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More Gift Certificate Options for Black Friday

We hope this finds you safe and healthy!

We've added some new gift certificate options that you might find helpful for Black Friday promotions.

You can incentivize customers to buy gift certificates by adding extra value to their certificate beyond the amount paid, and without the need to enter a discount code.

There are three types of extra value that you can choose from:

Extra Value Per Certificate

Adds a flat dollar value to each purchase.

For example, entering 50 in this box would give customers an additional $50 value on their certificate.

Extra Value Per Person

For certificates that are tied to an event type, this will add an extra value per person.

For example, entering 50 in this box would provide an extra $50 value for each ticket added to the certificate.

Please note that this is option is only compatible with event-oriented certificates, and can't be used with fixed value certificates.

Extra Value Percentage

Adds a percentage value to the certificate.

  • For a fixed value certificate, entering 20 in this box would add an extra 20% value to the fixed amount.
  • For an event-oriented certificate, entering 20 in this box would add 20% to the ticket subtotal (excluding taxes and fees).

Please note that you can only use one type of extra value on each certificate type.

E.g., Extra Value Per Certificate and Extra Value Per Person can't be used together on the same certificate type.

Happy Thanksgiving to all who are celebrating!


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Rom Coms

I’ve been sick on and off for the past two weeks and as it says in the About Me page on my website, I spend my sick days curled up on the couch watching romantic comedies (aka Rom Coms). I have spent most of my non-working hours with Sandra, Julia, Drew, Hugh and friends.

Romantic Comedies

 I pulled a portion of my Rom Com collection for the above photo – but there are many more where they came from!
I’m off to watch some more and hopefully feel better soon.

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Orchid Society Art Contest

This weekend is the 2013 Orchid Society Show – it also marks my second year of participation in the Art Contest. There are some really amazing artists (especially photographers) who participate in the contest so I don’t expect to win as I am just getting to know what the judges’ may or may not like. BUT I do love showing my work and hope that you will all venture over to the Nepean Sportsplex this weekend and check it out – if not to see the artwork, then to see the gorgeous orchids!!!

Yellow Orchids on Blue Background

This is one of my entries into the contest this year entitled “Polilla Amarilla” – bonus points to anyone who can translate this!

One thought on “Orchid Society Art Contest

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FREE Giveaway(ENDED) – One(1) Bottle of Ed Hardy GHOST SKULL Blushing Bronzer Tanning Lotion – 13.5 oz.

  • Value of this giveaway is $44.98

Ed Hardy GHOST SKULL Blushing Bronzer Tanning Lotion - 13.5 oz.

Ed Hardy GHOST SKULL Blushing Bronzer Tanning Lotion – 13.5 oz.

Exclusive blushing bronzer with luxurious silicone emulsion.

  • Skin nourishing ultra rich coconut milk moisturizes your skin
  • Energizing sensations of warmth for the darkest tan
  • CoQ10 defends your skin from natural elements while maintaining a long lasting tan
  • Fragrance: Fresh Citrus

How to Participate in this Giveaway?

Use your name and email. (link under The Facebook Login) or Click on the Facebook login image. If you are logged in to Facebook when you arrive on this page, you are ready to go!

Note that all requested information must be provided for the entry to be counted. Entries will be monitored and incomplete entries will be deleted. Winner will be contacted through e-mail and announced on this post.

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91 thoughts on “FREE Giveaway(ENDED) – One(1) Bottle of Ed Hardy GHOST SKULL Blushing Bronzer Tanning Lotion – 13.5 oz.

  1. My fave tanning lotions are Swedish Beauty and California Tan. I have never tried Ed Hardy, but have heard so much about them, so this would be so cool to win this lotion. I love blush lotions!!

  2. I love tanning! It’s very relaxing..and who doesn’t look better tan! I’ve been wanting to try ed Hardy ghost skull for a while!!

  3. i love tanforless…. yall are a great bussiness… and yall have always done me right… and have great prices, and great products … i have turned on my sun goddess friends to your website and they have ordered from yall as well… and they thanked me for turning them on to yall… keep up the good work… youll always have me as a customer… i am always game to try new products…….

  4. I’m on the lookout for a tanning lotion because my daughter’s getting married in July and I will need some color on my legs.

  5. I like tanning lotions over real suntanning because of the health benefits. I also like to have the tanned looking skin because i look healthier if i have that bronze look.

  6. I just recently went to the tanning bed for a couple of months before a trip to the bahamas. The tanning lotions that I used definitely helped make me darker and kept me from burning while on vacation.

  7. I have never used Ed Hardy tanning lotion I would love to try it the bottle desing is awesome currently I have been using Jergens Natural glow it’s got the lotion and tanner all in one.

  8. I dont know much about tanning lotions but I would like to try because I burn so easy!

    ptavernie at yahoo dot com

  9. growing up in the hawaiian islands I love to be tan, no beaches here so tanning beds are the best next thing! Love tanning products they do so much more than tan you, they are what makes you look and feel healthy!!

  10. I would love to win this lotion because I haven’t been tanning in over a year (due to being pregnant) so I realllly need to get back into it!! 🙂

    RickiReviews at gmail dot com

  11. I don’t go tanning too often, but when I do I hate not being able to buy the exact same lotion every time. I’d like to win this because it has bronzers in it!

  12. I live at the beach but can’t get tan to save my life! This could hopefully help me to fit in a bit down here 😛

  13. I’m using Phoenician right now and it has given me a great base tan, but I am looking for something with great dark bronzer to start rotating

  14. I haven’t used any tanning products in a long time, but I’m interested in something that moisturizes and has a good SPF rating.

  15. I have not tried this brand of tanning lotion, but I am looking forward to seeing the results. It’s hard for me to get a good, even tan because of my skin tone. Genetics- Ugh!

  16. I am excited to try this lotion! I have been tanning off and on for 11 years, and have used tons of different lotions. The Ed Hardy brand has been great so far…I’ve been using body shots in my lotion rotation and have gotten super dark results!

  17. I love the idea behind blush lotions. It’s great to get the results of a tingle without the itchiness!

  18. I haven’t been tanning in awhile since it is winter, but with Summer right around the corner I am fixing to start going back. I usually try the sample packs of tanning lotions you can get at the salons because I like to try out all different kinds

  19. i love your products… i just wished you had sample packets… so that i could try more… i have bought lotions that cost $25 or more that i wasnt happy with… so with packets you can try them and spend the money on the ones that you like… because lotions do everyone diffrent… but over all i like your prices and have never had any problems… my favorites are accelerators they tan me good…….

  20. My favorite tanning lotion I’ve used so far is Luminary. It is really good and I lokve the bottle.

  21. I’ve never used tanning lotion in my life – I’m a pale kid with tats, so if I won this, I’d give it to a friend who uses all kinds of products like this & would enjoy it!

  22. I haven’t really had the chance to use tanning lotion. I tend to burn bad, so I would love to try something that would keep me from burning as well as becoming tan.

  23. I have never used tanning stuff before.

    But I did put some stuff on me when I was in 10th grade. I sat outside for about 8 hours and couldn’t walk from the burns after that. oops….

    tam s.

  24. Ed Hardy Tanning LOTION would be a great asset for me. I have a condition that prevents me from being in the sun for long periods of time.

  25. It has been so long since I’ve gone tanning (booth or outside) that I don’t even know what’s out there anymore! My mom & I went when I was in High School & I use to use this stuff that smelt like bananas and strawberries but I don’t remember anything else about it.

  26. I can’t tan! I’m very pale and just burn. But this is so cool looking I want to try!

  27. I like self tanner in the winter. It’s an easy fix to a pale issue. I like Coppertone and banana boat too.

  28. I’ve never used a “tanning product”, just your typical off-the-shelf suntan lotions (like Coppertone or Banana Boat).

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How To Decorate A Room Using Monochromatic Colors

Do you want to create a serene living room space? Are you trying to make a small kitchen seem large? Do you like the clean look of modern bathrooms? There are a lot of reasons homeowners choose a monochromatic color scheme in their home, and if you answered yes to one of those questions, it might be the solution for you too. Monochromatic color schemes complement many different styles of home design. Here are a few ways decorating a room in one hue works:

It creates drama and elegance.

It creates drama and elegance.
If a dramatic look is what you want, you should stick to one shade. Monochromatic colors make a living room or bedroom sophisticated and elegant. When you are designing a room around one color, you also have the luxury of simplicity, which makes decorating the room without an interior designer a more feasible task.

It enhances a modern or contemporary room.

Monochromatic colors are often chosen for modern or contemporary rooms because they add to the clean look. Imagine complementing your shaker kitchen cabinets with flooring and walls just a few shades darker or lighter. This streamlined look is fresh and new, making it a popular element in modern rooms. With that said, monochromatic color schemes also add a soothing touch of elegance to other interior design styles, such as traditional and even country, and can add unexpected whimsy to a child’s room without being overly busy.

It creates the illusion of a larger space.

It creates the illusion of a larger space.
In the same way wearing black on black can make you appear taller, designing a room in one shade makes it appear larger. This is a great trick in kitchens and bathrooms, which can sometimes be short on square footage.

Tips to Remember When Decorating a Room Using Monochromatic Colors:

  • Monochromatic does not mean the entire room should be just one shade. Not only would that be extremely difficult to achieve but, unless done right, it won’t look very good either.
  • Monochromatic color palettes don’t have to be neutral. We instinctively think of grays or whites when we imagine a room designed around one color but any color works. Just keep in mind that undertones of individual shades should match so that they don’t clash with each other. If you fill the room with uncomplimentary shades the result will be a design fail.
  • Props are key. When you are decorating a room using monochromatic colors, your design is dependent on the props you place throughout the room. Make sure decorations (throw pillows, picture frame, vases, etc.) gel with your theme. Too many patterns or accents can make your chic style turn tacky fast.
  • Use furniture to break up colors. It’s important to maintain your monochromatic color scheme without crossing over to clownish. The easiest way to do this is to break up the room with neutral furniture. Think natural wood chairs or white kitchen cabinets that blend in without calling out for attention.

What is your favorite color to use when decorating? Leave us a comment and let us know!


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A Return to Oz in the Legitimate Theatre

The L. Frank Baum classic The Wizard of Oz was a highly complex universe of fictional and fantastic characters, though most people only remember the original musical of 1939. Wicked is perhaps the most ingenious of all these post-movie productions, as it strives to recreate the depth of the original novels (by L. Frank Baum, as well as the Gregory Maguire expansion of Oz continuity, published in 1995), while also including many allusions to the film version that everyone knows and loves. In fact, the musical Wicked adapts the novel, which parallels the movie, which is derived from the source material. Simply put, that means that Wicked is practically an official prequel/sequel to The Wizard of Oz, though it doesn’t have official studio backing.

The premise of the musical play is to ask the audience if they ever believed that there were two sides of the story to Dorothy-gate scandals of Oz. Wicked takes its name from the “Wicked Witch of the West”, or as those in the know like to call her, Elphaba. This little green woman presents a fresh new angle of the Wizard of Oz storyline, and is actually modeled after Margaret Hamilton’s character in the classic 1939 film, since Baum’s original novel explained very little about this “wicked” witch.

Wicked, the Broadway sensation is based on the book by Winnie Holzman, with music and lyrics by Steven Schwartz. The plot that unravels is a morally ambiguous tale of misunderstandings, social differences and corrupt government. Despite its heady pretentions, the musical Wicked is funny in dialogue, vivacious in song, and truly visionary, just as the original Hollywood film. This multi-award winning production has been running since 2003 and has immortalized songs such as “Defying Gravity”, “No One Mourns the Wicked”, “Popular” and “I’m Not That Girl.”

Come enjoy a true piece of American culture, and an iconic story that has captured the hearts of millions. It’s not just a movie sequel–it’s a live production with full costumes, an excellent soundtrack, and a fascinating glimpse into a fantasy world that truly comes to life in the details.

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The impact of digital transformation on people

More organisations are adapting to fast-paced delivery methods and digitising the workplace further every day. According to the IDC’s Worldwide Semiannual Digital Transformation Spending Guide, the global spending on Digital Transformation will reach more than $2.1 trillion in 2019. This would make it the fastest growing area in technology.

In digital transformation, like other areas of business, the ‘why’ an organisation is doing it is key. This article by Prof Thomas H. Davenport on why so many high-profile companies fail touches on a mismatch of strategies and implementations. The investment and strategy need to be right. Above all, the people within the team that deliver the work need to play a central role in order to become successful.

Digital Transformation without the support from the workforce is doomed to fail. This goes for strategies on implementing new processes or to simplify existing to replacing people for AI (in the future). Not participating in the digital transformation is not an option, change is inevitable – but the digital transformation is accelerating this at such speed that we simply can not keep up with the change. From guides and the vast amount of case studies we see, commonly shared practices are:

  • Standardisation of processes and tools
  • Cross-functional teams
  • T-shape skill profiled team members
  • Small teams responsible for an end-to-end service
  • Automated processes for repetitive work
  • Integrated into the business

When implemented well, and with support for and from the delivery teams real transformation can happen and teams will deliver more value than before. A collaborative research between the University of Oxford and McKinsey highlighted that IT projects are delivering 56% less value than predicted. A significant number which not only impacts a organisation financially but demotivates people within the projects itself by creating work that is not fit for purpose or that will never be used at all.

High skilled people are demanding purposeful work that contributes to a more ethical world. This trend will only become stronger with the public demands made by employees from Google, Microsoft and the like (known as GAFAM) for ethical policies on the use of big data, Artificial Intelligence and Machine Learning versus what is good for profits and will please shareholders.

The two developments of Digital Transformation and Purposeful work will strengthen each other if done well. It will create highly motivated and effective teams delivering software that will do good and benefit all people. Doing this well starts with understanding the ‘why’ which will be different for each organisation and team. Beyond the ‘why’ strategies is the alignment on practices and the tools that will support the teams through this ongoing and often slow process towards long-term improvements and delivering more value.

During the initial stages of the transitioning it can be attempting to report on the first results quickly and move along to a next transitioning or improvement. This is however contrary to a realistic trajectory, wherein teams will fall back into old habits or once the focus has shifted. Committing to digital transformation is committing to a long-term process where people need to adjust to the new practises and form new habits and offering the support and time for team to do this. New team metrics to help with this process are looking into the consistency of a team and their improvements on a daily and longer term trend.

For teams in their journey of continuous improvements tools like Umano can be a lighthouse in the middle of all changes and providing direction and support through a series of metrics and insights developed for agile software teams.

Umano is a people analytics platform that empowers agile software team to perform at their best, with insights drawn from the tools you already use. To see a demo and learn how Umano can support your team’s Digital Transformation contact or visit for more information.


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Learning And Social Networks

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Google Plus is making waves among technology savvy social networkers. Like so many other Google products, this one is in beta and is gradually opening up to more users.

One unique aspect separates Plus from other Google services. Unlike Facebook or Twitter where one accesses the ‘firehose’ of data that one subscribes to and is dependent on the Friends/Following, and where users mostly use features like groups/lists etc to sort out noise from the stream, Plus uses a different approach and lets users create ‘circles’ that allow them to separate streams. This is a more manageable approach for dealing with the humongous amount of incoming data that social networks generate.

When Google Plus started out, it was already ‘seeded’ with a large number of individuals who were already working on the concurrent development of the service. Since invitations were sent out from these accounts, the adoption of Plus propagated much faster through the web application/service development community. For now, it remains a geeky sort of place. As an early user, none of my ‘real’ social network peers were on it yet and it made me follow a large number of Google product engineering folks, developers from other companies, and technology journalists and yes, I also follow Mark Zuckerberg, who it seems is the most ‘followed’ person on Plus right now. Ironic that. The early user group was so technology driven and because of that, they were able to offer large amounts of bug reporting and constructive feedback to Google about the evolving feature set. It was great to see how Google’s engineers solicited feedback, which they got almost instantaneously and were able to act on it quickly. This interaction made it quite clear that Google was responsive to the limited user groups suggestions.

With individuals like Vic Gundotra and other senior engineering staff starting ‘hangouts’ (essentially video conference forums open to anyone who happens to be around at the time) users got a unique opportunity to interact with some superb engineering talent. I’m quite sure the engineers also benefit tremendously from such interaction with end-users, which would otherwise not have been possible. It led me to wonder about the evolving nature of such web services and applications. For perhaps the first time in the history of design, a large groups of users can influence the shape/form of a service they use. While designers always consider the user of a product/service, the scope/scale of interaction with users possible now was unheard of just a decade ago. Back then, as is now, designers depend a lot on ‘research’ to make design decisions. But I’m digressing, so without ever intending to learn from using Plus, I ended up learning several things mostly around:

  1. Insights into how Google’s engineering folk think about web service/application development.
  2. Observing the evolution of a web application’s feature set and the implications of the change for the user community.
  3. Seeing Google’s responses to opinions within the user community and how they prioritized requests was interesting to watch too.

It’s quite clear to me now how social networks could influence learning by:

  1. Providing a digital space for free expression about the work and workplace
  2. Creating a forum for interaction around the knowledge expressed
  3. Providing a sense of community and common purpose
  4. Providing the ability to observe and participate in tasks with other more experienced individuals
  5. Creating an environment where feedback is quick, almost in real-time, and could come from disparate parts of the networks, this offers users unique perspectives
  6. Providing a system that encourages and rewards discovery and contribution, and where emergence clearly marks important/linchpin users or important content
  7. Encouraging moments of serendipitous learning, or rather, providing a digital space for such learning serendipity to grow and thrive

Now if only organizations understood that such networks could be critical to learning and in turn survival.

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Bread From Heaven!

Christ is risen!

It’s a running joke in the family: “Where do you want to go eat?” “I don’t know. Where do you want to go?” What ensues now is a comedy of conversation that sees me offer several places, all of which are rejected. So, I finally say “OK, where do you want to go? What are you hungry for?” and then I hear the answer that sends us right back to the beginning of our restaurant challenge “Wherever you want to go!” UGH! I can’t wait until we can finally have this “fight” again!

While that is a familiar family discussion, in our own lives our inability to always recognize what we are truly hungry for usually means we are grasping at anything that we think might satisfy our hungers, usually with questionable results.

Look at our lesson today in John 6:27-33:

The Lord said to the Jews who came to him: “Do not labor for the food which perishes, but for the food which endures to eternal life, which the Son of man will give to you; for on him has God the Father set his seal.” Then they said to him, “What must we do, to be doing the works of God?” Jesus answered them, “This is the work of God, that you believe in him whom he has sent.” So they said to him, “Then what sign do you do, that we may see, and believe you? What work do you perform? Our fathers ate the manna in the wilderness; as it is written, ‘He gave them bread from heaven to eat.'” Jesus then said to them, “Truly, truly, I say to you, it was not Moses who gave you the bread from heaven; my Father gives you the true bread from heaven. For the bread of God is that which comes down from heaven and gives life to the world.”

Our Lord Jesus is dealing with a Jewish people who think they have this whole religion thing all figured out, and that means they think they are spiritually “eating” right. But, it turns out they have a severe deficiency in their spiritual diet that is making them blind to their real hungers. It’s one thing to have a bad diet when it comes to your physical body. That bad habit only lasts until you die. But a bad spiritual diet can have eternal consequences!

They hear the Lord and they ask the right question! They want to know what they should do to be doing the works of God. They are insightful enough to know they should be God’s companions. They are educated enough to know they were created to be God’s co-workers in the world. They know all the stories of how God desires to partner with us to make us like Himself. But, they want to hear from Jesus HOW to do that. And His answer reveals a powerful shift away from what they thought religion was all about. Jesus tells them it isn’t so much about doing as being. The works of God is for them to believe in the One God sent to them! Turns out if we ever want to accomplish WHY we were created in the first place it will be by being in relationship with the One the Father sent us so that we can become like Him!

And how do we become like Him? By finally feeding the deepest and truest hunger of our lives! Jesus goes on to tell these Jews the most familiar story they all know about how God fed the escaping Jews in the desert with heavenly bread called Manna so they could survive the desert. And Jesus tells these Jews that this story was merely preparation for all of us to learn that there was going to come a Day when the Father would send the True Bread from Heaven to feed our real human hunger – to be connected to our Creator!

Today, God has given us Heavenly Food in the Bread and Wine of the Holy Eucharist to feed us where we are deeply hungry. So, it’s time to feed that part of us first so that all the other lesser hungers of our lives won’t consume us. By being Orthodox on Purpose we eat the healthy spiritual diet that leads to life eternal! And avoid the unhealthy spiritual “food” of fear and suspicion!

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My Annual Review 2021

David Zilberman, professor, agriculture and resource economics | December 24, 2021

2021 was a better year than 2020, but there is still much room for improvement. The pandemic continued, and new strains of the virus have emerged – but we have effective vaccines. Leorah and I were vaccinated twice and received a booster shot. We continue to wear a mask and avoid large crowds – but we feel more confident leaving home. I was able to teach in person and work on campus. I realize that I prefer to mix zooming with teaching in-person- mainly working at home with two weekly visits office to campus.

I like traveling, and I was able to do it in 2021. I flew to Israel for work, a family visit, and Austin for the AAEA meeting. Both events required participants to be vaccinated- which is the right policy and makes me feel better. I respect people’s right to refuse to protect themselves, but we need to protect ourselves from the external risks the anti-vaxxers present. I attended my nephew Judah and his wife Gilly’s wedding, met the growing family, and realized that I have become by default the family elder – a dubious honor – but preferable to the alternative.  The vitality and diversity of agricultural economics were on display in Austin. It is much more than farming. It encompasses food and health, climate change, the environment, and economic development. It applies multiple approaches to understand our current reality and find policy solutions.

My wife Leorah and I visited our sons and their families this year. First, we saw our niece Angela and her family at their Oklahoma farm.  Then, we went to Arkansas, where Eyal was successfully operated on for diverticulitis. In the fall, Eyal and his family moved to Seattle, where his brother Shie lives. We visited the two brothers and their families in October.  We were privileged to spend Eyal’s birthday with him. For the first time, we trick-or-treated with four of our grandchildren. And finally, in December, we celebrated Hannukah in New York with Aytan and his family. We participated in the lighting of the world’s largest menorah, wandered through the fantastical #lightscape displays at the Brooklyn Botanical Gardens, and meandered through the amazingly decorated homes of Dyker Heights in Brooklyn. We visited with our Brooklyn Benaderets for the first time in over two years. Our granddaughters have blossomed and developed into accomplished and entertaining elementary school students, and we were able to meet our newest little grandson, Jacob David, for the first time.

In the farmMy research was affected by the pandemic. We found that social distancing measures make sense from an economic perspective. The gains in terms of lives saved, in many cases, are more significant than the economic costs. More interestingly, regions that enacted social distancing and other measures earlier suffered less economically and in terms of health. The crisis triggered innovation and change. Food systems adapted well to the pandemic, became more digitized, and introduced new ways to provide food to homes. Yet, the elderly and the poor suffered most from the pandemic, and unfortunately, cynical politicians manipulated the public, costing many lives to achieve their political aims.

Another area of my research was the bioeconomy. I was part of the Science Advisory Board of the World Food System Summit.  I found that many experts promote organic food and “ecological agriculture” and oppose using many modern technologies, particularly genetic engineering. I see the opposition to science-based solutions like GMOs and CRISPR to be counterproductive. In a recent paper, we detailed the immense loss of lives of poor people in India because of the delayed approval of Golden Rice. We all pay for rejecting scientific progress by Antivaxxers, Climate Change deniers, and Biotechnology resisters. I believe in an alternative vision of agriculture and see it as a critical component of the bioeconomy. With the new capabilities provided by modern biological knowledge, agriculture can produce much more than food. It can also mitigate climate change and provide fuels and valuable chemicals. The adoption of modern technologies can increase rice yields by 30% and triple cocoa yield, and it avails land for the production of biofuels. With modern methods, trees, soils, and algae can sequester carbon. Plant-based meats can save much of animal agriculture’s significant greenhouse gas emissions. But that can happen only with appropriate policies that enable the use of biotechnologies throughout the world and reward reduction in greenhouse gas emissions.

I continue to study the economics of supply chains, and this year we had an NBER workshop on risk management in supply chains. My basic premise is that it’s not sufficient to understand the economics of individual markets to conduct practical policy analysis. For this purpose, we need to understand how products and firms interact through supply chains and how supply chains evolve. For example, the pandemic led many restaurants to pivot from selling sit-in meals to takeout food. It also resulted in a growing food delivery sector, from the retailer to the consumer home. We are trying to study how the design of supply chains can address the challenges of climate change. How can food and equipment supply chains be more resilient and less vulnerable to tsunamis and hurricanes? What type of policies will lead to the emergence of supply chains for alternative energy like hydrogen?

One of my favorite activities is contributing to the education of leaders and practitioners, mainly from the developing world. I contributed to the establishment of two programs. One– the BEARS ELP (environmental leadership program), which for 25 years have has had three weeks of summer training for about 40 environmental leaders, mostly from developing countries. Unfortunately, concern about covid prevented us from holding the program last year. Instead, we held a virtual program with more than 40 participants over three months this year. Next year, we will have a hybrid program with two weeks of classes at Berkeley and the equivalent of one week of Zoom. Teaching will not be the same after the Covid-19 pandemic. The second program, The Master of Development Practice (MDP), is a two-year program that provides students with multidisciplinary classroom and field training to become practitioners and agents of change. The MDP graduate group is now associated with the Goldman School of Public Policy. The fit with Goldman is natural, it has a great tradition of training professional Masters’ students, and the MDP adds to Goldman an international dimension. I am confident that the MDP is on a path towards growth and further success.

I am fortunate to have a wonderful wife and family and great colleagues and friends. Being part of UC Berkeley is a treasured privilege. I am hopeful that 2022 will be a good year.   We got a vaccine and now a pill for covid, and our knowledge and capabilities improve constantly; we need to take better advantage of them and get along, which is our biggest challenge as humans.   Happy 2022.

with my son adn grandchildren in New York


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Interior moving forward with contentious desert solar projects

Patrick Donnelly-Shores, former student, College of Natural Resources | March 7, 2014

On February 19th, the Department of Interior announced that it had approved two utility-scale solar projects in the Mojave Desert: Silver State South Solar Project and Stateline Solar Farm Project. The two projects, which have already generated significant controversy, straddle the California/Nevada border in the remote Ivanpah Valley, and will combine to provide 550 MW of energy, … Continue reading »


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Melatonin therapy effective in treating primary insomnia

Insomnia is a highly prevalent condition, with up to a third of the general adult populace thought to suffer from insomnia at some time. Insomnia is generally associated with a negative impact on day-to-day functioning and has been noted to have co-morbid associations with a variety of psychiatric conditions.

Melatonin, an endogenous sleep regulating hormone, has been mooted as a potential therapy for this debilitating condition. Endogenous melatonin production is known to decrease as a person ages, therefore it has been hypothesised that treatment with this hormone may be efficacious in treating insomnia in the elderly population. However results from studies have often proved contentious, with a lack of consistency in the results seen in differing age groups exposed to melatonin therapy.

Results from a recently published randomized controlled trial in BMC Medicine have now shed new light on this controversial subject. Wade et al examined the use of prolonged release melatonin (PRM) in sufferers of primary insomnia across a wide range of ages. Their results showed that PRM is particularly effective and well tolerated in patients aged 65 years and over, with the treatment response increasing and being sustained over a 6 month period.

If you wish to learn more about this fascinating result and an array of other high impact articles visit the BMC Medicine website.

View the latest posts on the On Medicine homepage


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Columbia College Chicago Theatre Dept. Alum Makes Off-Broadway Debut in ‘Good Enemy’ Through Nov. 27

Alec Silver

Columbia College Chicago Theatre Department alum Alec Silver ’17, a graduate of the Theatre Department’s BA Program in Acting, is featured in the Audible Theatre’s Off-Broadway production Good Enemy, running through November 27 at the Minetta Lane Theatre, located at 18 Minetta Lane in New York City’s Greenwich Village neighborhood. The play, which marks Silver’s Off-Broadway acting debut, features Silver as an aspiring screenwriter who drives a Chinese immigrant from California to New York in hopes of turning his talkative passenger’s story into a movie.

Mikhail Fiksel

The production’s sound designer is Columbia College Theatre Department faculty member Mikhail Fiksel. For tickets, click here.


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Analysis of Microplastics - Sampling, preparation and detection methods

This status report was prepared within the framework of the cross-cutting topic 1 "Analytics and reference materials" of the research focus. It summarizes the contents of the project discussions and coordination within the cross-cutting issue. The organization of this ongoing process of development or elaboration has been supported by several events.

Cross-Cutting Topic 1: Analytics and Reference Materials: Comparative test

This comparative test from cross-cutting topic 1 "Analytics and reference materials" classifies different analytical methods for the identification and quantification of microplastics regarding their informative value and to work out the strengths and limitations of the respective methods. The comparative test was intended to provide the pre-requisites for comparing the analytical results of the individual projects within a given framework.

Representative Investigation Strategies for an Integrative System Approach to Specific Emissions of Plastics into the Environment
March 2018
March 2021

This project aims to develop representative investigation methods and strategies for an integrative system understanding of relevant plastic entry paths into the environmental compartment water.

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Long-term outcome and relapse patterns in Ewing sarcoma patients with extensive lung/pleural metastases after a complete response to systemic therapy

Ewing sarcoma (ES) is sensitive to systemic therapy, including chemotherapy and anti-angiogenesis Tyrosine Kinase Inhibitors(aaTKIs). However, the prognosis of patients with metastatic disease remains poor. Recurrence or distant metastasis after a complete response (CR) or near-CR due to systemic therapy is not rare.

We reviewed data from 187 ES patients between 2014–2019 treated at a single institute in China. Patients with extensive lung/pleural metastases (L/Pmeta) who had a CR or near-CR after first- or second-line chemotherapy with or without aaTKIs were retrospectively enrolled. Event-free survival (EFS) and overall survival (OS) were determined using the Kaplan–Meier method. For patients who had L/P recurrence, images were reviewed to define the exact location of each recurrent lesion, compared with the primary L/P lesion before chemotherapy and summarized as the relapse pattern.

Seventeen patients and 21 cases of CR/nCR (5 by VDC/IE, 3 by VIT, and 13 by AVI) were finally analyzed. Median follow-up for surviving patients was 39.6 (range, 14.5–60.9) months. Median EFS and OS were 9.3 (95% confidence interval [CI], 2.0–16.6) months and 37.5 (95% CI, 21.8–53.1) months, respectively. The 2-year EFS was 19% and the 2-year OS was 70.6%, respectively. Most patients (82.4%) received whole lung irradiation (WLI). Lung/pleural relapse occurred in 71.4% (15/21) of CR/nCR cases. Most notably, all recurrent lesions exactly coincided with the original metastatic lesions before chemotherapy (exactly in situ) in 9 of the 15 recurrent cases, which was thus the major relapse pattern, whereas 42.9% had distant metastases other than L/Pmeta.

Survival of ES patients with extensive L/Pmeta remains poor, even if they have a CR after systemic therapy. Recurrence exactly in situ is the major relapse pattern. WLI is not sufficient to prevent local recurrence in lung or pleura. More aggressive local treatment for metastatic lesions is warranted.

Peer Review reports

Ewing sarcoma (ES) is a small blue round cell tumor derived from primordial mesenchymal stem cells and is generally considered sensitive to chemotherapy. However, the prognosis of ES patients with initial or secondary metastatic disease is relatively poor [1]. Current therapies for patients who present with metastatic disease achieve 6-year event-free survival (EFS) of approximately 28% and overall survival (OS) of approximately 30% [2]. In the clinical trial series Euro-Ewing 99, 2008 [3] and 2012 [4], patients with pulmonary metastases were classified as intermedia risk, designated the Risk 2 pulmonary (R2pulm) group. For this group, 6-year EFS is approximately 40%, better than patients with bone/bone marrow metastases [5]. On the other hand, the prognosis of patients with recurrent or refractory disease is poor, with a 5-year OS after recurrence of 10–15% [1].

For patients with lung/pleural metastases (L/Pmeta), aggressive chemotherapy followed by whole lung irradiation (WLI) is considered to be standard treatment [3, 6, 7]. Most patients with ES are thought to be chemo-sensitive, and 4.2%-33.3% of patients with L/Pmeta had a complete response (CR) to either first- or second-line chemotherapy [5, 8]. Although WLI was given to prevent recurrence in the lung, not all of these complete responders survived longer-term. Secondary tumors refractory to chemotherapy or relapse in the follow-up period occurred in the majority of these former responders and limited their long-term survival.

There have been numerous clinical trials aiming at the prognosis of R2pulm group or recurrent/relapsed (RR) ES patients [1, 5, 8, 9]. However, for those who had extensive L/Pmeta and then completely responded to chemotherapy, there is insufficient high quality data to answer the following questions: 1. How much portion of these patients could be cured at last? 2. If not, what are the relapse patterns in these former responders? To answer these questions, we carried out this retrospective study and reviewed ES patients from one institutes in China.

Materials and methods

We conducted an Institutional Review Board-approved review of all patients with complete medical records diagnosed with ES and treated at Peking University People’s Hospital and Peking University Shougang Hospital between 2014 and 2019. Inclusion criteria were: 1. Histologically-confirmed EWS (but EWSR-FLI 1 translocation by fluorescence in situ hybridization (FISH) was not required); 2.Extensive L/Pmeta with no chance of radical radiotherapy (RT) or resection before multi-drug chemotherapy. Extensive L/Pmeta was defined when it fulfilled at least one of the following criteria: 1) Multiple pulmonary nodules in both lungs, and the largest nodule ≥ 0.5 cm (More than 5 nodules were defined as “multiple” in this study). 2) Pleural effusion and/or multiple pleural nodules; 3. Experiencing a complete response or nearly completely response (CR/nCR)] recorded and then confirmed after 6–8 weeks of multi-drug systemic therapy based on chemotherapy with or without aa-TKIs. CR was defined according to the Response Evaluation Criteria In Solid Tumors 1.1 (RECIST 1.1) guidelines. nCR was defined as each nodule < 3 mm. Exclusion criteria were: 1. Uncontrolled primary lesion during the same chemotherapy regimen: 1) Primary lesion too large for complete resection or radical radiation after induction chemotherapy. 2) Primary lesion progressing during the same regimen. 3) Distant metastasis other than in the lungs or pleura, such as bone, bone marrow, or lymph nodes.

Alternating vincristine/doxorubicin/cyclophosphamide and ifosfamide/etoposide (VDC/IE) q2w were administered as first-line chemotherapy. Irinotecan-based regimens such as vincristine/irinotecan/temozolomide (VIT), or anlotinib, an aa-TKI plus vincristine and irinotecan was used as second-line chemotherapy in recurrent or refractory patients (NCT03359005 and NCT03416517).

For newly-diagnosed patients, surgery was preferred as the local treatment modality unless it was judged to be associated with significant morbidity, in which case RT was recommended. RT doses were 55.8 Gy for gross disease and 50.4 Gy for resected disease with positive margins in three-dimensional conformal therapy (3DCRT). Stereotactic body radiation therapy (SBRT) was also allowed for certain cases.

WLI was given at the end for patients with first-line chemotherapy, or if all pulmonary lesions were < 3 mm in two consecutive CT scans for recurrent or relapsed patients. WLI was given by the 3DCRT technique. The median dose of prescribed radiation was 15 Gy/1.5 Gy/F, once per day; with the dose changing according to the hospital treatment policy from 12 Gy earlier to 15 Gy more recently. Notably, no patients received a boost dose.

EFS was defined from the date of first confirmation of CR/nCR to the first reported event (recurrence, progression, or death). Patients without an event were censored at the date of last follow-up. OS was defined from the date of first confirmation of CR/nCR to death or the date that they were last known to be alive. Chest computed tomography (CT) images were reviewed by two doctors to define the exact location of each recurrent lesion, compared with the primary L/P lesion before chemotherapy, and the relapse pattern was then summarized according to the following criteria:

  • Pattern 1 = All recurrent lesions completely coincide with the original metastatic lesions before chemotherapy (Fig. 1)

  • Pattern 2 = Some of the recurrent lesions coincide with the original lesions, but also with some new lesions

  • Pattern 3 = All recurrent lesions are completely new lesions

Fig. 1
figure 1

A 9-year-old girl diagnosed with ES of right proximal humerus. She showed multiple pulmonary metastasis at diagnosis at 2016–7-19. At the end of 14 cycles of first-line compressed VDC-IE, CR was confirmed at 2017–6-30. Neither maintenance therapy nor WLI were given. Half a year later, exactly relapse in situ was diagnosed at 2017–12-18

Statistical analysis

Images were retrospectively reviewed by two independent radiologists. Descriptive statistics including age, sex, time from initial diagnosis to extensive L/Pmeta, regimen of systemic therapy before CR/nCR and lesions with outside L/Pmeta were used to report patient characteristics. EFS and OS were calculated using the Kaplan–Meier method. All statistical analyses were performed in SPSS software package (SPSS Inc, Chicago, IL, USA).

Patient characteristics

From July 1st 2014 to July 1st 2019, 17 patients and 21 cases of CR/nCR (5 by VDC/IE, 3 by VIT, and 13 by AVI) were finally analyzed (Table 1). Among these 17 patients, two experienced CR/nCR twice and one patient experienced CR/nCR a third time. Median age at diagnosis of CR/nCR was 16 years (range, 4–39). Of these patients, 70.6% were male, and 23.8% had primary extensive L/Pmeta, while 19.0% suffered L/Pmeta within 12 months of the initial diagnosis of ES, and 57.1% after more than 12 months. The median time from extensive L/Pmeta to first confirmation of CR/nCR was 5.2 months. Median follow-up of surviving patients was 39.6 (range, 14.5–60.9) months.

Table 1 Demographics and baseline characteristics (21 CR/nCR in 17 patientsa)

Treatment details and survival

Details of treatments and outcomes for each case are summarized in Table 2, showing that 82.4% patients received WLI. Maintenance therapy was given in 16 cases tailored to the patient at the discretion of the investigator, including chemotherapy, anti-angiogenesis TKI, poly ADP-ribose polymerase (PARP) inhibitor and nonsteroidal anti-inflammatory drugs (NSAIDs).

Table 2 Maintenance therapy and survival after CR/nCR

At last assessment, 3 patients had no evidence of disease, 6 were still alive with disease and 8 had already died of disease. For 8 patients died of disease, 4 died of recurrent lung/pleural metastases, while 4 of them died of distant metastases other than lung/pleual lesions. The median EFS and OS were 9.3 (95% CI, 2.0–16.6) months and 37.5 (95% CI, 21.8–53.1) months. The 2-year EFS was 19%. The 2-year OS was 70.6% (Fig. 2). In all 17 patients, 12 were relapsed cases while the other 5 were initially metastatic cases. For the 12 relapsed cases, all of them joined clinical trial NCT03416517 (AVI for relapsed or recurrent EWS). The median EFS and OS were 6.5 (95% CI, 5.8–7.2) months and 37.5 (95% CI, 26.4–48.6) months. The 2-year EFS was 16.7% and OS was 66.7% (Fig. 3).

Fig. 2
figure 2

Event free survival and Overall survival calculated from the confirmation of CR/nCR to event or death

Fig. 3
figure 3

Event free survival and Overall survival calculated from the confirmation of CR/nCR to event or death for 12 relapsed cases

Patterns of relapse

Data on the patients who suffered disease relapse are summarized in Table 3. Lung/pleural relapse occurred in 71.4% (15/21) of CR/nCR cases. Most notably, in 9 of the 15 recurrent cases, the locations of all recurrent lesions exactly coincided with the original metastatic lesions before chemotherapy (i.e. exactly in situ). This was the major relapse pattern; however, 4 of these 9 cases also had distant metastases, while the other 5 cases had no lesions outside the lung/pleura. In 2 of the 15 cases with lung/pleural recurrence, some of the recurrent lesions were exactly in situ, but some new lesions in the lungs were also noted. Neither patient had distant metastases concurrently. For the last 4, all recurrent lung/pleural lesions were completely new, and two also had distant metastases as well. For the whole cohort, 42.9% had distant metastases outside of the L/Pmeta.

Table 3 Relapse pattern after CR/nCR

In the Children's Oncology Group studies in America, three risk groups are defined at diagnosis based on the location of lesions: patients with localized tumors, patients with lung or pleural metastases only, and patients with extrapulmonary or multiple metastases [4, 10,11,12]. For ES patients, L/Pmeta were noted in 25% at diagnosis and classified as intermediate risk [13]. The EFS of patients with L/Pmeta has improved in the last three decades, from 36% at 5 years in the German/European Intergroup Cooperative Ewing's Sarcoma Studies (CESS81, CESS86, EICESS92) [5], and 48% at 5 years in the Italian Sarcoma Group and Scandinavian Sarcoma Group ISG/SSG IV Study [14], to 53.6% at 3 years and 47.9% at 8 years in Euro-E.W.I.N.G. 99 or EWING 2008 studies [3]. In the most recent Euro-Ewing 2012 trial, survival data are not available [15] The EFS and OS in our study seemed much worse than in these historical trials. On the one hand, compared to these trials which recruited patients with one or more lesions, the patients in our study had extensive L/Pmeta, equivalent to a higher metastatic load. Patients with unilateral metastases had significantly better outcomes than patients with bilateral metastatic lesions [3, 5]. On the other hand, we enrolled patients failing first-line chemotherapy, which may also partly explain the unsatisfactory results.

The relapse rate was higher in L/Pmeta patients compared with patients with locoregional disease: 50% versus 20–39% [3, 5]. However, previous reports did not mention the location and relapse pattern of L/P recurrence. Our study is the first to investigate the location of recurrent and previous metastatic lesions before systemic treatment (Table 3). As most cases (9/15) in our study relapsed in situ, we conclude that recurrence in situ in L/Pmeta lesions is the major relapse pattern in these patients. A more aggressive local treatment other than WLI is needed. WLI may be used prophylactically in localized ES, rather than therapeutically in L/Pmeta, even for patients with a CR/nCR [16,17,18].

It is commonly accepted that ES prognosis is critically determined by the degree of adequacy of local control of the primary tumor and the efficacy of systemic chemotherapy to eradicate metastatic disease [12]. According to previous reports, lesions in L/Pmeta showed adequate responses during systemic treatment and CR/nCR was not rare. Whole lung irradiation improved outcome in ES patients with lung lesions by 5–20%, even when complete resolution of overt pulmonary metastatic disease had been achieved with chemotherapy [3, 6, 16, 19, 20]. Compared to the high dose of 55-60 Gy in radical radiation for ES lesions, the dose used for WLI is rather low considering the tolerance of normal pulmonary tissue. The higher rate of L/P recurrence might be partially explained by repopulation of the pulmonary space from subclinical metastases that were not eradicated completely by systemic treatment and low-dose WLI [20].

For most sarcoma patients, surgical resection of primary or metastatic lesions is important for long-term survival, as in osteosarcoma or chondrosarcoma. However, in ES, it was noted more than 20 years ago that pulmonary resection of metastatic lesions failed to improve survival [21]. This is in accordance with the high local recurrence rate for L/Pmeta even after adequate chemotherapy. Notably, the failure of surgical resection in L/P lesions in ES may be explained by inadequate resection, rather than surgery itself, given the fact that most L/P lesions were too small to resect after successful systemic treatment. Although ES is considered to be chemo-sensitive compared with other sarcomas, the biological behavior of ES still follows the classical pathway of resistance development in solid tumors and requires aggressive local treatment, but does not conform to the lymphoid and haematopoietic tissue scenario, such as in lymphoma or leukemia which totally relies on systemic treatment. These data support the proposal that more aggressive local treatment strategies, not only effective systemic treatments, should be applied to all involved lesions such as SBRT.

Our study also have some limitations. First, as a single-center retrospective study, we only enrolled 17 patients and 21 cases in the paper. The result may be not exact due to the small number of sample. Although we demonstrate that recurrence exactly in situ is the major relapse pattern, the portion of each pattern according the defination in our study may differs if more samples are analyzed. Second, aaTKIs have been used as part of chemotherapy in second line treatment. The mechanism of most aaTKIs was to cut off the blood supply to tumor resulting in hypoxia–ischemia necrosis. Although CR/nCR was noticed per imaging, a few active tumor cells may remain subclinically in the necrotic tissues. We listed the regimen of systemic therapy in Table 2, but did’t have engouh samples for further COX analysis to define if the use of aaTKIs had an impact on recurrence. Third, although EWSR rearrangedment was confirmed in all 13 patients, the other 4 patients did not have enough specimen for further molecular test. Given the retrospective nature of this study, we failed to get more specimen from biopsy or surgical resection. We indeed had a risk to include so-called Ewing-like sarcoma in our analysis.

Survival of ES patients with extensive L/Pmeta remains poor, even after they have a complete response to systemic therapy. Recurrence exactly in situ is the major relapse pattern. WLI is not sufficient to prevent local recurrence in lung or pleura. More aggressive local treatment for metastatic lesions is warranted.

Availability of data and material

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

  1. Stahl M, et al. Risk of recurrence and survival after relapse in patients with Ewing sarcoma. Pediatr Blood Cancer. 2011;57(4):549–53.

    Article  Google Scholar

  2. Miser JS, et al. Treatment of metastatic Ewing sarcoma/primitive neuroectodermal tumor of bone: evaluation of increasing the dose intensity of chemotherapy–a report from the children’s oncology group. Pediatr Blood Cancer. 2007;49(7):894–900.

    Article  Google Scholar

  3. Dirksen U, et al. High-dose chemotherapy compared with standard chemotherapy and lung radiation in Ewing sarcoma with pulmonary metastases: results of the european ewing tumour working initiative of national groups, 99 trial and EWING 2008. J Clin Oncol. 2019;37(34):3192–202.

    Article  CAS  Google Scholar

  4. Anderton J, et al. International randomised controlled trial for the treatment of newly diagnosed EWING sarcoma family of tumours - EURO EWING 2012 Protocol. Trials. 2020;21(1):96.

    Article  Google Scholar

  5. Paulussen M, et al. Ewing’s tumors with primary lung metastases: survival analysis of 114 (European Intergroup) Cooperative Ewing’s Sarcoma Studies patients. J Clin Oncol. 1998;16(9):3044–52.

    Article  CAS  Google Scholar

  6. Elghazawy H, et al. Whole lung irradiation for completely responding pulmonary metastases in pediatric Ewing sarcoma. Future Oncol. 2020;16(15):1043–51.

    Article  CAS  Google Scholar

  7. Casey DL, et al. Whole lung irradiation for adults with pulmonary metastases from Ewing sarcoma. Int J Radiat Oncol Biol Phys. 2014;89(5):1069–75.

    Article  Google Scholar

  8. Xu J, et al. Anlotinib, vincristine, and irinotecan for advanced ewing sarcoma after failure of standard multimodal therapy: a two-cohort. Phase Ib/II Trial Oncologist. 2021;26(7):e1256–62.

    CAS  PubMed  Google Scholar

  9. Xu J, et al. Management of recurrent or refractory Ewing sarcoma: a systematic review of phase II clinical trials in the last 15 years. Oncol Lett. 2019;18(1):348–58.

    Article  CAS  Google Scholar

  10. Felgenhauer JL, et al. A pilot study of low-dose anti-angiogenic chemotherapy in combination with standard multiagent chemotherapy for patients with newly diagnosed metastatic Ewing sarcoma family of tumors: a Children’s Oncology Group (COG) phase II study NCT00061893. Pediatr Blood Cancer. 2013;60(3):409–14.

    Article  CAS  Google Scholar

  11. Pappo AS, Dirksen U. Rhabdomyosarcoma, Ewing Sarcoma, and other round cell sarcomas. J Clin Oncol. 2018;36(2):168–79.

    Article  CAS  Google Scholar

  12. Gaspar N, et al. Ewing sarcoma: current management and future approaches through collaboration. J Clin Oncol. 2015;33(27):3036–46.

    Article  CAS  Google Scholar

  13. Balamuth NJ, Womer RB. Ewing’s sarcoma. Lancet Oncol. 2010;11(2):184–92.

    Article  CAS  Google Scholar

  14. Luksch R, et al. Primary metastatic Ewing’s family tumors: results of the Italian Sarcoma Group and Scandinavian Sarcoma Group ISG/SSG IV Study including myeloablative chemotherapy and total-lung irradiation. Ann Oncol. 2012;23(11):2970–6.

    Article  CAS  Google Scholar

  15. Brennan B, Kirton L, Marec-Berard P, et al. Comparison of two chemotherapy regimens in Ewing sarcoma (ES): Overall and subgroup results of the Euro Ewing 2012 randomized trial (EE2012). J Clin Oncol. 2020;38(15_suppl):11500–11500.

  16. Spunt SL, et al. Selective use of whole-lung irradiation for patients with Ewing sarcoma family tumors and pulmonary metastases at the time of diagnosis. J Pediatr Hematol Oncol. 2001;23(2):93–8.

    Article  CAS  Google Scholar

  17. Marinova L, et al. Protective, elective lung irradiation in non-metastatic Ewing’s sarcoma. Radiat Prot Dosimetry. 2015;165(1–4):492–4.

    Article  CAS  Google Scholar

  18. Nesbit ME Jr, et al. Multimodal therapy for the management of primary, nonmetastatic Ewing’s sarcoma of bone: a long-term follow-up of the First Intergroup study. J Clin Oncol. 1990;8(10):1664–74.

    Article  Google Scholar

  19. Paulussen M, Primary metastatic (stage IV) Ewing tumor: survival analysis of 171 patients from the EICESS studies, et al. European intergroup cooperative ewing sarcoma studies. Ann Oncol. 1998;9(3):275–81.

    Article  CAS  Google Scholar

  20. Ronchi L, et al. Whole lung irradiation in patients with osteosarcoma and ewing sarcoma. Anticancer Res. 2018;38(9):4977–85.

    Article  Google Scholar

  21. Heij HA, et al. Prognostic factors in surgery for pulmonary metastases in children. Surgery. 1994;115(6):687–93.

    CAS  PubMed  Google Scholar

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Authors and Affiliations

LX and JX conducted the literature search and generated all the figures in the study. XZ reviewed all the scans. LX, JX, and WG designed and developed the trial; LX, JX, and XS collected the data; KL, JX, and XL analyzed and interpreted the data; XZ and JX wrote the manuscript. All the authors reviewed the article for intellectual content, provided comments, and gave their final approval.

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Correspondence to Wei Guo.

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All data used in the study was obtained from existing medical records in our hospital. The study protocol was approved and consent waiver was obtained from the Institutional Review Board of Peking University People’s Hospital. All methods were carried out in accordance with relevant guidelines and regulations.

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Xu, J., Zhi, X., Xie, L. et al. Long-term outcome and relapse patterns in Ewing sarcoma patients with extensive lung/pleural metastases after a complete response to systemic therapy. BMC Cancer 22, 500 (2022).

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  • Ewing sarcoma
  • Metastases
  • Relapse
  • Complete remission