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Background: In this randomized phase II study, we evaluated the efficacy and safety of sorafenib in combination with capecitabine and cisplatin (XP) as first‐line chemotherapy in advanced gastric cancer. Patients and Methods: Patients with metastatic gastric or gastroesophageal junction adenocarcinoma were randomized (1:1) to receive either sorafenib plus XP (S + XP) or XP alone. In cases of disease progression in the XP arm, crossover to sorafenib alone was allowed. The primary endpoint was progression‐free survival (PFS). The secondary endpoints included overall survival (OS), response rates, safety profiles, and biomarkers, and the response rates and PFS with secondline sorafenib alone after progression in the XP arm. Results: Between Jan 2011 and Feb 2013, a total of 195 patients were accrued (97 in the S + XP arm and 98 in the XP alone arm). The overall response rate was 54% with S + XP, and 52% with XP alone (p = 0.83). With a median follow‐up of 12.6 months (range, 0.1–29.2), the median PFS assessed by independent review was 5.6 months in the S + XP arm and 5.3 months in the XP arm (hazard ratio [HR] 0.92, 95% confidence interval [CI] 0.67–1.27, p = 0.61). Overall survival was not different between the two arms (median 11.7 vs. 10.8 months; HR 0.93, 95% CI 0.65–1.31, p = 0.66). Frequencies of grade 3/4 toxicities were similar between the S + XP and XP alone arms, except for neutropenia (21% vs. 37%), anorexia (0% vs. 5%), and hand‐foot skin reaction (7% vs. 1%). Among 51 patients who crossed over to sorafenib alone after disease progression in the XP arm, there was no objective response and their median PFS was 1.3 months (95% CI, 1.2–1.7). Conclusion: The addition of sorafenib to XP chemotherapy was safe but not more effective than XP alone for first‐line treatment of metastatic gastric cancer. [ABSTRACT FROM AUTHOR]

With the growing worldwide prevalence of private tutoring, the causes and effects of private tutoring have been drawing increasing attention both academically and policy wise. This study intends to draw policy implications by investigating the determinants of private tutoring participation of school-aged children and expenditures per child for such private tutoring. The logistic regression (for participation), OLS, and F.E. panel models (for expenditures) were adopted for the analysis, using the Korean panel data. The empirical findings indicate that private tutoring for children--both in terms of participation and expenditures--has a positive correlation with the mother's educational attainment (preference effect), a negative correlation with the mother's employment status (time constraint effect), and a positive correlation with the household income (income effect). (Contains 4 tables, 2 figures, and 2 footnotes.)

A common justification for state-sponsored merit scholarships like Georgia's HOPE program is to promote academic achievement. However, grade-based retention rules encourage other behavioral responses. Using longitudinal records of enrolled undergraduates at the University of Georgia between 1989 and 1997, we estimate the effects of HOPE on course-taking, treating nonresidents as a control group. First, we find that HOPE decreased full load enrollments and increased course withdrawals among resident freshmen. Second, the scholarship's influence on course-taking behavior is concentrated on students whose predicted freshmen GPAs place them on or below the scholarship-retention margin. Third, HOPE substantially increased summer school credits.

Objectives: Rehmannia glutinosa pharmacopuncture solution (RGPS) was investigated to determine both its anti-allergic inflammatory effects on mast cells and its detailed mechanism of actions. Methods: We investigated whether RGPS suppress cytokines, enzymes, FcεRI expression and FcεRI mediated signaling in RBL-2H3 cells stimulated with anti-DNP IgE/DNP-HSA. The suppressive effects of RGPS on the levels of cytokines such as IL-1β, IL-6 and GM-CSF were measured using emzyme-linked immunospecific assay (ELISA). The mRNA expression levels of cytokines, enzymes (HDC2, COX-1, COX-2 and 5LO) and FcεRI αβγ subunits were measured using reverse transcription polymerase chain reaction (RTPCR) method. The activation of FcεRI-mediated signaling was examined using Western blot analyses. Results: RGPS suppressed production of proinflammatory cytokines (IL-1β, IL-6, and GM-CSF) in stimulated RBL-2H3 cells significantly (P < 0.05). RGPS also suppressed mRNA expression of inflammatory enzymes (HDC2, COX-1, COX-2, 5LO). In addition, mRNA expression levels of FcεRIα, FcεRIβ and FcεRIγ were lowered by treatment with RGPS. Finally, RGPS prevented phosphrylation of Lyn, Syk, LAT, Gab2, PLC γ1/2, PI3K, Akt, cPLA2 and IκBα. Conclusions: RGPS effectively suppresses mast cell activations such as degranulation and inflammatory response via down-regulation of the FcεRI-mediated signaling pathways in IgE/Ag-stimulated mast cells.