4. |
- Sparovek, Gerd, 1962, et al.
(author)
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Sustainable bioproducts in Brazil: disputes and agreements on a common ground agenda for agriculture and nature protection
- 2016
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In: Biofuels, Bioproducts and Biorefining. - : Wiley. - 1932-1031 .- 1932-104X. ; 10:3, s. 204-221
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Journal article (peer-reviewed)abstract
- A key question for food, biofuels, and bioproducts production is how agriculture affects the environment, and social and economic development. In Brazil, a large agricultural producer and among the biologically wealthiest of nations, this question is challenging and opinions often clash. The Brazilian parliament and several stakeholders have recently debated the revision of the Forest Act, the most important legal framework for conservation of natural vegetation on Brazilian private agricultural lands. Past decades have shown improvements in the agricultural sector with respect to productivity and efficiency, along with great reductions in deforestation and growth of environmentally certified production. However, the opposing sides in the debate have ignored this progress and instead continue to entrench their respective combative positions. A structured exchange involving nine experts associated with major producer interests (livestock, crops, planted forest, and charcoal) and environmental NGOs was moderated based on a framework that sorted viewpoints into four categories: (i) common ground - compatible interests considered to be high priority for Brazilian sustainable agricultural development; (ii) serving exclusive nature conservation interest; (iii) serving exclusive agricultural production interest; and (iv) mainly serving the purpose of sustaining dispute. We conclude that the majority of actions and expected future trends reflect achievements and ambitions to balance production and conservation, but much public opinion - and in turn decisions in the parliament and government for agriculture and conservation - is shaped by a perceived conflict between these objectives and a debate that has become, at least to some extent, an end in itself.
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5. |
- Hoffman, Lindsey M., et al.
(author)
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Clinical, Radiologic, Pathologic, and Molecular Characteristics of Long-Term Survivors of Diffuse Intrinsic Pontine Glioma (DIPG) : A Collaborative Report From the International and European Society for Pediatric Oncology DIPG Registries
- 2018
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In: Journal of Clinical Oncology. - : AMER SOC CLINICAL ONCOLOGY. - 0732-183X .- 1527-7755. ; 36:19, s. 1963-1972
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Journal article (peer-reviewed)abstract
- PurposeDiffuse intrinsic pontine glioma (DIPG) is a brainstem malignancy with a median survival of < 1 year. The International and European Society for Pediatric Oncology DIPG Registries collaborated to compare clinical, radiologic, and histomolecular characteristics between short-term survivors (STSs) and long-term survivors (LTSs).Materials and MethodsData abstracted from registry databases included patients from North America, Australia, Germany, Austria, Switzerland, the Netherlands, Italy, France, the United Kingdom, and Croatia.ResultsAmong 1,130 pediatric and young adults with radiographically confirmed DIPG, 122 (11%) were excluded. Of the 1,008 remaining patients, 101 (10%) were LTSs (survival 2 years). Median survival time was 11 months (interquartile range, 7.5 to 16 months), and 1-, 2-, 3-, 4-, and 5-year survival rates were 42.3% (95% CI, 38.1% to 44.1%), 9.6% (95% CI, 7.8% to 11.3%), 4.3% (95% CI, 3.2% to 5.8%), 3.2% (95% CI, 2.4% to 4.6%), and 2.2% (95% CI, 1.4% to 3.4%), respectively. LTSs, compared with STSs, more commonly presented at age < 3 or > 10 years (11% v 3% and 33% v 23%, respectively; P < .001) and with longer symptom duration (P < .001). STSs, compared with LTSs, more commonly presented with cranial nerve palsy (83% v 73%, respectively; P = .008), ring enhancement (38% v 23%, respectively; P = .007), necrosis (42% v 26%, respectively; P = .009), and extrapontine extension (92% v 86%, respectively; P = .04). LTSs more commonly received systemic therapy at diagnosis (88% v 75% for STSs; P = .005). Biopsies and autopsies were performed in 299 patients (30%) and 77 patients (10%), respectively; 181 tumors (48%) were molecularly characterized. LTSs were more likely to harbor a HIST1H3B mutation (odds ratio, 1.28; 95% CI, 1.1 to 1.5; P = .002).ConclusionWe report clinical, radiologic, and molecular factors that correlate with survival in children and young adults with DIPG, which are important for risk stratification in future clinical trials.
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6. |
- Lobon-Iglesias, M. J., et al.
(author)
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Diffuse intrinsic pontine gliomas (DIPG) at recurrence : is there a window to test new therapies in some patients?
- 2018
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In: Journal of Neuro-Oncology. - : SPRINGER. - 0167-594X .- 1573-7373. ; 137:1, s. 111-118
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Journal article (peer-reviewed)abstract
- Children with diffuse intrinsic pontine glioma (DIPG) need new and more efficient treatments. They can be developed at relapse or at diagnosis, but therefore they must be combined with radiotherapy. Survival of children after recurrence and its predictors were studied to inform the possibility to design early phase clinical trials for DIPG at this stage. Among 142 DIPG patients treated between 1998 and 2014, 114 had biopsy-proven DIPG with histone H3 status available for 83. We defined as long survivors' patients who survived more than 3 months after relapse which corresponds to the minimal life expectancy requested for phase I/II trials. Factors influencing post-relapse survival were accordingly compared between short and long-term survivors after relapse. Fifty-seven percent of patients were considered long survivors and 70% of them had a Lansky Play Scale (LPS) above 50% at relapse. Patients who became steroids-independent after initial treatment for at least 2 months had better survival after relapse (3.7 versus 2.6 months, p = 0.001). LPS above 50% at relapse was correlated with better survival after relapse (3.8 versus 1.8 months, p < 0.001). Patients with H3.1 mutation survived longer after relapse (4.9 versus 2.7 months, p = 0.007). Patients who received a second radiotherapy at the time of relapse had an improved survival (7.5 versus 4 months, p = 0.001). In the two-way ANOVA analysis, steroid-independence and LPS predicted survival best and the type of histone H3 (H3.1 or H3.3) mutated did not improve prediction. Survival of many DIPG patients after relapse over 3 months would make possible to propose specific trials for this condition. Steroid-independence, H3 mutation status and LPS should be considered to predict eligibility.
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