. Planning target volumes (PTVs), CTVs, and organs at risks (OARs) doses were analyzed with dose–volume histograms (DVHs). Results No differences could be observed among the techniques for doses received by 95% of the volume (D95%) of lymphatics. However, the FP‐IMRT resulted in a significantly lower D95% dose to the CW‐PTV compared to other techniques (P = 0.002). The 9‐field IP‐IMRT achieved the lowest volumes receiving higher doses (hotspots). Both IP‐IMRT techniques provided similar mean doses (Dmean) for the left lung which were smaller than the other techniques. There was no difference between the techniques for maximum dose (Dmax) of right breast. However, FP‐IMRT resulted in lower Dmean and volume of right breast receiving at least 5 Gy doses compared to other techniques. Conclusion The dose homogeneity in CW‐CTV was better using IMRT techniques compared to 3DCRT. Especially 9‐field IP‐IMRT provided a more homogeneous dose distribution in IM and axillary CTVs. Moreover, the OARs volumes receiving low radiation doses were larger with IP‐IMRT technique, while volumes receiving high radiation doses were larger with FP‐IMRT technique. Hybrid IMRT plans were found to have the advantages of both FP‐ and IP‐IMRT techniques.PubMedWoSScopu