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Livelihood trajectories are a conceptual device to synthetize the collection of successive strategies displayed by individuals and groups to ensure survival and wellbeing over time. Using this concept, we conduct an explorative analysis of how various episodes, interventions, and ecological change have influenced different livelihood strategies of small-scale fishermen in the southernmost region of the world, the Patagonian region of Magallanes, Chile. Through ethnographic research, we identified four trajectories along five distinct periods: (i) 1960-1972, from the year of the largest recorded earthquake in world history to the initial expansion of industrial fishing; (ii) 1973-1982, from the military coup and the beginning of neoliberal reforms; (iii) 1983-1990, marked by fishing export booms; (iv) 1991-2000, noted by return to democracy and enactment of the first Fishing and Aquaculture General Act; and (v) 2000 to present, characterized by coastal planning and changes to the aforementioned law. Along these periods, trajectories are marked by migration waves and the deployment of specific livelihood strategies, highly modulated by both global seafood markets and legal changes. The results show the potential of ethnographic approaches to the study of long-term interactions in marine and coastal socioecological systems by identifying underlying historical dynamics, specific pulses and pressures, and actors' responses to regional socioecological changes. [ABSTRACT FROM AUTHOR]

Two million children experience sibling death annually and have problems that require clinical intervention although few receive such help. Effects on surviving siblings’ mental health has been well documented, however their physical health has not. This study described surviving siblings’ illnesses, treatments/health services at 2, 4, 6, and 13 months post-sibling death. The 132 children (76 girls, 56 boys, M 10.6 years, SD 3.43); 30% Hispanic, 51% Black, 26% White were recruited via hospital ICUs and published obituaries. Using a longitudinal design, parents reported types and numbers of surviving siblings’ illnesses, treatments/health services, and dates post-sibling death. Most of the 207 illnesses and 674 treatments/health services occurred in the first 6 months post-sibling death. While girls had more illnesses (131) than boys (76) and Hispanic children had more illnesses than White or Black children, these differences were not statistically significant. Girls accounted for 66% of the treatments/health services and boys 34%. There was no significant difference in treatments/health service use by gender of the children (F = 1.00, p = .32). Hispanic children had significantly more treatments/health service use than Black children (F = 6.81, p = .002). Sibling death affects surviving siblings’ physical health. Study data document the importance of monitoring the health, treatments and health service use of surviving siblings especially in the first 6 months after a sibling death, regardless of the child’s gender. On average, Hispanic children had greater health service use, which may warrant greater attention. [ABSTRACT FROM AUTHOR]

Background: Three EQ-5D value sets (EQ-5D-3L, crosswalk, and EQ-5D-5L) are now available for cost-utility analysis in the UK and/or England. The value sets' characteristics differ, and it is important to assess the implications of these differences.Objective: The aim of this paper is to compare the three value sets.Methods: We carried out analysis comparing the predicted values from each value set, and investigated how differences in health on the descriptive system is reflected in the utility score by assessing the value of adjacent states. We also assessed differences in values using data from patients who completed both EQ-5D-3L and EQ-5D-5L.Results: The distribution of the value sets systematically differed. EQ-5D-5L values were higher than EQ-5D-3L/crosswalk values. The overall range and difference between adjacent states was smaller. In the patient data, the EQ-5D-5L produced higher values across all conditions and there was some evidence that the value sets rank different health conditions in a similar severity order.Conclusions: There are important differences between the value sets. Due to the smaller range of EQ-5D-5L values, the possible change in quality-adjusted life years (QALYs) might be reduced, but they will apply to both control and intervention groups, and will depend on whether the gain is in quality of life, survival, or both. The increased sensitivity of EQ-5D-5L may also favour QALY gains even if the changes in utility are smaller. Further work should assess the impact of the different value sets on cost effectiveness by repeating the analysis on clinical trial data. [ABSTRACT FROM AUTHOR]

Derek Parfit’s argument against the platitude that identity is what matters in survival does not work given his intended reading of the platitude, namely, that what matters in survival to some future time is being identical with someone who is alive at that time. I develop Parfit’s argument so that it works against the platitude on the intended reading. [ABSTRACT FROM AUTHOR]

Background and Aims: Hepatocellular carcinoma (HCC) incidence is increasing at differential rates depending on race. We aimed to identify associations between race and survival after HCC diagnosis in a diverse American population.Methods: Using the cancer registry from Sylvester Comprehensive Cancer Center, University of Miami and Jackson Memorial Hospitals, we performed retrospective analysis of 999 patients diagnosed with HCC between 9/24/2004 and 12/19/2014. We identified clinical characteristics by reviewing available electronic medical records. The association between race and survival was analyzed using Cox proportional hazards regression.Results: Median survival in days was 425 in Blacks, 904.5 in non-Hispanic Whites, 652 in Hispanics, 570 in Asians, and 928 in others, p < 0.01. Blacks and Asians presented at more advanced stages with larger tumors. Although Whites had increased severity of liver disease at diagnosis compared to other races, they had 36% reduced rate of death compared to Blacks, [hazard ratio (HR) 0.64, 95% confidence interval (CI) 0.51-0.8, p < 0.01]. After adjusting for significant covariates, Whites had 22% (HR 0.78, 95% CI 0.61-0.99, p 0.04) reduced risk of death, compared to Blacks. Transplant significantly reduced rate of death; however, only 13.3% of Blacks had liver transplant, compared to 40.1% of Whites, p < 0.01.Conclusions: In this diverse sample of patients, survival among Blacks is the shortest after HCC diagnosis. Survival differences reflect a more advanced tumor stage at presentation rather than severity of underlying liver disease precluding treatment. Improving survival in minority populations, in whom HCC incidence is rapidly increasing, requires identification and modification of factors contributing to late-stage presentation. [ABSTRACT FROM AUTHOR]

The main threats to primates worldwide are the degradation, fragmentation, and loss of their habitats; hunting (especially for bushmeat); and illegal trade. For many species, the most important threat is forest fragmentation, resulting in small populations that are restricted to isolated forest patches. In this situation, primates are particularly vulnerable to disease. The Endangered blonde capuchin ( Sapajus flavius) is now restricted to a few forest patches in Northeast Brazil. We investigated the occurrence of parasites and bacterial diseases in one of three free-ranging groups of S. flavius in a small forest patch in Paraíba state, Northeast Brazil. We tested for antibodies against Leishmania spp ., Trypanosoma cruzi, Toxoplasma gondii, Leptospira spp. (24 strains), and Brucella spp.. We used molecular analysis to detect Plasmodium spp., and evaluated blood smears for the presence of hemoparasites. All individuals tested negative for Leptospira spp. and B. abortus, but 8 of 48 (16%) presented antibodies for both Leishmania spp. and T. cruzi. We identified antibodies to T. gondii in 12% of the individuals tested. Plasmodium brasilianum infection was present in 4% of the individuals tested, and blood smears showed microfilariae parasites in 46% of the individuals tested. The occurrence of these infectious diseases in S. flavius may pose a significant threat in terms of reduced recruitment and poor survival rates, and an understanding of the influence of pathogens is crucial for the management of small populations of primates. [ABSTRACT FROM AUTHOR]

Because of the important role that survival expectations play in individual decision making, we investigate the extent to which individual responses to survival probability questions are informative about actual mortality. In contrast to earlier studies, which relied on the Health and Retirement Study (HRS) of US individuals aged 50 and over, we combine household survey data on subjective survival probabilities with administrative data on actual mortality for Dutch respondents aged 25 and over. Our main finding is that in our sample, individual life expectancies (measured as subjective survival probabilities) do predict actual mortality even when we control for a large set of health indicators. Our results further suggest that, on average, women underestimate their remaining life duration, whereas men tend to predict their survival chances more realistically. Both sexes, however, tend to overestimate the age gradient in mortality risk and underestimate the health risks of smoking. [ABSTRACT FROM AUTHOR]

Operant behavior involves many physical dimensions, including time, force, location, and distance. Energy is an important dimension in foraging behavior or motor response. Kono ( Learning & Behavior, 41, 425-432, 2013) developed a schedule in which the controlling variable was the energy of responses, calculated by dividing the squared value of the distance between two consecutive responses by the squared value of the interresponse time, or the elapsed time between the two responses. This energy schedule demonstrated the possibility of differential reinforcement of the energy of responses, but the effect was relatively weak. Kono ( Learning & Behavior, 41, 425-432, 2013) proposed that this weak effect could have been caused by two features of the adjusting procedure: the use of two or more schedules and variation in the reinforced energy of responses across trials depending on the subjects' previous choice. The present study employed a single energy schedule whose requirement was fixed throughout the session. The results showed that the energy of responses increased as the requirement of the energy schedule increased. In addition, the degree of increase was greater for distance of responses than for time of responses. These results suggest that the energy schedule is a suitable method for controlling the energy of behavior, and the distance of responses has a greater effect than time. [ABSTRACT FROM AUTHOR]

The present study examines the influence that environmental variables exerted on changes in condition index (CI), shell height (SH-dorsal-ventral axis) and soft tissue mass increments (STM) of the winged oyster Pteria colymbus in suspended culture during periods of upwelling (December to April) and non-upwelling (August to November) in the Cariaco Gulf, northeastern Venezuela. Environmental variables recorded between April 2012 and May 2013 included seston, water transparency, temperature, dissolved oxygen, chlorophyll a (Chl a) and the upwelling index (UI). Individuals were cultivated in lantern nets with an overall density of 56 individuals/0.123 m. From three randomly chosen baskets, five individuals were sampled each month and changes in CI, STM and SH were related to the environmental variables using Spearman correlation and PCA. Results show that during upwelling, both Chl a and UI presented a positive and significant relationship with the oyster condition and growth parameters. During non-upwelling (low UI), this relationship was inverse, demonstrating the important influence of upwelling and non-upwelling periods on the ecophysiology of the species. Furthermore, it was shown that the non-upwelling, characterized by high temperatures and low food availability, is a critical period for P. colymbus, judging by a decrease in growth and survival rate. Nonetheless, this species reached 50 mm in 5 months, a size considered as commercially viable, suggesting that the study area is favourable to the cultivation of the winged oyster despite a dramatic decrease in upwelling intensity in the last decade. [ABSTRACT FROM AUTHOR]

The outcomes of second primary oropharyngeal cancer (SPOPC) may not be determined by oropharyngeal cancer but from the other index cancer as well. The management of (SPOPC) remains inconclusive and limited. Transoral robotic surgery (TORS) to maximize the functional outcomes without reducing oncologic effect is suggested as the primary treatment for selected oropharyngeal cancer. This study aimed to evaluate the feasibility and outcomes of TORS for the management of SPOPC. Patients who underwent TORS from January 2011 to June 2015 at a tertian referral center in Taiwan were recruited. Loco-regional status, overall survival (OS), disease-specific survival (DSS), and postoperative functional status were evaluated. Fifteen patients received TORS for SPOPC with curative intent, including eleven with tongue-base carcinomas, and four with tonsil carcinomas. One case was terminated because of inadequate exposure and the other 14 cases were completed with negative pathologic margins. Two-year OS and DSS were 53 and 77%, respectively. Patients with SPOPC occurring within 6 months had poorer outcomes ( p = 0.044). The median time to feeding-tube removal was 5 days, and one patient had long-term gastric-tube dependence. Patients of age <65 years with synchronous SPOPC and esophageal cancer as the other index cancer were significant worse in oncologic outcomes. We concluded that TORS is a feasible alternative treatment in selected patients with SPOPC. Patients with metachronous T1-2 SPOPC without an esophageal primary can achieve excellent survival after TORS, while TORS can maximize functional preservation with limited destruction in patients with low life expectancy. [ABSTRACT FROM AUTHOR]

The objective of this study was to construct empowerment model through strength-based LEGO SERIOUS PLAY (LSP) workshop and to explore the effects and change connotations of this workshop. Two adult participants who had experienced domestic violence in childhood were invited to a 6-h strength-based LSP workshop. The research instruments included The Experiences in Close Relationships-Revised, Positive and Negative Affect Schedule, and Critical Positivity Ratio Self-Test Scale. They were employed on pretest, posttest, and follow-up test. Subsequently, group interview was conducted to explore the effectiveness of the strength-based LSP workshop. According to the research results, two participants exhibited a consistently increasing trend on their Critical Positivity Ratio Self-Test Scale. They demonstrated positive changing trend on the posttest involving attachment-related avoidance scale, and their scores on the attachment-related anxiety scale also presented an increasing trend. Furthermore, the textual information collected from the LegoViews revealed that the strength-based LSP workshop could ingrain inner strengths, develop strengths in a relationship, and reconstruct life experience. [ABSTRACT FROM AUTHOR]

This study examined whether tsunami survivors' coping styles mediate the effects of attachment styles on posttsunami trauma. Four hundred and sixteen survivors were interviewed from Tamil Nadu (India) 14 months posttsunami. Attachment style, coping, and posttsunami trauma were assessed using inventories, and exposure was assessed using a checklist. The female and the more exposed survivors experienced more posttsunami trauma. After controlling the effects of disaster exposure and gender, high fearfully attached persons had more trauma, used more problem-focused coping, and less active and avoidant emotional coping. High dismissively attached persons had less trauma, used less problem-focused coping, and more active and avoidant emotional coping. Attachment styles are related to trauma and coping styles, but indirect effects of attachment styles via coping styles do not predict posttsunami trauma. [ABSTRACT FROM AUTHOR]

Application of the enhanced recovery after surgery (ERAS) to the bariatric surgical procedures is at its early stages with little consolidated evidence. This meta-analysis evaluates present literature and indicates pathways for development of evidence-based standardized ERAS protocols for bariatric surgery. Comparative trials between ERAS and conventional bariatric surgery published till June 2016 were searched in the medical database. Comparisons were made for length of stay (LOS), readmission, complications (major/minor), and reoperation rates. Trial sequential analysis (TSA) for the strength of meta-analysis was performed for the primary outcome LOS. Five subgroups with a total of 394 and 471 patients in ERAS and conventional group respectively were included. LOS was shorter in ERAS group by 1.56 ± 0.18 days (random-effects, p < 0.001, I = 93.07 %). The sample size in ERAS was well past the 'information size' variable which was calculated to be 189 as per the TSA for power 85%. MH odds ratio [1.41 (95% CI 1.13 to1.76)] was higher for minor complications in the ERAS group (fixed effects, I = 0, p < 0.001). Superiority/inferiority of ERAS could not be established for major or overall complications, readmission, and anastomotic leak rates. No publication bias was found in the included trials (Egger's test, X-intercept = 6.14, p = 0.66). Evaluation based on Cochrane collaboration recommendations suggested that all the five included trials had a high risk of methodological bias. ERAS protocols for bariatric procedures allow faster return to home for patients. The present bariatric ERAS protocols have high heterogeneity and would benefit from standardization. Minor complication rates increase with implementation of ERAS, however without any significant effect on overall patient morbidity. Further randomized trials comparing ERAS with conventional care are required to consolidate these findings. [ABSTRACT FROM AUTHOR]

Laoya Cave is a long-term occupation site of Late Paleolithic humans in the Yunnan-Guizhou Plateau, southwest China, where abundant lithic, bone materials were recovered. Dating by the AMS technique showed a significant depositional process during marine isotope stage (MIS) 3/2. In this study, the species spectrum was presented from the perspective of zooarchaeology and the mortality profile of large Cervidae was examined to help increase our understanding of the subsistence strategy of local people dealing with climate and environmental changes. The main part of the diet was focused on large Cervidae, and the dominance of Ungulates indicates effective management of the cave and local fauna. On the other hand, the mortality profiles of large Cervidae varied correspondingly with climate change. The evidence indicates a specialized hunting strategy that was also flexible, depending on the prevailing climate and environment. [ABSTRACT FROM AUTHOR]

Individuals care not only about their own survival, but also about the survival of other persons. However, little attention has been paid so far to measuring the contribution of longer coexistence time to living standards. For that purpose, we develop a measure of coexistence time-the joint life expectancy-which quantifies the average duration of existence for a group of persons. Then, using a lifecycle model with risky lifetime, we construct an equivalent consumption measure incorporating gains in single and joint life expectancies. An empirical application to France (1820-2010) shows that, assuming independent individual mortality risks, the rise in joint life expectancies contributed to improve standards of living significantly. We examine the robustness of that result to the introduction of dependent mortality risks using copulas, and we show that equivalent consumption patterns are robust to introducing risk dependence. [ABSTRACT FROM AUTHOR]

Horqin Sandy Land, a region in China that suffers from desertification, has become a primary economic zone in Inner Mongolia MengDong. Ecological and environmental problems continue to affect the local environment and human survival, becoming one of the bottlenecks to economic and social development. Thus, research on the characteristics of climatic variation is urgently required. This study used the comprehensive timeline for the regional tree wheel width of Horqin Sandy Land to reconstruct the average minimum winter temperatures of the study area. The timeline, which has been in use for 183 years, was established using core samples from the annual growth rings of elm trees in 10 sampling sites. For 181 years (1826-2006), varying minimum temperatures were observed: a gentle wave stage (1826-1923), an intense cooling stage (1923-1957), and a considerable heating stage (1957-2006). The longest continuous heating stage was observed from 1957 to 2006, during which time the average minimum temperature was −16.81 °C, a value greater than the mean temperature over the entire study period. The coldest 10 years occurred during the 1950s, until 1957, at which point the temperature sharply increased. The next 50 years exhibited a general warming trend until 2000. This period reflected a time span with the warmest minimum temperature and displayed a warming trend rate of 0.575 °C/10 years and an overall increase of up to 1.5° every 50 years. A continued rise in temperature is predicted to cause a wider range and longer time scale of ecological and environmental problems. [ABSTRACT FROM AUTHOR]

This study examines functional outcome (speech and swallowing), survival, and disease control in patients receiving an intensified treatment regimen with primary aggressive surgery, and postoperative radiotherapy or postoperative concomitant chemoradiotherapy, for previously untreated, resectable, stage III and IV squamous cell carcinoma (SCC) of the tongue base. Sixty-six consecutive patients treated from June 1997 to June 2006 were followed prospectively through the Multidisciplinary Head and Neck Surgery Reconstruction Clinic. Speech and swallowing data were gathered at four evaluation times during the first year. Speech assessment was conducted by PERCI, Nasometer, and C-AIDS and swallowing assessment by Modified barium swallow, Diet survey and G-tube. Also, the overall survival, disease-specific survival and loco regional control were measured. The average age of the patients was 56.8, 85 % male and 15 % female. All patients had primary surgical resection and 83 % received postoperative radiotherapy and 17 % chemoradiation therapy. Overall survival at 3 years was 80.3 % and 5 years 52.2 %. Disease-specific survival at 3 years was 86.7 % and 5 years was 77.5 %. Local control was 94 %. Distal metastasis and second primary were found to be 7.5 % each. Primary surgical treatment of advanced BOT cancer offers excellent functional outcome, local control and disease-specific survival. [ABSTRACT FROM AUTHOR]

Sinonasal malignant neoplasms are rare and adenocarcinomas account for 10-20 % of these cancers. Our aim is to characterise the clinical presentation, risk factors and outcomes of patients with adenocarcinoma treated at our institution. Retrospective review of medical records of patients with sinonasal adenocarcinomas, treated at IPO-Porto from January 2008 until December 2012. Twenty-eight patients with adenocarcinomas were selected from a total of 53 patients with sinonasal cancers. There was a male predominance (93 %), a mean age at diagnosis of 56 years and a rate of occupational wood dust exposure of 71 %. The most common treatment option was surgery followed by adjuvant radiotherapy. The 5 year disease-free and cancer-specific survival was 58 and 60 %, respectively. The following factors had negative impact on disease-free survival: advanced AJCC stage ( p = 0.014); skull base invasion ( p = 0.002); poorly differentiated or mucinous subtypes histology ( p = 0.034) and imaging findings of residual tumour before adjuvant radiotherapy ( p < 0.001). Endoscopic tumour resection was not associated with adverse outcomes. The role of volume-modulated arch therapy in the treatment of sinonasal tumours has to be clarified. The higher rate of adenocarcinomas among sinonasal cancers in this series comparing with previous reports, even from our institution, suggests that this pathology is rising in Northern Portugal. Despite substantial local failure, sinonasal adenocarcinomas have a relatively favourable prognosis in terms of cancer-specific survival. [ABSTRACT FROM AUTHOR]

Open partial horizontal laryngectomy (OPHL) specimens include cartilage and lymph nodes. Pathological adverse findings (PAF): perichondrium, cartilage, perineural invasion, microvessel spread and prelaryngeal metastases can be detected histologically. We aimed at examining PAF in OPHL specimens and examining the interdependence with oncological outcomes. Prospective analysis of 254 glottis cancers: 87-T2a, 77-T2b and 90-T3 with anterior commissure (AC) involvement treated by OPHL at tertiary referral centre between 2001 and 2008. In 38/254 patients (15 %) PAF were found (16 prelaryngeal metastases, 22 other); more often in stage T2b/T3 versus T2a ( p = 0.008). PAF other than prelaryngeal metastases were found more often in T2b than T2a tumours ( p = 0.005). Outcomes revealed that out of 36 patients with local recurrence, 19 had PAF. Comparison of 216 patients with no PAF and 16 patients with prelaryngeal metastases revealed, respectively: 7.9 versus 81.3 % local recurrences ( p = 0.034), 3.2 versus 68.8 % nodal recurrences ( p = 0.011), 90.7 versus 43.8 % of 5-year organ preservation ( p = 0.021) and 92.6 versus 75 % 5-year overall survival ( p = 0.022). Out of 10 patients with close margins, 1 developed the local recurrence; impact for organ preservation and overall survival was not significant. In 22/254 cases including the cartilage into the operating specimen were therapeutically meaningful; in 16/254 with prelaryngeal metastases, the impact for larynx preservation and overall survival was significant. T2b patients had higher probability of PAF than T2a. PAF significantly influenced higher local recurrence rate. This finding ensures the authors, that OPHL type II is not the 'overtreatment' compared to the TLM. [ABSTRACT FROM AUTHOR]

Background:To compare the accuracy of five major risk stratification systems (RSS) in classifying the risk of recurrence and nodal metastases in early-stage endometrial cancer (EC).Methods:Data of 553 patients with early-stage EC were abstracted from a prospective multicentre database between January 2001 and December 2012. The following RSS were identified in a PubMed literature search and included the Post Operative Radiation Therapy in Endometrial Carcinoma (PORTEC-1), the Gynecologic Oncology Group (GOG)-99, the Survival effect of para-aortic lymphadenectomy (SEPAL), the ESMO and the ESMO-modified classifications. The accuracy of each RSS was evaluated in terms of recurrence-free survival (RFS) and nodal metastases according to discrimination.Results:Overall, the ESMO -modified RSS provided the highest discrimination for both RFS and for nodal metastases with a concordance index (C-index) of 0.73 (95% CI, 0.70-0.76) and an area under the curve (AUC) of 0.80 (0.78-0.72), respectively. The other RSS performed as follows: the PORTEC1, GOG-99, SEPAL, ESMO classifications gave a C-index of 0.68 (0.66-0.70), 0.65 (0.63-0.67), 0.66 (0.63-0.69), 0.71 (0.68-0.74), respectively, for RFS and an AUC of 0.69 (0.66-0.72), 0.69 (0.67-0.71), 0.68 (0.66-0.70), 0.70 (0.68-0.72), respectively, for node metastases.Conclusions:None of the five major RSS showed high accuracy in stratifying the risk of recurrence or nodal metastases in patients with early-stage EC, although the ESMO-modified classification emerged as having the highest power of discrimination for both parameters. Therefore, there is a need to revisit existing RSS using additional tools such as biological markers to better stratify risk for these patients. [ABSTRACT FROM AUTHOR]

Current chemotherapeutic regimens achieve CR in a large percentage of patients with AML. However, relapse after CR remains a significant problem. The presence of leukemic cells at levels too low to be detected by conventional microscopy, termed minimal residual disease (MRD), has been associated with an increased risk of relapse and shortened survival. Detection of MRD requires the use of highly sensitive ancillary techniques. Multi-color flow cytometric immunophenotyping is a sensitive method for quick and accurate detection of MRD. Use of this method in patient management may result in lower rates of relapse and improved survival, and is an effective means of assessing novel therapeutic agents. This method can be used in the vast majority of patients with AML, regardless of the immunophenotypic, cytogenetic and molecular genetic abnormalities present. Unfortunately, conflicting data regarding optimum methods of measurement and reporting, as well as the expertize required to interpret results have limited broad application of this technique. We provide a broad overview of this technique, including its advantages and limitations, and discuss the methods employed at our institution. We also review several possible areas of future investigation. [ABSTRACT FROM AUTHOR]

On average, 'young' people underestimate whereas 'old' people overestimate their chances to survive into the future. Such subjective survival beliefs violate the rational expectations paradigm and are also not in line with models of rational Bayesian learning. In order to explain these empirical patterns in a parsimonious manner, we assume that self-reported beliefs express likelihood insensitivity and can, therefore, be modeled as non-additive beliefs. In a next step we introduce a closed form model of Bayesian learning for non-additive beliefs which combines rational learning with psychological attitudes in the interpretation of information. Our model gives a remarkable fit to average subjective survival beliefs reported in the Health and Retirement Study. [ABSTRACT FROM AUTHOR]

Neurotrophic factors are operationally defined as molecules that promote the survival and differentiation of neurons. Chemically, they belong to divergent classes of molecules but most of the classic neurotrophic factors are proteins. Together with stem cells, viral vectors and genetically engineered cells, they constitute important tools in neuroprotective and regenerative neurobiology. Protein neurotrophic molecules signal through receptors located on the cell membrane. Their downstream signaling exploits pathways that are often common to chemically different factors and frequently target a relatively restricted set of transcription factors, RNA interference and diverse molecular machinery involved in the life vs. death decisions of neurons. Application of neurotrophic factors with the aim of curing or, at least, improving the outcome of neurodegenerative diseases requires (1) profound knowledge of the complex molecular pathology of the disease, (2) the development of animal models as closely as possible resembling the human disease, (3) the identification of target cells to be addressed, (4) intense efforts in chemical engineering to ensure the stability of molecules or to design carriers and small analogs with the ability to cross the blood-brain barrier and (5) scrutinity with regard to possible side effects. Last, but not least, engineering efforts to optimize administration, e.g., by designing the right canulae and infusion devices, are important for the successful translation of preclinical advances into clinical benefit. This article presents selected examples of neurotrophic factors that are currently being tested in animal models or developed for transfer to the clinic, with a major focus on factors with the potential of becoming applicable in various forms of retinal degeneration. [ABSTRACT FROM AUTHOR]

Despite the fact that the survival of people infected with human immunodeficiency virus (HIV) has improved worldwide because of the increasingly powerful and highly active antiretroviral therapy, opportunistic infections (OIs) of the central nervous system (CNS) remain a serious burden. HIV-1 is capable of entering the CNS through infected peripheral monocytes, but its effect on OIs of CNS remains unclear. In this study, we investigated the characteristics of HIV-1 in acquired immunodeficiency syndrome (AIDS) patients with CNS OIs. A total of 24 patients with CNS OIs and 16 non-CNS OIs (control) cases were selected. These AIDS patients were infected with HIV-1 by paid blood donors in China. HIV-1 loads in plasma and cerebrospinal fluid (CSF) were detected using RT-PCR, and the C2-V5 region of HIV-1 envelope gene was amplified from viral quasispecies isolated from CSF using nested PCR. The CSF HIV-1 load of CNS OIs was higher than that of non-CNS OIs, but plasma HIV-1 load of CNS OIs was not higher than that of non-CNS OIs. The nucleotide sequence of C2-V5 region of the HIV-1 quasispecies isolated from the CSF of CNS OIs had a high diversity, and the HIV-1 quasispecies isolated from the CSF of CNS OIs revealed R5 tropism as 11/25 charge rule. These results suggest that high levels of divergent HIV-1 quasispecies in the CNS probably contribute to opportunistic infections. [ABSTRACT FROM AUTHOR]

Using genome-wide promoter methylation analysis, we identified a disintegrin-like and metalloprotease with thrombospondin type 1 motif 9 (ADAMTS9) is methylated in cancer. We aim to clarify its epigenetic inactivation, biological function and clinical implication in gastric cancer. ADAMTS9 was silenced in 6 out of 8 gastric cancer cell lines. The loss of ADAMTS9 expression was regulated by promoter hypermethylation and could be restored by demethylation agent. Ectopic expression of ADAMTS9 in gastric cancer cell lines (AGS, BGC823) inhibited cell growth curve in both the cell lines (P<0.0001), suppressed colony formation (P<0.01) and induced apoptosis (P<0.001 in AGS, P<0.01 in BGC823). Moreover, conditioned culture medium from ADAMTS9-transfected cell lines significantly disrupted the human umbilical vein endothelial cell tube formation capacity on Matrigel (P<0.01 in AGS, P<0.001 in BGC823). The in vivo growth of ADAMTS9 cells in nude mice was also markedly diminished after stable expression of ADAMTS9 (P<0.001). On the other hand, ADAMTS9 knockdown promoted cell proliferation (P<0.001). We further revealed that ADAMTS9 inhibited tumor growth by blocking activation of Akt and its downstream target the mammalian target of rapamycin (mTOR). ADAMTS9 also reduced phosphorylation of mTOR downstream targets p70 ribosomal S6 kinase, eIF4E-binding protein and downregulated hypoxia-inducible factor-1α. Therefore, this is the first demonstration that ADAMTS9 is a critical tumor suppressor of gastric cancer progression at least in part through suppression of oncogenic AKT/mTOR signaling. Moreover, promoter methylation of ADAMTS9 was detected in 29.2% (21/72) of primary gastric tumors. Multivariate analysis showed that patients with ADAMTS9 methylation had a poorer overall survival (relative risk (RR)=2.788; 95% confidence interval, 1.474-5.274; P=0.002). Kaplan-Meier survival curves showed that ADAMTS9 methylation was significantly associated with shortened survival in gastric cancer patients (P=0.001, log-rank test). In conclusion, ADAMTS9 acts as a functional tumor suppressor in gastric cancer through inhibiting oncogenic AKT/mTOR signaling pathway. Methylation of ADAMTS9 is an independent prognostic factor of gastric cancer. [ABSTRACT FROM AUTHOR]

Purpose: We evaluated the attitude in using chemotherapy near the end of life in advanced pancreatic adenocarcinoma (PAC). Clinical and laboratory parameters recorded at last chemotherapy administration were analyzed, in order to identify risk factors for imminent death. Methods: Retrospective analysis of patients who underwent at least one line of palliative chemotherapy was made. Data concerning chemotherapy (regimens, lines, and date of last administration) were collected. Clinical and laboratory factors recorded at last chemotherapy administration were: performance status, presence of ascites, hemoglobin, white blood cell (WBC), platelets, total bilirubin, albumin, LDH, C-reactive protein (C-rp), and Ca 19.9. Results: We analyzed 231 patients: males/females, 53/47 %; metastatic/locally advanced disease, 80/20 %; and median age, 66 years (range 32-85). All patients died due to disease progression. Median overall survival was 6.1 months (95 % CI 5.1-7.2). At the last chemotherapy delivery, performance status was 0-1 in 37 % and 2 in 63 %. Fifty-nine percent of patients received one chemotherapy line, while 32, 8, and 1 % had second-, third-, and fourth line, respectively. The interval between last chemotherapy administration and death was <4 weeks in 24 %, ≥4-12 in 47 %, and >12 in 29 %. Median survival from last chemotherapy to death was 7.5 weeks (95 % CI 6.7-8.4). In a univariate analysis, ascites, elevated WBC, bilirubin, LDH, C-rp and Ca 19.9, and reduced albumin were found to predict shorter survival; however, none of them remained significant in a multivariate analysis. Conclusions: A significant proportion of patients with advanced PAC received chemotherapy within the last month of life. The clinical and laboratory parameters recorded at last chemotherapy delivery did not predict shorter survival. [ABSTRACT FROM AUTHOR]

Purpose: The study seeks to prospectively evaluate pulmonary function and quality of life (QOL) in medically inoperable early-stage lung cancer patients undergoing stereotactic body radiotherapy (SBRT). Methods: QOL was assessed by Functional Assessment of Cancer Therapy-Lung (FACT-L) and the UCSD Medical Center Pulmonary Rehabilitation Program Shortness-of-Breath Questionnaire before and after SBRT at 6 weeks, and every 3 months until 12 months. Clinical investigations included pulmonary functions tests and blood profile and chemistries. SBRT was delivered on a Novalis/BrainLab system. Results: Twenty-one analyzable patients were enrolled between July 2008 to April 2009. There were 12 males (52.4 %), 14 patients (66.7 %) had Zubrod performance 1, the median age was 77 years (range 61-90), and 87 % was inoperable because of pulmonary impairment. Median tumor size was 3.0 cm (range 1-4.6). Median follow-up was 17.6 months. One-year local control was 100 %. There were no significant changes in the median total FACT-L scores: 109 at baseline compared to 112 at 1 year. Mean UCSD scores were not significant for the year. No significant changes in mean baseline compared to 1-year FEV1 and 6-min walks as % predicted were seen but a significant DLCO change ( p = 0.012) was attributed to the decreased range in the standard deviations. Conclusions: Following SBRT, QOL is not significantly degraded. Pulmonary function is likewise not significantly impaired overall. Along with favorable survival results, these findings confirm that SBRT is appropriate for this patient population. [ABSTRACT FROM AUTHOR]

Background Increased survival in patients with systemic lupus erythematosus (SLE) has shifted attention towards the burden that SLE imposes upon patients, healthcare systems and society. New interventions aimed at alleviating this burden will require economic evaluation. A summary of the current evidence of the humanistic and economic burden provides a platform for such subsequent studies. Objective The objective of this study was to systematically review the current evidence on the humanistic and economic burden of SLE in terms of health-related quality of life (HR-QOL) and costs, and summarize the evidence on the factors found to be associated with this burden. Methods Relevant literature for the years 1990 to February 2011 were obtained from systematic searches of MEDLINE, EMBASE and Web of Science. Articles reporting the humanistic (preference-based outcome measures or an SLE disease-specific HR-QOL measure) or economic burden (costs) of SLE in adult populations published in English were identified. The following exclusion criteria were applied: studies specifically examining lupus nephritis, SLE not being the main condition of focus (e.g. SLE is a co-existing condition), studies focusing on diagnostics or tests (including genetics and antibodies), mixed patient groups from which SLE could not be separated, paediatric populations, case studies, abstract unavailable, and non-English language studies. Estimates of the burden in terms of either HR-QOL or costs were extracted, tabulated and reported narratively. Annual cost figures were also converted into year 2010 US dollars using the consumer price index (CPI) and the purchasing power parity (PPP) conversion factor to allow for greater comparability across studies. Evidence on the factors found to be independently associated with either HR-QOL or costs was also examined. Results Of the 1969 studies initially identified as being potentially relevant, 32 papers were retained for the final review. Eighteen of these presented estimates of the burden in terms of HR-QOL, and 14 in terms of the economic cost. Mean utility scores reported on preference-based measures of HR-QOL ranged from 0.6 to 0.75. Mean annual direct costs per patient ranged from US$2,214 to US$16,875, and mean annual indirect cost estimates from US$2,239 to US$35,540 (year 2010 values). Disease activity and damage, along with poor mental and physical health, were repeatedly reported to predict both reduced HR-QOL and increased costs. Conclusions The burden of SLE was found to be substantial, not only for patients but also for the health services that provide care for them. Treatments that are able to alleviate this burden are therefore likely to be highly valued by sufferers. After an extended period in which few therapeutic advances were made or treatments licensed, fundamental developments are finally being made. These new treatments will need to be evaluated for both clinical and cost effectiveness if their use is to be widely implemented. [ABSTRACT FROM AUTHOR]

The skin interfollicular epidermis (IFE) is the first barrier against the external environment and its maintenance is critical for survival. Two seemingly opposite theories have been proposed to explain IFE homeostasis. One posits that IFE is maintained by long-lived slow-cycling stem cells that give rise to transit-amplifying cell progeny, whereas the other suggests that homeostasis is achieved by a single committed progenitor population that balances stochastic fate. Here we probe the cellular heterogeneity within the IFE using two different inducible Cre recombinase-oestrogen receptor constructs targeting IFE progenitors in mice. Quantitative analysis of clonal fate data and proliferation dynamics demonstrate the existence of two distinct proliferative cell compartments arranged in a hierarchy involving slow-cycling stem cells and committed progenitor cells. After wounding, only stem cells contribute substantially to the repair and long-term regeneration of the tissue, whereas committed progenitor cells make a limited contribution. [ABSTRACT FROM AUTHOR]

Background: The life span of cancer patients has improved due to advancements in cancer management. With long survival periods, more patients show metastatic disease. Osteolytic tumours of spine are generated by metastatic deposits or primary tumours of the spine. A prospective study was performed to evaluate the efficacy and safety of percutaneous kyphoplasty in patients with osteolytic tumours of the thoracic and lumbar spine. Materials and methods: Eleven patients (age range 52-77/average 65 years; 7 female, 4 male) with osteolytic tumours of the spine were treated with kyphoplasty. The main Tokuhashi score was registered preoperatively. Outcome was assessed prospectively by visual analogue scale (VAS) for pain, ECOG performance status, walking distance, standing and sitting time. Results: Preoperative VAS (average 7.5; range 2.6-10) dropped to 3.0, 5 days postoperatively and remained below 5 for follow-up. Main Tokuhashi score was 6.3, ranging from 3 to 9. Survival time ranged from 2 to 293 (average 74.4) weeks. Average walking distance, standing and sitting time and ECOG performance score showed improvement. All patients returned home and no patient required re-operation or readmission due to local disease progression or recurrence. Conclusion: Kyphoplasty is a suitable palliative treatment option for patients with advanced metastatic disease of the spine even with low Tokuhashi scores allowing rapid pain relief and mobilisation to increase the quality of life. [ABSTRACT FROM AUTHOR]

Background: Few reports exist on long-term survival after minimally invasive liver surgery (MILS) for colorectal liver metastases (CRLM). No data are available assessing prognostic factors in the era of current modern treatment strategies. Methods: Between October 2002 and December 2008, 274 consecutive patients were analyzed on an intention-to-treat basis. Open liver surgery (OLS) was performed in 193 patients for a total of 437 metastases, and MILS was performed in 81 patients for 176 metastases. Systemic chemotherapy was administered preoperatively in 173 and postoperatively in 174 patients. The impact of 23 potential prognostic factors on disease-free (DFS) and overall survival (OS) was evaluated using univariable and multivariable Cox regression models. Results: Postoperative complications were observed in 54 patients after OLS and in 11 after MILS ( p = 0.016). The median postoperative length of hospital stay was 9 days after OLS and 5 days after MILS ( p < 0.0001). For the entire patient population, the 5 year DFS and OS rates were 29.9 and 59.5%, respectively. No differences in survival between patients treated with MILS and OLS were observed ( p = 0.63). In univariable analyses, the number of liver metastases and the overall Fong's clinical risk score (CRS) were the only two variables that predicted DFS ( p ≤ 0.0035) and OS ( p ≤ 0.0005). In multivariable analyses, the total CRS was the only independent predictor of both DFS ( p = 0.0002) and OS ( p = 0.002). Conclusion: The long-term oncologic outcome of surgically treated patients with CRLM is determined by the Fong's CRS. Although MILS does not influence long-term survival, it has a beneficial impact on the immediate postoperative clinical outcome. [ABSTRACT FROM AUTHOR]

Background: This study aimed to examine the incidence and survival of lung cancer patients from several different ethnic groups in a large ethnically diverse population in the United Kingdom.Methods: Data on residents of South East England diagnosed with lung cancer between 1998 and 2003 were extracted from the Thames Cancer Registry database. Age- and socioeconomic deprivation-standardised incidence rate ratios were calculated for males and females in each ethnic group. Overall survival was examined using Cox regression, adjusted for age, socioeconomic deprivation, stage of disease and treatment. Results are presented for White, Indian, Pakistani, Bangladeshi, Black Caribbean, Black African and Chinese patients, apart from female survival results where only the White, South Asian and Black ethnic groups were analysed.Results: Compared with other ethnic groups of the same sex, Bangladeshi men, White men and White women had the highest incidence rates. Bangladeshi men had consistently higher survival estimates compared with White men (fully adjusted hazard ratio 0.46; P<0.001). Indian (0.84; P=0.048), Black Caribbean (0.87; P=0.47) and Black African (0.68; P=0.007) men also had higher survival estimates. South Asian (0.73; P=0.006) and Black (0.74; P=0.004) women had higher survival than White women.Conclusion: Smoking prevention messages need to be targeted for different ethnic groups to ensure no groups are excluded. The apparent better survival of South Asian and Black patients is surprising, and more detailed follow-up studies are needed to verify these results. [ABSTRACT FROM AUTHOR]

Background: This study aims to identify prognostic factors and to develop a risk model predicting survival in patients undergoing secondary cytoreductive surgery (SCR) for recurrent epithelial ovarian cancer.Methods: Individual data of 1100 patients with recurrent ovarian cancer of a progression-free interval at least 6 months who underwent SCR were pooled analysed. A simplified scoring system for each independent prognostic factor was developed according to its coefficient. Internal validation was performed to assess the discrimination of the model.Results: Complete SCR was strongly associated with the improvement of survival, with a median survival of 57.7 months, when compared with 27.0 months in those with residual disease of 0.1-1 cm and 15.6 months in those with residual disease of >1 cm, respectively (P<0.0001). Progression-free interval (≤23.1 months vs >23.1 months, hazard ratio (HR): 1.72; score: 2), ascites at recurrence (present vs absent, HR: 1.27; score: 1), extent of recurrence (multiple vs localised disease, HR: 1.38; score: 1) as well as residual disease after SCR (R1 vs R0, HR: 1.90, score: 2; R2 vs R0, HR: 3.0, score: 4) entered into the risk model.Conclusion: This prognostic model may provide evidence to predict survival benefit from secondary cytoreduction in patients with recurrent ovarian cancer. [ABSTRACT FROM AUTHOR]

This paper discusses the vital role of disaster psychiatry in the evolving structures for preparedness and response in the fields of disaster management. The authors address the role of science and experience in addressing the tragedies of mass catastrophe, the need for systems and the challenges of integrating mental health contributions into the practical requirements for survival, aid, emergency management and ultimately recovery. The human face of disaster and the understanding of human strengths and resilience alongside the protection of, and care for, those suffering profound trauma and grief are central issues. [ABSTRACT FROM AUTHOR]

Background: Tissue micro-arrays (TMAs) are increasingly used to generate data of the molecular phenotype of tumours in clinical epidemiology studies, such as studies of disease prognosis. However, TMA data are particularly prone to missingness. A variety of methods to deal with missing data are available. However, the validity of the various approaches is dependent on the structure of the missing data and there are few empirical studies dealing with missing data from molecular pathology. The purpose of this study was to investigate the results of four commonly used approaches to handling missing data from a large, multi-centre study of the molecular pathological determinants of prognosis in breast cancer.Patients and Methods: We pooled data from over 11,000 cases of invasive breast cancer from five studies that collected information on seven prognostic indicators together with survival time data. We compared the results of a multi-variate Cox regression using four approaches to handling missing data - complete case analysis (CCA), mean substitution (MS) and multiple imputation without inclusion of the outcome (MI-) and multiple imputation with inclusion of the outcome (MI+). We also performed an analysis in which missing data were simulated under different assumptions and the results of the four methods were compared.Results: Over half the cases had missing data on at least one of the seven variables and 11 percent had missing data on 4 or more. The multi-variate hazard ratio estimates based on multiple imputation models were very similar to those derived after using MS, with similar standard errors. Hazard ratio estimates based on the CCA were only slightly different, but the estimates were less precise as the standard errors were large. However, in data simulated to be missing completely at random (MCAR) or missing at random (MAR), estimates for MI+ were least biased and most accurate, whereas estimates for CCA were most biased and least accurate.Conclusion: In this study, empirical results from analyses using CCA, MS, MI- and MI+ were similar, although results from CCA were less precise. The results from simulations suggest that in general MI+ is likely to be the best. Given the ease of implementing MI in standard statistical software, the results of MI+ and CCA should be compared in any multi-variate analysis where missing data are a problem. [ABSTRACT FROM AUTHOR]

Background: Breast cancer relative survival (BCRS), which compares the observed survival of women with breast cancer with the expected survival of women for the whole population of the same age, time period, and geographical region, tends to be poorer in older women, but the reasons for this are not clear. We examined the influence of patient and tumour characteristics, and treatment on BCRS to see whether these could explain the age-specific effect.Methods: Data for 14,048 female breast cancer patients diagnosed from 1999 to 2007, aged 50 years or over were obtained from the Eastern Cancer Registration and Information Centre. We estimated relative 5- and 10-year survival for patients in four age groups (50-69, 70-74, 75-79, and 80+ years). We also modelled relative excess mortality (REM) rate using Poisson regression adjusting for patient characteristics and treatment. The REMs derived from these models quantify the extent to which the hazard of death differs from the hazard in the reference category, after taking into account the background risk of death in the general population. We compared the results with those obtained for breast cancer-specific mortality, analysed using multivariate Cox regression.Results: Median follow-up time was 4.7 years. Relative 5-year survival was 89, 81, 76, and 70% for patients aged 50-69, 70-74, 75-79, and 80+ years, respectively. Corresponding relative 10-year survival was 84, 77, 67, and 66%. Unadjusted REM was 1.93, 2.74, and 3.88 for patients aged 70-74, 75-79, and 80+ years, respectively, (50-69 years as reference). The equivalent hazard ratios from the Cox model were 1.88, 2.45, and 3.81. These were attenuated after adjusting for confounders (REM - 1.49, 1.36, and 1.23; Cox - 1.47, 1.50, and 1.76).Conclusion: We confirmed poorer BCRS in older women in our region. This was partially explained by known prognostic factors. Further research is needed to determine whether biological differences or suboptimal management can explain the residual excess mortality. [ABSTRACT FROM AUTHOR]

Introduction: A selective combination of C-reactive protein and albumin (termed the modified Glasgow Prognostic Score, mGPS) has been shown to have prognostic value, independent of tumour stage, in lung, gastrointestinal and renal cancers. It is also of interest that liver function tests such as bilirubin, alkaline phosphatase and γ-glutamyl transferase, as well as serum calcium, have also been reported to predict cancer survival. The aim of the present study was to examine the relationship between an inflammation-based prognostic score (mGPS), biochemical parameters, tumour site and survival in a large cohort of patients with cancer.Methods: Patients (n=21,669) who had an incidental blood sample taken between 2000 and 2006 for C-reactive protein, albumin and calcium (and liver function tests where available) and a diagnosis of cancer were identified. Of this group 9608 patients who had an ongoing malignant process were studied (sampled within 2 years before diagnosis). Also a subgroup of 5397 sampled at the time of diagnosis (sampled within 2 months prior to diagnosis) were examined. Cancers were grouped by tumour site in accordance with International Classification of Diseases 10 (ICD 10).Results: On follow up, there were 6005 (63%) deaths of which 5122 (53%) were cancer deaths. The median time from blood sampling to diagnosis was 1.4 months. Increasing age, male gender and increasing deprivation was associated with a reduced 5-year overall and cancer-specific survival (all P<0.001). An elevated mGPS, adjusted calcium, bilirubin, alkaline phosphatase, aspartate transaminase, alanine transaminase and γ-glutamyl transferase were associated with a reduced 5-year overall and cancer-specific survival (independent of age, sex and deprivation in all patients sampled), as well as within the time of diagnosis subgroup (all P<0.001). An increasing mGPS was predictive of a reduced cancer-specific survival in all cancers (all P<0.001).Conclusion: The results of the present study indicate that the mGPS is a powerful prognostic factor when compared with other biochemical parameters and independent of tumour site in patients with cancer. [ABSTRACT FROM AUTHOR]

This paper reports the results of an empirical study investigating people's preferences over three different types of perturbation to their survival function, each perturbation generating the same gain in life expectancy. Preferences over the three different perturbations were found to be distributed more or less evenly across the subject pool. Use of a novel experimental methodology generated economically consistent and intuitively plausible responses to (necessarily) hypothetical questions concerning improvements in life expectancy by first allowing respondents to gain experience while making similar choices in an incentivized setting involving financial risk. The results demonstrate the potential for economic experiments to contribute to the development of more robust methods for policy evaluation in domains where physical risk is an important factor. [ABSTRACT FROM AUTHOR]

Choussat's 'Ten Commandments,' which describes the components of an ideal Fontan candidate, was first published in 1977. Despite the wisdom in these commandments, it is clear from a historic perspective that total compliance with all criteria does not necessarily portend excellent long-term survival. I believe the end point of the original commandments should be modified to include improvement in long-term survival. I suggest the following single commandment: 'Thou Shalt Be Perfect.' [ABSTRACT FROM AUTHOR]

Information about discussions during the 2007 Royal Colloquium in Narsaq, Greenland is presented. Topics include the opening address by His Majesty King Carl XVI Gustaf about the theme of the 2005 Royal Colloquium, regarding the thawing of the Arctic tundra, several speeches about climate change including one by Professor Wibjörn Karlén about global warming scenarios, and a discussion about human multisource survival strategies through the ice ages.

Compares surveys conducted between 1972-1976 and 1994-1995 on farming and herding strategies for food insecurity caused by droughts in Southern Kajiado District, Kenya. Patterns of change in the socioeconomic system; Similarities and differences in the strategies; Relationships between patterns of coping and developmental context.

This article discusses survival when life is in an extremely threatening situation, such as in the German concentration camps. The author discusses the will to keep on living despite the bleak outlook. In Walter Langhoff's memoirs "Die Moorsoldaten, 13 Monaten Konzentrationslager," he describes the organization of the "Zirkus Konzentrazani" as a way to uplift the prisoner's spirits, after brutal beatings by Nazi soldiers. The author comments on the fact, that despite the depravity, there was still time for "gallows" humor.

The article examines the fate of Jewish women in forests in different partisan groups and its dissimilarity from other illegal forest dwellers. Concentrating on the German occupation of Western Belorussia, now known as Belorus, findings from the book "Defiance," tell about women in the forest and about forest life in general. Much of Western Belorussia is covered by thick jungle-like, partly inaccessible forests. Until 1939, the area belonged to Poland. By September 17, 1939, because of the German-Russian friendship treaty, it was transferred to the Soviet Union. In less than two years, as a result of the German-Russian War, control over this territory switched hands. Under the German occupation these forests became a home for different kinds of fugitives and partisan groups. Eventually, Western Belorussia was known as an important center for the Soviet partisan movement. Women in general and Jewish women in particular, fit in unusual ways into these forest environments.

In this article, the author addresses a commentary about his article "So What's So Wrong With a Being a Street Child?," discussed within the issue. He argues that it was not his intention to romanticize the survival strategy of street children. He explains that writers on street children commit two cardinal errors. In conclusion, he raises three questions that need to be addressed to achieve a more balanced approach to street children.

The article presents a study about the chitobiosyldiphosphodolichol beta-mannosyltransferase that is encoded by the Alg1 gene. Topics discussed include the sequencing of the coding exons and flanking intronic sequences of the Alg1 gene, the frequency of the disease based on the prevalence of birth and population and the survival behavior of the human beings.

Approximately 20% of patients with acute myeloid leukaemia (AML) have a mutation in FMS-like-tyrosine-kinase-3 (FLT3). FLT3 is a trans-membrane receptor with a tyrosine kinase domain which, when activated, initiates a cascade of phosphorylated proteins including the SRC family of kinases. Recently our group and others have shown that pharmacologic inhibition and genetic knockdown of Bruton's tyrosine kinase (BTK) blocks AML blast proliferation, leukaemic cell adhesion to bone marrow stromal cells as well as migration of AML blasts. The anti-proliferative effects of BTK inhibition in human AML are mediated via inhibition of downstream NF-κB pro-survival signalling however the upstream drivers of BTK activation in human AML have yet to be fully characterised. Here we place the FLT3-ITD upstream of BTK in AML and show that the BTK inhibitor ibrutinib inhibits the survival and proliferation of FLT3-ITD primary AML blasts and AML cell lines. Furthermore ibrutinib inhibits the activation of downstream kinases including MAPK, AKT and STAT5. In addition we show that BTK RNAi inhibits proliferation of FLT3-ITD AML cells. Finally we report that ibrutinib reverses the cyto-protective role of BMSC on FLT3-ITD AML survival. These results argue for the evaluation of ibrutinib in patients with FLT3-ITD mutated AML. [ABSTRACT FROM AUTHOR]