Opra mani 7

ADVANCED (UGLY) risk category rectal cancer (cT3 with any MRF involved, any cT4a/b, lateral node +). a. Upfront surgery b. Short course radiotherapy (SCRT) followed by surgery c. Long-course chemoradiotherapy (LCCRT) followed by surgery d. Total Neoadjuvant Therapy (TNT) If choosing a TNT approach, which protocol would you prefer in this case? a. PRODIGE 23 (FOLFIRINOX – LCCRT – Surgery – FOLFOX) b. RAPIDO or STELLAR (SCRT – FOLFOX or CAPOX – Surgery) c. Induction OPRA or CAO/ARO/AIO-12 (FOLFOX – LCCRT – Surgery) d. Consolidation OPRA or CAO/ARO/AIO-12 (LCCRT – FOLFOX – Surgery) ResultsOne hundred and seventy delegates attended the AICCC including 17 colorectal surgeons (CRS), 7 radiation oncologists (RO) and 21 medical oncologists (MO). Forty-five participants answered at least one question in the survey. Thirteen were excluded from subsequent analysis as they did not specify their specialty. The response rate was therefore 71%. Data was 95% complete for this group.Early riskSeventy-seven percent (24/31) of all specialists preferred an upfront surgery approach whilst neoadjuvant LCCRT and SCRT were preferred by 10% each (Fig. 3A). CRS and RO almost unanimously chose upfront surgery whereas MO were split between upfront surgery (50%) and a form of neoadjuvant radiation (40%) (p = 0.41) (Fig. 3B). Just one participant selected TNT for early-risk rectal cancer.Fig. 3Preferred treatment approaches to ESMO rectal cancer risk categories, A all participants, B–E by specialistFull size imageIntermediate riskThe greatest heterogeneity of responses was observed in this category. Just over half of respondents (16/30) indicated a preference for TNT whilst a third chose LCCRT as the preferred neoadjuvant strategy. Seven percent of specialists opted for SCRT with another 7% preferring upfront surgery. TNT was selected most prominently by MO (71%) whilst LCCRT was most popular amongst RO (57%) and CRS (44%) (p = 0.30) (Fig. 3C).If utilizing a TNT approach, 55% (17/31) selected a consolidation-type (OPRA or CAO/ARO/AIO-12) regimen, 23% a RAPIDO or STELLAR regimen, 16% PRODIGE-23 and 6% an induction-type (OPRA or CAO/ARO/AIO-12) regimen (Fig. 4A). The majority of CRS and RO preferred a consolidation regimen whilst MO were divided between consolidation (40%) and a RAPIDO or STELLAR regimen

Approach for a patient with a stage II-III ESMO EARLY (GOOD) risk category rectal cancer (cT3a/b in mid- or high rectum, N0 (or also cN1 if high), MRF clear, no EMVI). a. Upfront surgery b. Short course radiotherapy (SCRT) followed by surgery c. Long-course chemoradiotherapy (LCCRT) followed by surgery d. Total Neoadjuvant Therapy (TNT) If choosing a TNT approach, which protocol would you prefer in this case? a. PRODIGE 23 (FOLFIRINOX – LCCRT – Surgery – FOLFOX) b. RAPIDO or STELLAR (SCRT – FOLFOX or CAPOX – Surgery) c. Induction OPRA or CAO/ARO/AIO-12 (FOLFOX – LCCRT – Surgery) d. Consolidation OPRA or CAO/ARO/AIO-12 (LCCRT – FOLFOX – Surgery) Case 2 – Indicate your preferred approach for a patient with an ESMO INTERMEDIATE risk category rectal cancer (cT3a/b if low rectum, levators clear, MRF clear OR cT3a/b in mid- or high rectum, cN1-2 (not extra-nodal), no EMVI). a. Upfront surgery b. Short course radiotherapy (SCRT) followed by surgery c. Long-course chemoradiotherapy (LCCRT) followed by surgery d. Total Neoadjuvant Therapy (TNT) If choosing a TNT approach, which protocol would you prefer in this case? a. PRODIGE 23 (FOLFIRINOX – LCCRT – Surgery – FOLFOX) b. RAPIDO or STELLAR (SCRT – FOLFOX or CAPOX – Surgery) c. Induction OPRA or CAO/ARO/AIO-12 (FOLFOX – LCCRT – Surgery) d. Consolidation OPRA or CAO/ARO/AIO-12 (LCCRT – FOLFOX – Surgery) Case 3 – Indicate your preferred approach for a patient with an ESMO BAD risk category rectal cancer (cT3c/d or very low localisation, levators threatened, MRF clear OR cT3c/d mid-rectum, cN1–N2 (extra-nodal), EMVI + OR limited cT4aN0). a. Upfront surgery b. Short course radiotherapy (SCRT) followed by surgery c. Long-course chemoradiotherapy (LCCRT) followed by surgery d. Total Neoadjuvant Therapy (TNT) If choosing a TNT approach, which protocol would you prefer in this case? a. PRODIGE 23 (FOLFIRINOX – LCCRT – Surgery – FOLFOX) b. RAPIDO or STELLAR (SCRT – FOLFOX or CAPOX – Surgery) c. Induction OPRA or CAO/ARO/AIO-12 (FOLFOX – LCCRT – Surgery) d. Consolidation OPRA or CAO/ARO/AIO-12 (LCCRT – FOLFOX – Surgery) Case 4 – Indicate your preferred approach for a patient with an ESMO

This survey. The consolidation arms of these trials demonstrated significantly higher rates of pCR (AIO-12) or cCR (OPRA) when compared to induction chemotherapy. In addition, 53% of patients in the consolidation arm of the OPRA trial avoided surgery at 3-year follow-up making this regimen attractive for those aiming for non-operative management (NOM), an approach that can improve quality of life by reducing low anterior resection syndrome (LARS). However, it must be noted that neither of these phase 2 trials significantly improved DFS or OS, and most centres do not recommend NOM unless as part of a clinical trial. Notably, at the American Society of Clinical Oncology (ASCO) 2023 conference, the 5-year OPRA update showed persistent differences in organ preservation using the consolidation approach (54% vs 39% with induction TNT) and lower rates of local regrowth (29% vs 44% with induction TNT). Furthermore, there was no oncologic detriment in either arm when integrating a watch-and-wait approach with salvage surgery for regrowth [18].More than 60% of colorectal surgeons in this survey preferred a consolidation TNT approach, despite historical concerns about the potential risk of pelvic fibrosis as the time interval between radiation and surgery is extended. The French GRECCAR-6 trial showed greater surgical complications and morbidity when waiting for 11 weeks, as opposed to 7, after neoadjuvant chemoradiotherapy, which may partly explain the preference for the induction PRODIGE regimen in France. However, several trials have not demonstrated increased surgical difficulty or compromised R0 resection rates with a consolidation TNT approach [19,20,21].Specialists in this survey demonstrated a low preference for the PRODIGE regimen, especially for advanced-risk disease for which it was chosen by less than 10%, surprising considering the robust data supporting this approach. PRODIGE-23, a phase 3, randomized controlled trial of induction FOLFIRINOX chemotherapy followed by LCCRT, demonstrated superior pCR rates (28% vs 12%, p p = 0·034) and metastasis-free survival (hazard ratio 0·64, p = 0·017) compared to LCCRT alone. Furthermore, since conducting our survey, additional follow-up data presented at ASCO 2023 demonstrated a significant increase in 5-year overall survival (6.9%), the only TNT trial to do so [22].In the setting

The latest appliance is purpose-built to reliably handle rising market data volumes and volatility, including the upcoming OPRA feed upgradeSt. Louis, MO— August 23rd, 2023 – Exegy, a leading provider of end-to-end, front-office trading solutions for capital markets, is announcing its next generation ticker plant, purpose-built for processing options market data. This cutting-edge platform can process the OPRA feed on a single 2U server and provides an immediate 2x latency reduction compared to the previous generation.This 6th generation ticker plant is the foundation for future latency improvements and feature updates, continuing its 15+ year history as the ideal, managed market data solution for the industry’s top brokers, trading venues, and global hedge funds.With ever-increasing options trading volumes and the new OPRA feed going live on October 9th, the ability to reliably process growing quantities of market data with consistent, low latency is critically important for the trading community. Exegy’s unique, FPGA-based, managed appliance has scalability that cannot be matched by fully software-based solutions.David Taylor, CEO of Exegy, says: “The sustained volatility in capital markets continues to drive market data volumes to new historic peaks, especially in the US equity options markets. The OPRA consolidated tape doubling its data streams and new options markets coming online imminently further increases the pressure on existing market data infrastructures.”By the end of 2022, US stock options surpassed 10 billion contracts, with single-stock and index options volumes more than doubling since 2019. Now, OPRA’s guidance states that participants should prepare for capacity of 120+ million messages per second following the expansion.Arnaud Derasse, CPO at Exegy, adds: “Trading institutions need to boost capacity regularly with scalable and resilient infrastructure to keep pace with data volumes. This is particularly true for US options trading today. Exegy’s latest generation ticker plant offers the most compact and efficient solution,

Open Public Records Act (OPRA)To obtain the OPRA Form, CLICK HEREState of New Jersey, Government Records CouncilCommon LawA public record under common law is one required to be kept, or necessary to be kept in discharge of a duty imposed by law, or directed by law to serve as a memorial and evidence of something written, said, or done, or a writing filed in a public office. The elements essential to constitute a public record are that it be a written memorial, that it be made by a public officer, and that the officer be authorized by law to make it.If the information requested is a "public record" under common law and the requester has a legally recognized interest in the subject matter contained in the material, then the material must be disclosed if the individual's right of access outweighs the State's interest in preventing disclosure.Note that any challenge to a denial of a request for records under common law cannot be made to the Government Records Council, as the Government Records Council only has jurisdiction to adjudicate challenges to denials of OPRA requests. A challenge to the denial of access under common law can be made by filing an action in Superior Court.What is the Open Public Records Act (OPRA)? What to do if your request has been denied?If you wish to have copies of any of these records the fees are:· $0.05 per page for letter sized pages and smaller· $0.07 per page for legal sized pages and larger· For delivery, all fees will be based upon the type of delivery requested and the fee will be added to page costs.· Extraordinary service fees are dependent upon the request (i.e. computer disc, CD-ROM, DVD).· Payment may be in the form of cash, check or money order.

With its stark landscape and rocky backbone, the Mani peninsula in the southern Peloponnese region of Greece has a personality of its own. The Taygetos mountains drop steeply down to coves of crystal clear water. On the high ground, stone tower houses keep a watchful eye for invaders from the sea. Read about our delightful road trip around the Mani, starting in Kalamata, looping south around Cape Tenaro and returning via the sea port of Gythio in the east.Life in the Mani PeninsulaWhere is the Mani Peninsula?Map of Mani Peninsula GreeceThings to do in the Mani PeninsulaThe Outer Mani / Exo Mani / Messinian ManiKardamyliStoupaAgios NikolaosOitylo and Neo ItiloLimeniThe Deep Mani / Mesa ManiAreopoliDiros cavesGerolimenasVathiaCape TenaroPorto KagioThe Inner Mani / Kato ManiGythioMore places to visit near the Mani peninsulaMonemvasiaMystrasFood in the Mani PeninsulaWhere to stay in the Mani Peninsula GreeceBest time to visit the Mani PeninsulaHow to get to the Mani PeninsulaGetting around the Mani PeninsulaSustainable travel in the Mani PeninsulaMap of Mani Peninsula showing places to visitRead NextMore articles to read about GreecePlan your trip to the Peloponnese in GreecePin itNever miss an update! – Subscribe to receive our latest articles and newsletterLife in the Mani PeninsulaIn past centuries, life in the Mani Peninsula of Greece, governed by strong family clans, who were known for their blood feuds that sometimes lasted generations. But the independent spirit of the Maniots was also shown in their determination to resist Ottoman occupation. Unusually, they negotiated their own self-government through local Beys or rulers. There’s local pride that the flag of revolt in the Greek War of Independence of 1821 was first raised in the Mani, and taken to Kalamata where the Ottoman garrison was overthrown. This article may contain affiliate links that provide commission on purchases you make at no extra cost to you. As an Amazon Associate I earn from qualifying purchases.Kardamyli Mani Peloponnese GreeceWhere is the Mani Peninsula?The most southerly part of mainland Greece, the Peloponnese stretches three fingers southwards towards Crete and the coast of North Africa beyond. Of these three peninsulas, the Mani is the middle one, split between the administrative regions of Messinia to the east and Laconia to the west. This is as far south in Greece as you can go without hitting the coast of Africa. A spine of the Taygetos mountains runs down its centre, giving the Mani a wild and rugged landscape, with fortified tower houses clustered in hilltop villages. Until the 1970s many parts of the Mani were only accessible by boat or stone kaldarimi paths that connected villages. But these days the gateway town of Kalamata receives international flights and there’s a fast road from Athens that makes the Mani much