A phase II study of high dose epirubicin in unresectable non small cell lung cancer.

Epirubicin (EPI), a doxorubicin analogue, is reported to have equal antitumour activity with lower cardiac and systemic toxicity. Recently, the maximum tolerated dose of this drug has been revised upwards with reported increased response rates in several malignancies. We initiated a phase II study of high-dose EPI as initial treatment for patients with advanced non-small cell lung cancer (NSCLC) (stage III and IV). Between May 1988 and November 1989, 25 patients were entered. The starting dose of EPI was 135 mg m-2, with dose attenuations and escalations of 15 mg m-2 based on mid-cycle evaluation of toxicity. Treatment was repeated every 3 weeks. Nine partial responses (36%, 95% CI: 18-57.5%) and 11 patients with disease stabilisation (44%) were observed. Median (range) time to progression was 19 (3-70) weeks. Median (range) survival is 32 (9-116+) weeks. There were no treatment related deaths. Major side effects were leukocytopenia WHO grade III/IV (23% of courses) and mucositis WHO grade II/III (15% of courses). In two patients left ventricular ejection fraction decreased greater than 15% compared to baseline values after a cumulative Epirubicin dose of 435 mg m-2, and therefore went off study. In none of the patients clinical signs of congestive heart failure were observed. We conclude from our data that high-dose EPI, contrary to previous negative studies using lower doses of EPI, ranks amongst the most active regimens against advanced NSCLC. Toxicity of high-dose EPI is moderate. Further evaluation of this compound in combination regimens is recommended

{\beta}-YbAlB4: a critical nodal metal

We propose a model for the intrinsic quantum criticality of {\beta}-YbAlB4, in which a vortex in momentum space gives rise to a new type of Fermi surface singularity. The unquenched angular momentum of the |J = 7/2,m_J = \pm5/2> Yb 4f-states generates a momentum-space line defect in the hybridization between 4f and conduction electrons, leading to a quasi-two dimensional Fermi surface with a k\perp4 dispersion and a singular density of states proportional to E^{-1/2}. We discuss the implications of this line-node in momentum space for our current understanding of quantum criticality and its interplay with topology

99mTc-sestamibi is a substrate for P-glycoprotein and the multidrug resistance-associated protein.

99mTc-sestamibi (99mTc-MIBI) is a substrate for the P-glycoprotein (P-gp) pump but it is not known whether it is a substrate for the multidrug resistance-associated protein (MRP) pump. Therefore, 99mTc-MIBI was evaluated in the GLC4 cell line and its doxorubicin-resistant MRP-, but not P-gp-, overexpressing GLC4/ADR sublines as well as in the S1 cell line and its MRP-transfected subline S1-MRP. 99mTc-MIBI concentration decreased in the GLC4/ADR sublines with increasing MRP overexpression and was lower in S1-MRP than in S1. 99mTc-MIBI plus vincristine increased 99mTc-MIBI concentration in GLC4 lines compared with 99mTc-MIBI alone. 99mTc-MIBI efflux raised with increasing MRP expression in the GLC4 lines. Glutathione depletion elevated 99mTc-MIBI concentration in GLC4/ADR150x. Cross resistance for 99Tc-MIBI, used to test cytotoxicity of the Tc compound, was observed in GLC4/ADR150x vs GLC4. 99Tc-MIBI induced a synergistic effect on vincristine cytotoxicity in GLC4/ADR150x. These results show that 99mTc-MIBI is involved in MRP-mediated efflux. The fact that 99mTc-MIBI efflux is influenced by MDR1 and MRP expression must be taken into account when this gamma-rays-emitting complex is tested for tumour efflux measurements

Eliashberg-type equations for correlated superconductors

The derivation of the Eliashberg -- type equations for a superconductor with strong correlations and electron--phonon interaction has been presented. The proper account of short range Coulomb interactions results in a strongly anisotropic equations. Possible symmetries of the order parameter include s, p and d wave. We found the carrier concentration dependence of the coupling constants corresponding to these symmetries. At low hole doping the d-wave component is the largest one.Comment: RevTeX, 18 pages, 5 ps figures added at the end of source file, to be published in Phys.Rev. B, contact: [email protected]

Agreement of nursing home staff with palliative care principles : a pace cross-sectional study among nurses and care assistants in five european countries

Contains fulltext : 215538.pdf (publisher's version ) (Open Access)CONTEXT: To provide high-quality palliative care to nursing home residents, staff need to understand the basic principles of palliative care. OBJECTIVES: To evaluate the extent of agreement with the basic principles of palliative care of nurses and care assistants working in nursing homes in five European countries and to identify correlates. METHODS: This is a cross-sectional study in 214 homes in Belgium, England, Italy, the Netherlands, and Poland. Agreement with basic principles of palliative care was measured with the Rotterdam MOVE2PC. We calculated percentages and odds ratios of agreement and an overall score between 0 (no agreement) and 5 (total agreement). RESULTS: Most staff in all countries agreed that palliative care involves more than pain treatment (58% Poland to 82% Belgium) and includes spiritual care (62% Italy to 76% Belgium) and care for family or relatives (56% Italy to 92% Belgium). Between 51% (the Netherlands) and 64% (Belgium) correctly disagreed that palliative care should start in the last week of life and 24% (Belgium) to 53% (Poland) agreed that palliative care and intensive life-prolonging treatment can be combined. The overall agreement score ranged between 1.82 (Italy) and 3.36 (England). Older staff (0.26; 95% confidence interval [CI]: 0.09-0.43, P = 0.003), nurses (0.59; 95% CI: 0.43-0.75, P < 0.001), and staff who had undertaken palliative care training scored higher (0.21; 95% CI: 0.08-0.34, P = 0.002). CONCLUSIONS: The level of agreement of nursing home staff with basic principles of palliative care was only moderate and differed between countries. Efforts to improve the understanding of basic palliative care are needed

Frustration and the Kondo effect in heavy fermion materials

The observation of a separation between the antiferromagnetic phase boundary and the small-large Fermi surface transition in recent experiments has led to the proposal that frustration is an important additional tuning parameter in the Kondo lattice model of heavy fermion materials. The introduction of a Kondo (K) and a frustration (Q) axis into the phase diagram permits us to discuss the physics of heavy fermion materials in a broader perspective. The current experimental situation is analysed in the context of this combined "QK" phase diagram. We discuss various theoretical models for the frustrated Kondo lattice, using general arguments to characterize the nature of the $f$-electron localization transition that occurs between the spin liquid and heavy Fermi liquid ground-states. We concentrate in particular on the Shastry--Sutherland Kondo lattice model, for which we establish the qualitative phase diagram using strong coupling arguments and the large-$N$ expansion. The paper closes with some brief remarks on promising future theoretical directions.Comment: To appear in a special issue of JLT

Culture, entrepreneurship and uneven development: a spatial analysis

Interest in the proposed connection between culture and entrepreneurship has grown significantly in recent years. However, less attention has been given to the nature of the overall impact of this proposed association on development outcomes, particularly at a local level. In response, this paper analyses the relationship between the nature of the culture, entrepreneurship and development experienced across localities, proposing that the link between culture and development is mediated by entrepreneurship. It focuses upon the concept of community culture, as well as embracing a notion of development incorporating both economic and social well-being outcomes. Drawing upon a multivariate spatial analysis of data from localities in Great Britain, the findings indicate that differences in rates of entrepreneurship are strongly influenced by the community culture present in these localities. Furthermore, a bidirectional relationship is found to exist between entrepreneurship and economic and social development outcomes. It is concluded that the embeddedness of local community culture presents a significant challenge for those places seeking to promote entrepreneurially-driven development

Who I Am: The Meaning of Early Adolescents’ Most Valued Activities and Relationships, and Implications for Self-Concept Research

Self-concept research in early adolescence typically measures young people’s self-perceptions of competence in specific, adult-defined domains. However, studies have rarely explored young people’s own views of valued self-concept factors and their meanings. For two major self domains, the active and the social self, this mixed-methods study identified factors valued most by 526 young people from socioeconomically diverse backgrounds in Ireland (10-12 years), and explored the meanings associated with these in a stratified subsample (n = 99). Findings indicate that self-concept scales for early adolescence omit active and social self factors and meanings valued by young people, raising questions about content validity of scales in these domains. Findings also suggest scales may under-represent girls’ active and social selves; focus too much on some school-based competencies; and, in omitting intrinsically salient self domains and meanings, may focus more on contingent (extrinsic) rather than true (intrinsic) self-esteem

Machine learning-enabled maternal risk assessment for women with pre-eclampsia (the PIERS-ML model): a modelling study.

Affecting 2-4% of pregnancies, pre-eclampsia is a leading cause of maternal death and morbidity worldwide. Using routinely available data, we aimed to develop and validate a novel machine learning-based and clinical setting-responsive time-of-disease model to rule out and rule in adverse maternal outcomes in women presenting with pre-eclampsia. We used health system, demographic, and clinical data from the day of first assessment with pre-eclampsia to predict a Delphi-derived composite outcome of maternal mortality or severe morbidity within 2 days. Machine learning methods, multiple imputation, and ten-fold cross-validation were used to fit models on a development dataset (75% of combined published data of 8843 patients from 11 low-income, middle-income, and high-income countries). Validation was undertaken on the unseen 25%, and an additional external validation was performed in 2901 inpatient women admitted with pre-eclampsia to two hospitals in south-east England. Predictive risk accuracy was determined by area-under-the-receiver-operator characteristic (AUROC), and risk categories were data-driven and defined by negative (-LR) and positive (+LR) likelihood ratios. Of 8843 participants, 590 (6·7%) developed the composite adverse maternal outcome within 2 days, 813 (9·2%) within 7 days, and 1083 (12·2%) at any time. An 18-variable random forest-based prediction model, PIERS-ML, was accurate (AUROC 0·80 [95% CI 0·76-0·84] vs the currently used logistic regression model, fullPIERS: AUROC 0·68 [0·63-0·74]) and categorised women into very low risk (-LR 0·2 and +LR 10·0; 11 [1·0%] women). Adverse maternal event rates were 0% for very low risk, 2% for low risk, 5% for moderate risk, 26% for high risk, and 91% for very high risk within 48 h. The 2901 women in the external validation dataset were accurately classified as being at very low risk (0% with outcomes), low risk (1%), moderate risk (4%), high risk (33%), or very high risk (67%). The PIERS-ML model improves identification of women with pre-eclampsia who are at lowest and greatest risk of severe adverse maternal outcomes within 2 days of assessment, and can support provision of accurate guidance to women, their families, and their maternity care providers. University of Strathclyde Diversity in Data Linkage Centre for Doctoral Training, the Fetal Medicine Foundation, The Canadian Institutes of Health Research, and the Bill & Melinda Gates Foundation. [Abstract copyright: Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license

Molecular fluorescence above metallic gratings

P. Andrew and William L. Barnes, Physical Review B, Vol. 64, article 125405 (2001). "Copyright © 2001 by the American Physical Society."We present measurements of the fluorescence of emitters located in close proximity (d<λ) to metallic grating surfaces. By measuring both the spontaneous emission lifetime and angle-dependent radiation pattern of a monolayer of dye molecules as a function of their separation from planar and periodically corrugated mirrors of increasing modulation depth, we are able to examine the effect of varying the surface profile on the emission process. Both the distance dependence of the lifetime and the spatial distribution of the emitted light are significantly changed upon the introduction of a corrugation, quite apart from the appearance of the familiar Bragg-scattered bound-mode features. It is postulated that these perturbations arise from the interference of the grating scattered dipole fields with the usual upward propagating and reflected fields. In addition, the measurement of nonexponential decay transients for the deepest gratings examined provide evidence for the existence of optically dissimilar dipole positions above the grating surface