Toxicity and Efficacy of Stereotactic Ablative Body Radiotherapy for Moderately Central Non-small Cell Lung Cancers Using 50 Gy in Five Fractions.

AIMS: Stereotactic ablative body radiotherapy doses for peripheral lung lesions caused high toxicity when used for central non-small cell lung cancer (NSCLC). To determine a safe stereotactic ablative body radiotherapy dose for central tumours, the phase I/II Radiation Therapy Oncology Group RTOG 0813 trial used 50 Gy/five fractions as a baseline. From 2013, 50 Gy/five fractions was adopted at the Beatson West of Scotland Cancer Centre for inoperable early stage central NSCLC. We report our prospectively collected toxicity and efficacy data. MATERIALS AND METHODS: Patient and treatment characteristics were obtained from electronic medical records. Tumours were classed as moderately central or ultra-central tumours using published definitions. Toxicity was assessed in a centralised follow-up clinic at 2 weeks, 6 weeks, 3 months, 6 months, 1 year and 2 years after treatment. RESULTS: Fifty patients (31 women, 19 men, median age 75.1 years) were identified with T1-2N0M0 moderately central NSCLC; one patient had both an ultra-central and a moderately central tumour. Eighty-four per cent were medically unfit for surgery. Forty per cent had biopsy-proven NSCLC and 60% were diagnosed radiologically using 18-fluorodeoxyglucose positron emission tomography/computed tomography imaging. Fifty-six per cent of patients were Eastern Cooperative Oncology Group (ECOG) performance status 2 or worse. All patients received 50 Gy/five fractions on alternate days on schedule. Two patients died within 90 days of treatment, one from a chest infection, the other cause of death was unknown. There was one episode of early grade 3 oesophagitis and one grade 3 late dyspnoea. There was no grade 4 toxicity. Over a median follow-up of 25.2 months (range 1-70 months), there were 34 deaths: 18 unrelated to cancer and 16 due to cancer recurrence. The median overall survival was 27.0 months (95% confidence interval 20.6-35.9) and cancer-specific survival was 39.8 months (95% confidence interval 28.6, not reached). CONCLUSION: This study has shown that 50 Gy/five fractions is a safe dose and fractionation for early stage inoperable moderately central NSCLC, with outcomes comparable with other series, even with patients with a poor performance status.

An integrated assessment model of carbon sequestration benefits: a case study of Liping county, China.

This research attempts to model the complexity of planting trees to increase China's CO(2) sequestration potential by using a GIS-based integrated assessment (IA) approach. We use the IA model to assess the impact of China's Grain for Green reforestation and afforestation program on farmer and state incomes as well as CO(2) sequestration in Liping County, Guizhou Province. The IA model consists of five sub-models for carbon sequestration, crop income, timber income, Grain for Green, and carbon credits. It also includes a complementary qualitative module for assessing program impacts by gender and ethnicity. Using four scenarios with various assumptions about types of trees planted, crop incomes by township, CO(2) credit prices, state subsidies, methods for estimating carbon sequestered, and harvesting of trees, we find great variation in the impact of the Grain for Green program on incomes and on carbon sequestered over a 48 year period at both the county and township levels.

Enhancing forest carbon sequestration in China: toward an integration of scientific and socio-economic perspectives.

This article serves as an introduction to this special issue, "China's Forest Carbon Sequestration", representing major results of a project sponsored by the Canadian International Development Agency and the Chinese Academy of Sciences. China occupies a pivotal position globally as a principle emitter of carbon dioxide, as host to some of the world's largest reforestation efforts, and as a key player in international negotiations aimed at reducing global greenhouse gas emission. The goals of this project are to develop remote sensing approaches for quantifying forest carbon balance in China in a transparent manner, and information and tools to support land-use decisions for enhanced carbon sequestration (CS) that are science based and economically and socially viable. The project consists of three components: (i) remote sensing and carbon modeling, (ii) forest and soil assessment, and (iii) integrated assessment of the socio-economic implications of CS via forest management. Articles included in this special issue are highlights of the results of each of these components.

Evaluation of the economic and environmental impact of converting cropland to forest: a case study in Dunhua county, China.

The Sloping Land Conversion Program (also known as "Grain for Green" or the Upland Conversion Program) for converting cropland to forest is one of China's most ambitious environmental initiatives, and is one of the world's largest land-conservation programs with a budget of RMB 337 billion (over US$ 40 billion). Although environmental impacts have played a vital role in the general reasoning and argumentation for forest plantations, environmental impact analyses have often received less attention than economic analyses in the planning of plantation forestry projects. The overall goal of this paper is to evaluate the program's environmental impact considering the farmer's interests and the potential social benefits due to carbon sequestration in different scenarios based on household and field survey data in Dunhua County. Our findings are that: (1) in many cases, the program did not give adequate consideration to land productivity and environmental heterogeneity when selecting plots; (2) more than half of the reforestation plots were on flat cropland (slopes of less than 5 degrees ); (3) in five of the eight townships, net incomes on reforested land were substantially above or below previous crop incomes, raising questions about the efficiency of the allocation of compensation to farmers participating in the program; (4) the potential carbon co-benefit increased the NPV of the program by 5954-7009 RMB/ha. In conclusion, we recommend that more attention should be paid to the quality of reforestation programs rather than just their scale and note that consideration of potential carbon sequestration co-benefits enhances the benefits of cropland conversion programs.

A quantitative review of the guilty knowledge test.

The guilty knowledge polygraph test (GKT; D. T. Lykken, 1959, 1960) is a psychophysiological method of identifying suspects with concealed information about a crime. A meta-analysis of 50 treatment groups drawn from 22 laboratory simulation studies (total N = 1,247) was conducted to provide a comprehensive estimate of GKT accuracy under controlled conditions. Electrodermal measures correctly identified 76% of participants with concealed knowledge and 83% of those without information. Informed participants were detected at rates significantly in excess of chance, with a mean weighted effect size of .57. Enactment of mock crimes increased the hit rate to 82%. The rates of false-positive error among noninformed treatment groups did not significantly exceed chance. Applications and research directions are discussed.

Neuropsychiatric profile of a case of post traumatic stress disorder following an electric shock.

Exposure to extraordinary stressors or life-threatening events has been shown to result in negative cognitive, behavioural and emotional outcomes including the cluster of symptoms constituting Post Traumatic Stress Disorder (PTSD). This disorder has most often been studied in military veterans and victims of abuse who also show high rates of comorbid conditions. We report a case of PTSD following an electrical injury in a patient with no past psychiatric history. Implications for a full range of examinations including comprehensive neuropsychiatric testing are discussed. Results suggest that such approach addresses the complexity of a differential diagnosis between organic and psychiatric dysfunctions.

The Control Question Test in polygraphic examinations with actual controls for truth.

Subjects who were guilty of a mock crime, innocent and informed of the details of the crime or innocent, and uninformed of the details were examined on the polygraph with a modified version of a Control Question Test, which normally contains questions which are incriminating, ambiguous, and likely to be answered with a lie. We challenged the necessity of using incriminating, ambiguous control questions which may demand a lie as an answer. Instead, we created and tested control questions that were unambiguous and answered truthfully. The results, with the modified questions, showed correct identification of 86% of the guilty subjects and 83 to 89% of the innocent subjects.

An overview of municipal state of the environment reporting in Canada.

State of the Environment (SOE) reporting is an emerging municipal management tool designed to monitor and increase awareness of the current status, changes and trends in the condition of the local environment. A multifaceted investigation was undertaken to examine municipal SOE reporting in Canada and to identify barriers to its widespread implementation. Highlights of the case study and survey components are summarized and a conceptual model for municipal SOE reporting is proposed. Overall, the study revealed considerable interest in environmental reporting, however, the lack of common municipal indicators, organizing frameworks and environmental data accessible at the local level impedes its widespread implementation. Future needs to enhance SOE reporting include: development of common municipal indicators, including environmental sustainability indicators; enhancement of the compatibility of SOE reporting frameworks across municipal, provincial and national levels; and re-examination of the data collected by diverse levels of government to optimize their utilization at the local level.