Personalised and Precision Medicine in Cancer Clinical Trials: Panacea for Progress or Pandora's Box?

Cancer clinical trials have been one of the key foundations for significant advances in oncology. However, there is a clear recognition within the academic, care delivery and pharmaceutical/biotech communities that our current model of clinical trial discovery and development is no longer fit for purpose. Delivering transformative cancer care should increasingly be our mantra, rather than maintaining the status quo of, at best, the often miniscule incremental benefits that are observed with many current clinical trials. As we enter the era of precision medicine for personalised cancer care (precision and personalised medicine), it is important that we capture and utilise our greater understanding of the biology of disease to drive innovative approaches in clinical trial design and implementation that can lead to a step change in cancer care delivery. A number of advances have been practice changing (e.g. imatinib mesylate in chronic myeloid leukaemia, Herceptin in erb-B2-positive breast cancer), and increasingly we are seeing the promise of a number of newer approaches, particularly in diseases like lung cancer and melanoma. Targeting immune checkpoints has recently yielded some highly promising results. New algorithms that maximise the effectiveness of clinical trials, through for example a multi-stage, multi-arm type design are increasingly gaining traction. However, our enthusiasm for the undoubted advances that have been achieved are being tempered by a realisation that these new approaches may have significant cost implications. This article will address these competing issues, mainly from a European perspective, highlight the problems and challenges to healthcare systems and suggest potential solutions that will ensure that the cost/value rubicon is addressed in a way that allows stakeholders to work together to deliver optimal cost-effective cancer care, the benefits of which can be transferred directly to our patients.

Implicit optimality criterion for convex SIP problem with box constrained index set

We consider a convex problem of Semi-Infinite Programming (SIP) with multidimensional index set. In study of this problem we apply the approach suggested in [20] for convex SIP problems with one-dimensional index sets and based on the notions of immobile indices and their immobility orders. For the problem under consideration we formulate optimality conditions that are explicit and have the form of criterion. We compare this criterion with other known optimality conditions for SIP and show its efficiency in the convex case.

‘To me, it's like a little box of tricks’: Breaking the depressive interlock as a programme participant in mindfulness-based cognitive therapy

Objectives. Mindfulness meditation practices have become increasingly popular in clinical therapies, changing patterns of depressogenic thinking for individuals who experience consecutive episodes of depression. We were interested in finding out how Mindfulness Based Cognitive Therapy (MBCT) worked for programme participants by focussing on how meditative practices changed their relationships to their thoughts. Design. Data for the study came from six semi-structured research interviews carried out with individuals who had taken part in an 8 week MBCT programme Methods. We used Interpretative Phenomenological Analysis (IPA) to analyse the experiential accounts. Results. We report on two superordinate themes – Engaging the Neutral Mind (with subordinate themes ‘breaking the paralysis of worry’ and ‘choosing to think differently’) and Experiencing the Neutral Mind (with subordinate themes of ‘reflection on previous thinking styles’ and ‘becoming psychologically self-reliant’). Conclusions. Themes from the present study offer support to the assertion that mindfulness meditation helps facilitate a different mode of meta-cognitive processing with which to handle depression-related cognitions. Practitioner Points Participants reported that they experienced an enhanced capacity to differentiate between their thought processes, experiencing an ability to tolerate some more uncomfortable thoughts and experiencing a/more choice in how to respond to thoughts Participants recognised that ruminating over negative thoughts was related to depressive states and experienced a shift in meta-cognitive processes that actively challenged depressogenic cognitions Participants became more psychologically self-reliant and therapeutically independent following MBCT Integrating mindfulness based practices in therapy may be a mediating factor in sustaining psychological wellbeing and may help clients develop self-compassion Future research looks to examining exit cases to understand elements of MBCT which are experienced as less successful by clients

Análise do investimento direto estrangeiro em Portugal utilizando a metodologia de box-jenkins

Dissertação para obtenção do Grau de Mestre em Contabilidade e Finanças Orientadora: Professora Doutora Patrícia Ramos

Cu2ZnSnS4 absorber layers obtained through sulphurization of metallic precursors: Graphite box versus sulphur flux

In this work we employed a hybrid method, combining RF-magnetron sputtering with evaporation, for the deposition of tailor made metallic precursors, with varying number of Zn/Sn/Cu (ZTC) periods and compared two approaches to sulphurization. Two series of samples with 1×, 2× and 4× ZTC periods have been prepared. One series of precursors was sulphurized in a tubular furnace directly exposed to a sulphur vapour and N2+5% H2 flux at a pressure of 5.0×10+4 Pa. A second series of identical precursors was sulphurized in the same furnace but inside a graphite box where sulphur pellets have been evaporated again in the presence of N2+5% H2 and at the same pressure as for the sulphur flux experiments. The morphological and chemical analyses revealed a small grain structure but good average composition for all three films sulphurized in the graphite box. As for the three films sulphurized in sulphur flux grain growth was seen with the increase of the number of ZTC periods whilst, in terms of composition, they were slightly Zn poor. The films' crystal structure showed that Cu2ZnSnS4 is the dominant phase. However, in the case of the sulphur flux films SnS2 was also detected. Photoluminescence spectroscopy studies showed an asymmetric broad band emission whichoccurs in the range of 1–1.5 eV. Clearly the radiative recombination efficiency is higher in the series of samples sulphurized in sulphur flux. We have found that sulphurization in sulphur flux leads to better film morphology than when the process is carried out in a graphite box in similar thermodynamic conditions. Solar cells have been prepared and characterized showing a correlation between improved film morphology and cell performance. The best cells achieved an efficiency of 2.4%.

How to increase value for customers of style in a box: The first Portuguese online platform for renting luxury dresses

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics

Cardboard Box from Pascall Chocolate Animals of London

The box contained the chocolate elephant.

Samuel DeVeaux Woodruff's Pewter Match Box

This pewter hinged flip-top box is 9 cm x 7 cm and has a 2 cm depth. It contains lit and unlit matches. It is worn and slightly dented.

Tin box "Waldmeister zur Bowle, Woodruff"

Tin box with the title “Waldmeister zur Bowle, Woodruff” on it, 10 cm x 16 cm. The box is from Julius Schade and Co., German Army and Navy Contractors, Leipzig-Lindenau, Germany. This box contains dried woodruff leaves. Accompanying this box of woodruff is a handwritten recipe for woodruff brew, n.d.

L'impact d'une politique publique fiscale sur l'evolution demographique du Quebec: une application de la methode d'analyse avec intervention de Box & Tiao.

Rapport de recherche