In the early stages of cutaneous malignant melanoma (MM), it is extremely difficult to predict adequately the risk from hematogenic and lymphatic metastasis. We investigate whether the immunohistochemical expression of Ki-67 and estrogen receptor beta (ER&bgr;) in cells of MM could predict the status of regional lymph nodes. A total of 55 tissue samples of primary cutaneous melanomas with known status of regional lymph nodes were retrospectively evaluated for Ki-67 and ER&bgr; expression by quantitative immunohistochemistry and then correlated with the status of regional lymph nodes and relevant clinicopathologic parameters. The ER&bgr;-positive expression was detected in 38 of 55 tumors (69.09%). The Clark level showed a strong correlation with ER&bgr; expression, as well as pT stage. All cases of MM showed Ki-67-positive expression and an elevated Ki-67 expression was strongly associated with increased Breslow thickness, Clark level, ulceration, lymphovascular invasion, number of mitosis, and pT stage. Logistic regression analysis showed that when ER&bgr; levels increase by 1%, the risk of positive lymph nodes decreases by 7% (odds ratio=0.930; 95% confidence interval, 0.87-0.99; P=0.036), and, when the Ki-67 expression increases by 1%, the risk of lymph nodes’ positivity increases by 10% (odds ratio=1.108; 95% confidence interval, 1.02-1.19; P=0.009). Correlation between expression of Ki-67 and ER&bgr; and the status of lymph nodes has better prognostic significance than the relationship between melanoma thickness and the status of lymph nodes. Our study showed a significant prognostic value of Ki-67 expression in predicting the behavior of MM and the potential prognostic significance of ER&bgr;.

The socio-economic crisis of 2008 persists in creating a need for structural change and radical transformation by applying systemic thinking and holistic approaches to design solutions. This paper questions those limits with regards to economic failures of income distribution among social entrepreneurs in co-working spaces. The argument focuses on exploring the potential for introducing alternative solutions where design can cut across traditional models and lead to economic transformations through new service models. Complementary currency systems structurally diversify monetary eco-systems and act as a mechanism for territorial and social cohesion. Strategic design is summoned here to focus on a new currency through the development of an integrated and resilient service system, a model for activating idle capabilities of community members into innovative collaboration opportunities. On-field research encompassing interviews, survey and persona design methods have been conducted with members of the Impact HUB social business network. The analysis of existing collaborative service models serves as an enabling action platform for service innovation to take place, driven by bottom-up behaviour changes towards social innovation. This research sets the stage to open up possibilities for empowering professionals and capacity building approaches to be implemented in emerging collaborative economies. Keywords: complementary currency systems, strategic design, service system design, resilient strategy.

The International Committee of Medical Journal Editors (ICMJE) provides recommendations to improve the editorial standards and scientific quality of biomedical journals. These recommendations range from uniform technical requirements to more complex and elusive editorial issues including ethical aspects of the scientific process. Recently, registration of clinical trials, conflicts of interest disclosure, and new criteria for authorship - emphasizing the importance of responsibility and accountability-, have been proposed. Last year, a new editorial initiative to foster sharing of clinical trial data was launched. This review discusses this novel initiative with the aim of increasing awareness among readers, investigators, authors and editors belonging to the Editors´ Network of the European Society of Cardiology.