Double-blind, placebo-controlled, randomized study of eicosapentaenoic acid diester in patients with cancer cachexia

Purpose: Eicosapentaenoic acid (EPA) has been proposed to have specific anticachectic effects. This trial compared EPA diethyl ester with placebo in cachectic cancer patients for effects on weight and lean body mass. Patients and Methods: Five hundred eighteen weight-losing patients with advanced gastrointestinal or lung cancer were studied in a multicenter, double-blind, placebo controlled trial. Patients were randomly assigned to receive a novel preparation of pure EPA at a dose of 2 g or 4 g daily or placebo (2g EPA, n = 175; 4 g EPA, n = 172; placebo, n = 171). Patients were assessed at 4 weeks and 8 weeks. Results: The groups were well balanced at baseline. Mean weight loss at baseline was 18% (n = 518). Over the 8-week treatment period, both intention-to-treat analysis and per protocol analysis revealed no statistically significant improvements in survival, weight, or other nutritional variables. There was, however, a trend in favor of EPA with analysis of the primary end point, weight, at 8 weeks showing a borderline, nonsignificant treatment effect (P = .066). Relative to placebo, mean weight increased by 1.2 kg with 2 g EPA (95% CI, 0 kg to 2.3 kg) and by 0.3 kg with 4g EPA (-0.9 kg to 1.5 kg). Conclusion: The results indicate no statistically significant benefit from single agent EPA in the treatment of cancer cachexia. Future studies should concentrate on other agents or combination regimens. © 2006 by American Society of Clinical Oncology.

Sobolev-Morrey Type Inequality for Riesz Potentials, Associated with the Laplace-Bessel Differential Operator

2000 Mathematics Subject Classification: 42B20, 42B25, 42B35

Prognostic value of lymph node ratio and extramural vascular invasion on survival for patients undergoing curative colon cancer resection

Peer reviewed

Coupled symplectic maps as models for subdiffusive processes in disordered Hamiltonian lattices

Acknowledgements One of us (T. B.) acknowledges many interesting discussions on coupled maps with Professor C. Tsallis. We are also grateful to the anonymous referees for their constructive feedback that helped us improve the manuscript and to the HPCS Laboratory of the TEI of Western Greece for providing the computer facilities where all our simulations were performed. C. G. A. was partially supported by the “EPSRC EP/I032606/1” grant of the University of Aberdeen. This research has been co-financed by the European Union (European Social Fund - ESF) and Greek national funds through the Operational Program “Education and Lifelong Learning” of the National Strategic Reference Framework (NSRF) - Research Funding Program: THALES - Investing in knowledge society through the European Social Fund.

Coupled symplectic maps as models for subdiffusive processes in disordered Hamiltonian lattices

Acknowledgements One of us (T. B.) acknowledges many interesting discussions on coupled maps with Professor C. Tsallis. We are also grateful to the anonymous referees for their constructive feedback that helped us improve the manuscript and to the HPCS Laboratory of the TEI of Western Greece for providing the computer facilities where all our simulations were performed. C. G. A. was partially supported by the “EPSRC EP/I032606/1” grant of the University of Aberdeen. This research has been co-financed by the European Union (European Social Fund - ESF) and Greek national funds through the Operational Program “Education and Lifelong Learning” of the National Strategic Reference Framework (NSRF) - Research Funding Program: THALES - Investing in knowledge society through the European Social Fund.

Psychosocial morbidity in women with abnormal cervical cytology managed by cytological surveillance or initial colposcopy : longitudinal analysis from the TOMBOLA randomised trial

We are grateful for the co-operation and assistance that we received from NHS staff in the co-ordinating centres and clinical sites. We thank the women who participated in TOMBOLA. The TOMBOLA trial was supported by the Medical Research Council (G9700808) and the NHS in England and Scotland. The TOMBOLA Group comprises the following: Grant-holders: University of Aberdeen and NHS Grampian, Aberdeen, Scotland: Maggie Cruickshank, Graeme Murray, David Parkin, Louise Smart, Eric Walker, Norman Waugh (Principal Investigator 2004–2008) University of Nottingham and Nottingham NHS, Nottingham, England: Mark Avis, Claire Chilvers, Katherine Fielding, Rob Hammond, David Jenkins, Jane Johnson, Keith Neal, Ian Russell, Rashmi Seth, Dave Whynes University of Dundee and NHS Tayside, Dundee, Tayside: Ian Duncan, Alistair Robertson (deceased) University of Ottawa, Ottawa, Canada: Julian Little (Principal Investigator 1999–2004) National Cancer Registry, Cork, Ireland: Linda Sharp Bangor University, Bangor, Wales: Ian Russell University of Hull, Hull, England: Leslie G Walker Staff in clinical sites and co-ordinating centres Grampian Breda Anthony, Sarah Bell, Adrienne Bowie, Katrina Brown (deceased), Joe Brown, Kheng Chew, Claire Cochran, Seonaidh Cotton, Jeannie Dean, Kate Dunn, Jane Edwards, David Evans, Julie Fenty, Al Finlayson, Marie Gallagher, Nicola Gray, Maureen Heddle, Alison Innes, Debbie Jobson, Mandy Keillor, Jayne MacGregor, Sheona Mackenzie, Amanda Mackie, Gladys McPherson, Ike Okorocha, Morag Reilly, Joan Rodgers, Alison Thornton, Rachel Yeats Tayside Lindyanne Alexander, Lindsey Buchanan, Susan Henderson, Tine Iterbeke, Susanneke Lucas, Gillian Manderson, Sheila Nicol, Gael Reid, Carol Robinson, Trish Sandilands Nottingham Marg Adrian, Ahmed Al-Sahab, Elaine Bentley, Hazel Brook, Claire Bushby, Rita Cannon, Brenda Cooper, Ruth Dowell, Mark Dunderdale, Dr Gabrawi, Li Guo, Lisa Heideman, Steve Jones, Salli Lawson, Zoë Philips, Christopher Platt, Shakuntala Prabhakaran, John Rippin, Rose Thompson, Elizabeth Williams, Claire Woolley Statistical analysis Seonaidh Cotton, Kirsten Harrild, John Norrie, Linda Sharp External Trial Steering Committee Nicholas Day (chair, 1999–2004), Theresa Marteau (chair 2004-), Mahesh Parmar, Julietta Patnick and Ciaran Woodman.

Description of manganese nodules and crust collected from the Hakurei Maru Cruise GH76-1, January-March, 1976, in the Central Pacific Basin

This report of the GH76-1 cruise mainly includes the results of the on-board observations in the survey area of the medial-eastern part of Central Pacific Basin (5 degree -10 degree N, 170 degree -175 degree W) and partly of analytical work at the on-shore laboratory. In addition, the results of some on-board optical and geophysical works along the tracks of Japan-Ogasawara-survey area-Hawaii, are described in appendices. The GH76-1 cruise of the R/V Hakurei-maru was carried out from the 10th January to the 9th March, 1976 as the second phase field work of the Geological Survey of Japan five-year research program of study on the manganese nodule deposits of the Central Pacific Basin and also as a part of the National Research Institute for Pollution and Resources research program of technological study on the exploitation of deep sea mineral resources. The GSJ research program (F.Y. 1974-F.Y. 1978) aims at providing basic information on the manganese nodule distribution and their origin on the deep sea floor of the Central Pacific Basin bounded by the Marshall Ridge to the west, the Christmas Ridge to the east, and the Mid-Pacific Mountains to the north. The first phase of investigation was carried out during the GH74-5 cruise in the eastern part of the area (6 degree -10 degree 30'W, 164 degree 30'-171 degree 30'N)(Mizuno and Chujo, eds., 1975), and the present second phase covered an areas of 5 degree square, just west of the GH74-5 area.

Annotated record of the detailed examination of Mn deposits from R/V Bosei Maru Cruise GH72-2 stations

In 1972, the five years program 'Basic investigations for exploration of deep sea mineral resources' was laid out by the Agency of Industrial Science and Technology, Ministry of International Trade and Industry. The Geological Survey of Japan and the National Research Institute of Pollution and Resources undertook the first survey project. The survey team consisted of four geologists and a surveyor of the Geological Survey of Japan, and a mechanical, engineer and four mining engineers of National Research Institute of Polution and Resources. The survey started on November 11 using the "Bosei Maru" survey vessel (1100 tons) chartered from Tokai University. The cruise departed from Shimizu harbor to the Ponape and Guam islands, and terminated at the harbor of departure on December 11. The surveyed area was mainly covered the Mariana basin and the Magellan seamounts, and fifteen bottom samples were collected during the cruise. Ferromanganese nodules were obtained at several stations at a depth over 5000m.

La Ciberseguridad como factor crítico en la Seguridad de la Unión Europea

El ciberespacio es un escenario de conflicto altamente complejo al estar en constante evolución. Ni la Unión Europea ni ningún otro actor del sistema internacional se encuentra a salvo de las amenazas procedentes del ciberespacio. Pero los pasos dados desde la UE en el mundo de la ciberseguridad no son en absoluto suficientes. Europa necesita que su Estrategia de ciberseguridad sea realmente capaz de integrar a las diferentes Estrategias nacionales. Es urgente una mayor determinación, unos mayores recursos y unos mejores instrumentos que permitan a la Unión implementar una gestión de crisis y una prevención de ciberconflictos verdaderamente eficaz.

Use of an employment advisory service by cancer survivors

Employment issues for cancer survivors (CS) were investigated fromthe perspective of Northern Ireland government general employmentadvisors. An e-survey was designed and developed based on the resultsof a scoping search of journal articles, previously validatedquestionnaires and relevant related surveys; discussions of draftversions of the e-survey and method with lead representatives ofstakeholder organizations; and a pilot study with seven prospectiverespondents. The e-survey and subsequent reminder to employmentadvisors were distributed internally by the government employmentadvisory agency. The e-survey was completed by 78/156 (50%) advisors,the majority of whom (74%) received a request for advicein the last year from at least one CS. Most CS used the employmentservice less than 1 year (52%) or 1 year or more after treatment(32%). Fatigue was the most commonly reported barrier to returningto work (10%) and staying in work (14%), and a supportiveemployer was the top facilitating factor in returning to (21%) andcontinuing in (27%), employment. Although most advisors had apositive attitude about a CS’s capacity to return to work, half wereuncertain about how best to advise cancer survivors.

BRAF mutation testing algorithm for vemurafenib treatment in melanoma: recommendations from an expert panel.

The incidence of melanoma has increased rapidly over the past 30 years, and the disease is now the sixth most common cancer among men and women in the U.K. Many patients are diagnosed with or develop metastatic disease, and survival is substantially reduced in these patients. Mutations in the BRAF gene have been identified as key drivers of melanoma cells and are found in around 50% of cutaneous melanomas. Vemurafenib (Zelboraf(®) ; Roche Molecular Systems Inc., Pleasanton, CA, U.S.A.) is the first licensed inhibitor of mutated BRAF, and offers a new first-line option for patients with unresectable or metastatic melanoma who harbour BRAF mutations. Vemurafenib was developed in conjunction with a companion diagnostic, the cobas(®) 4800 BRAF V600 Mutation Test. The purpose of this paper is to make evidence-based recommendations to facilitate the implementation of BRAF mutation testing and targeted therapy in patients with metastatic melanoma in the U.K. The recommendations are the result of a meeting of an expert panel and have been reviewed by melanoma specialists and representatives of the National Cancer Research Network Clinical Study Group on behalf of the wider melanoma community. This article is intended to be a starting point for practical advice and recommendations, which will no doubt be updated as we gain further experience in personalizing therapy for patients with melanoma.

Radiotherapy and Immunotherapy Combinations in Non-small Cell Lung Cancer: A Promising Future?

The goal of re-programming the host immune system to target malignancy with durable anti-tumour clinical responses has been speculated for decades. In the last decade such speculation has been transformed into reality with unprecedented and durable responses to immune checkpoint inhibitors seen in solid tumours. This mini-review considers the mechanism of action of immune modulating agents and the potential for combination with radiotherapy in the treatment of non-small cell lung cancer.

Self-refraction, ready-made glasses and quality of life among rural myopic Chinese children: a non-inferiority randomized trial.

PURPOSE: To study, for the first time, the effect of wearing ready-made glasses and glasses with power determined by self-refraction on children's quality of life. METHODS: This is a randomized, double-masked non-inferiority trial. Children in grades 7 and 8 (age 12-15 years) in nine Chinese secondary schools, with presenting visual acuity (VA) ≤6/12 improved with refraction to ≥6/7.5 bilaterally, refractive error ≤-1.0 D and <2.0 D of anisometropia and astigmatism bilaterally, were randomized to receive ready-made spectacles (RM) or identical-appearing spectacles with power determined by: subjective cycloplegic retinoscopy by a university optometrist (U), a rural refractionist (R) or non-cycloplegic self-refraction (SR). Main study outcome was global score on the National Eye Institute Refractive Error Quality of Life-42 (NEI-RQL-42) after 2 months of wearing study glasses, comparing other groups with the U group, adjusting for baseline score. RESULTS: Only one child (0.18%) was excluded for anisometropia or astigmatism. A total of 426 eligible subjects (mean age 14.2 years, 84.5% without glasses at baseline) were allocated to U [103 (24.2%)], RM [113 (26.5%)], R [108 (25.4%)] and SR [102 (23.9%)] groups, respectively. Baseline and endline score data were available for 398 (93.4%) of subjects. In multiple regression models adjusting for baseline score, older age (p = 0.003) and baseline spectacle wear (p = 0.016), but not study group assignment, were significantly associated with lower final score. CONCLUSION: Quality of life wearing ready-mades or glasses based on self-refraction did not differ from that with cycloplegic refraction by an experienced optometrist in this non-inferiority trial.