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Aim: To report on the management strategies in patients with cancer of unknown primary (CUP) in middle-income countries. Methods: We conceived a survey of 20 items concerning the management of patients with CUP in daily clinical practice. Only participants from lower- and higher-middle-income countries, as per the World Bank Classification, were eligible for this study. Results: The indications for the first-line treatment did not differ between the two economic regions, whereas those for second-line treatment were more prevalent in higher-middle-income countries. The use of targeted therapy based on immunohistochemistry alone was higher in lower-middle-income countries, although the access to CUP classifiers was similar between the two regions. Conclusions: Proper recommendations must ensure that the economic burden is minimized and that other benefits outweigh the limited survival benefit achieved in patients with CUP.

Depression ist eine weit verbreitete psychische Erkrankung, die mit erheblichen persönlichen und gesellschaftlichen Kosten verbunden ist. Antidepressiva und Psychotherapien stellen die dominierenden Behandlungsformen dar. Tradition hat in diesem Kontext die Psychodynamische Kurzzeittherapie (short-term psychodynamic psychotherapy, STPP), für die in Metastuien z. T. große Behandlungseffekte gefunden wurden.

The desire to gain knowledge about the quality and timing of construction projects delivered to clients has become an increased focus point in the field of construction management. Clients have expectations that are often based on their assumptions about the validity of making the learning curve theory applicable to construction projects. This research aims to determine what criteria need to be met for the learning curve theory to have some validity for construction projects. The results from the questionnaire survey, completed by professionals from the construction industry, show that several concepts were found to be of importance: project specifications, design, scope, budget, site management, planning, monitoring and controlling, and quality. If these concepts correspond between two projects, the chance of successfully applying the learning curve theory increases. Practical recommendations are made that highlight the concepts identified as critical for the successful application of the learning curve theory to construction projects, and that can be used by clients and contractors as a basis for negotiating project schedules.

Fast pyrolysis of Eucalyptus grandis was carried out using different reactor configurations and scale setups, a 0.1 kg/h bubbling fluidised bed (BFB) reactor, a 1 kg/h BFB reactor and a 10 kg/h twin-screw reactor. The influence of lignocellulosic composition, process configuration (reactor configuration, separation and condensation system) and their feed capacity on yields and quality of pyrolysis products was discussed. The increasing reactor scale study had constraints such as the availability of biomass feedstock with inherent changes in the chemical composition and the practicality of the condensation chain. Although the methods employed for phase separation and liquid collection differ from plant to plant limiting the repeatability of results, it was clearly identified that the implementation of efficient solid separation and use of mineral oil as the coolant system were crucial aspects of the mass production of organics. These results suggest that yields and quality of fast pyrolysis at a larger scale are all process-related rather than feedstock conditioned. A comparison of energy balances indicated that fast pyrolysis retained the same energy yield at scales of 1 and 10 kg/h.

International audience; The paper describes the fast pyrolysis conversion of lignocellulosic materials inside a bubbling fluidizedbed. The impact of biopolymers distribution in the biomass feed, namely hemicelluloses, cellulose, andlignin, on the yields and properties of pyrolytic bio-oils and chars was investigated.Although it is not possible to deconvoluate chemical phenomena from transfer phenomena using bubblingfluidized bed reactors, the key role of hemicelluloses in biomass feedstocks was illustrated by (i) itsinfluence on the production of pyrolytic water, (ii) its impact on the production of organics, apparentlydue to its bonding relationship with the lignin and (iii) its ability to inhibit the development of charsporosity, while the cellulose appeared to be the precursor for the microporous character of the biochars.These results are of interest in the selection of suitable feedstocks aimed at producing bio-oil and char asfuels and soil amendment, respectively.

The azepines 5a-5c were obtained by photochemical nitrene rearrangement of the azides 1e/1f and 4b/4c in cyclohexene, but not in other solvents. They are ring expansion products of podophyllotoxin (1a) and resemble steganacin (9), but show only low biological activity. The triazenes 7a/8a and the aziridine 8b are also less active than 1a.

Lean product design has the potential to reduce the overall product development time and cost and can improve the quality of a product. However, it has been found that no or little work has been carried out to provide an integrated framework of ‘lean design’ and to quantitatively evaluate the effectiveness of lean practices/principles in product development process. This research proposed an integrated framework for lean design process and developed a dynamic decision making tool based on Methods Time Measurement (MTM) approach for assessing the impact of lean design on the assembly process. The proposed integrated lean framework demonstrates the lean processes to be followed in the product design and assembly process in order to achieve overall leanness. The decision tool consists of a central database, the lean design guidelines, and MTM analysis. Microsoft Access and C# are utilized to develop the user interface to use the MTM analysis as decision making tool. MTM based dynamic tool is capable of estimating the assembly time, costs of parts and labour of various alternatives of a design and hence is able to achieve optimum design. A case study is conducted to test and validate the functionality of the MTM Analysis as well as to verify the lean guidelines proposed for product development.

El análisis integrado de la topografía y las anomalías gravimétricas en la Península Ibérica invoca a la presencia de grandes pliegues que afectan a toda la litosfera como precursores de los relieves E-O a NE-SO que se distribuyen por el Macizo Varisco, así como a un mecanismo de engrosamiento cortical nucleado a partir de fallas Tardi-Variscas, como origen del relieve del este peninsular (Cadena Ibérica-Costero Catalana), con patrones dominantes E-O, NE-SO y NO-SE. El modo de deformación, así como el estilo, dependen tanto de las propiedades reológicas iniciales de una litosfera a otra (litosfera resistente Varisca hacia el oeste peninsular/litosfera débil y caliente resultado de la extensión Mesozoica hacia el este) como a los accidentes tectónicos pre-existentes. Presentamos una nueva metodología aplicada a la modelación análoga, basada en el estudio del espectro de las anomalías gravimétricas y la topografía que nos han permitido inferir los procesos responsables de la asimetría en el patrón del relieve intra-placa de la Península Ibérica. A su vez, nuestros resultados arrojan luz sobre los mecanismos generadores del relieve en zonas de intra-placa donde la escasez o falta de resolución de los perfiles sísmicos y geomagnéticos impide la interpretación de la parte más profunda de la litosfera como Asia Central o los Atlas del norte de África.

Instead of abolishing internal border controls in 1993, the European Union (EU) replaced them with VAT and statistical requirements that appear to be just as onerous. For Dutch businesses, the compliance costs of the new requirements are, on average, 5 per cent of the value of their intra-EU trade. This figure is probably higher for other EU Member States. Obviously, the costs constitute a (differentiated) border tax that impedes intra-EU trade. The paper analyses the determinants of the compliance costs, as well as their effect on intra-EU trade intensity. The paper submits that the differential compliance costs violate the non-discrimination provisions of the EC Treaty. Suggestions are made to reduce them.

For the larval hemoglobin III of the insect Chironomus thummi thummi, the rotational strength of the B (Soret) and Q band is calculated with a monopole/monopole and a dipole/dipole approximation applied to the atomic coordinates of the X-ray structures at 2.5 and 1.4 Å resolution. In previous calculations using the 2.5 Å coordinates and with perturbing groups being restricted to aromatic side-chains, the dipole/dipole approximation clearly confirmed the negative sign ob­served by experiment. The predominant interactions were those of phenylalanine residues. Recalculation with X-ray data refined to the present limits of performance corroborates the negativity of the rotational strength, but now the most important contributions are due to the peptide bonds formerly neglected. Also for the 2.5 Å coordinates it is learned that in contrast to earlier expectation the influence of the backbone in this hemoglobin is rather strong. A substantial contribution is further obtained for the perturbation by one of the propionic acid carboxylate groups of the heme. Perspectives and problems of the approach are outlined.

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