Clinical and cost-effectiveness of capecitabine and tegafur with uracil for the treatment of metastatic colorectal cancer: systematic review and economic evaluation

Objectives: To evaluate the clinical and costeffectiveness of capecitabine and tegafur with uracil (UFT/LV) as first-line treatments for patients with metastatic colorectal cancer, as compared with 5- fluorouracil/folinic acid (5-FU/FA) regimens. Data sources: Electronic databases, reference lists of relevant articles and sponsor submissions were also consulted. Review methods: Systematic searches, selection against criteria and quality assessment were performed to obtain data from relevant studies. Costs were estimated through resource-use data taken from the published trials and the unpublished sponsor submissions. Unit costs were taken from published sources, where available. An economic evaluation was undertaken to compare the cost-effectiveness of capecitabine and UFT/LV with three intravenous 5- FU/LV regimens widely used in the UK: the Mayo, the modified de Gramont regimen and the inpatient de Gramont regimens. Results: The evidence suggests that treatment with capecitabine improves overall response rates and has an improved adverse effect profile in comparison with 5-FU/LV treatment with the Mayo regimen, with the exception of hand–foot syndrome. Time to disease progression or death after treatment with UFT/LV in one study appears to be shorter than after treatment with 5-FU/LV with the Mayo regimen, although it also had an improved adverse effect profile. Neither capecitabine nor UFT/LV appeared to improve healthrelated quality of life. Little information on patient preference was available for UFT/LV, but there was indicated a strong preference for this over 5-FU/LV. The total cost of capecitabine and UFT/LV treatments were estimated at £2111 and £3375, respectively, compared with the total treatment cost for the Mayo regimen of £3579. Cost estimates were also presented for the modified de Gramont and inpatient de Gramont regimens. These were £3684 and £6155, respectively. No survival advantage was shown in the RCTs of the oral drugs against the Mayo regimen. Cost savings of capecitabine and UFT/LV over the Mayo regimen were estimated to be £1461 and £209, respectively. Drug acquisition costs were higher for the oral therapies than for the Mayo regimen, but were offset by lower administration costs. Adverse event treatment costs were similar across the three regimens. It was inferred that there was no survival difference between the oral drugs and the de Gramont regimens. Cost savings of capecitabine and UFT/LV over the modified de Gramont regimen were estimated to be £1353 and £101, respectively, and over the inpatient de Gramont regimen were estimated to be £4123 and £2870, respectively. Conclusions: The results show that there are cost savings associated with the use of oral therapies. No survival difference has been proven between the oral drugs and the Mayo regimen. In addition, no evidence of a survival difference between the Mayo regimen and the de Gramont regimens has been identified. However, improved progression-free survival and an improved adverse event profile have been shown for the de Gramont regimen over the Mayo regimen. Further research is recommended into the following areas: quality of life data should be included in trials of colorectal cancer treatments; the place of effective oral treatments in the treatment of colorectal cancer, the safety mechanisms needed to ensure compliance and the monitoring of adverse effects; the optimum duration of treatment; the measurement of patient preference; and a phase III comparative trial of capecitabine and UFT/LV versus modified de Gramont treatment to determine whether there was any survival advantage and to collate the necessary economic data

UniquID: A Quest to Reconcile Identity Access Management and the Internet of Things

The Internet of Things (IoT) has caused a revolutionary paradigm shift in computer networking. After decades of human-centered routines, where devices were merely tools that enabled human beings to authenticate themselves and perform activities, we are now dealing with a device-centered paradigm: the devices themselves are actors, not just tools for people. Conventional identity access management (IAM) frameworks were not designed to handle the challenges of IoT. Trying to use traditional IAM systems to reconcile heterogeneous devices and complex federations of online services (e.g., IoT sensors and cloud computing solutions) adds a cumbersome architectural layer that can become hard to maintain and act as a single point of failure. In this paper, we propose UniquID, a blockchain-based solution that overcomes the need for centralized IAM architectures while providing scalability and robustness. We also present the experimental results of a proof-of-concept UniquID enrolment network, and we discuss two different use-cases that show the considerable value of a blockchain-based IAM.Comment: 15 pages, 10 figure

Penning traps with unitary architecture for storage of highly charged ions

Penning traps are made extremely compact by embedding rare-earth permanent magnets in the electrode structure. Axially-oriented NdFeB magnets are used in unitary architectures that couple the electric and magnetic components into an integrated structure. We have constructed a two- magnet Penning trap with radial access to enable the use of laser or atomic beams, as well as the collection of light. An experimental apparatus equipped with ion optics is installed at the NIST electron beam ion trap (EBIT) facility, constrained to fit within 1 meter at the end of a horizontal beamline for transporting highly charged ions. Highly charged ions of neon and argon, extracted with initial energies up to 4000 eV per unit charge, are captured and stored to study the confinement properties of a one-magnet trap and a two-magnet trap. Design considerations and some test results are discussed

Fe I Oscillator Strengths for the Gaia-ESO Survey

The Gaia-ESO Public Spectroscopic Survey (GES) is conducting a large-scale study of multi-element chemical abundances of some 100 000 stars in the Milky Way with the ultimate aim of quantifying the formation history and evolution of young, mature and ancient Galactic populations. However, in preparing for the analysis of GES spectra, it has been noted that atomic oscillator strengths of important Fe I lines required to correctly model stellar line intensities are missing from the atomic database. Here, we present new experimental oscillator strengths derived from branching fractions and level lifetimes, for 142 transitions of Fe I between 3526 {\AA} and 10864 {\AA}, of which at least 38 are urgently needed by GES. We also assess the impact of these new data on solar spectral synthesis and demonstrate that for 36 lines that appear unblended in the Sun, Fe abundance measurements yield a small line-by-line scatter (0.08 dex) with a mean abundance of 7.44 dex in good agreement with recent publications.Comment: Accepted for publication in Mon. Not. R. Astron. So

Microsomal incubation test of potentially hemolytic drugs for glucose‐6‐phosphate dehydrogenase deficiency

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/109761/1/cptclpt198354.pd

Virtual light-by-light scattering and the g factor of a bound electron

The contribution of the light-by-light diagram to the g factor of electron and muon bound in Coulomb field is obtained. For electron in a ground state, our results are in good agreement with the results of other authors obtained numerically for large Z. For relatively small Z our results have essentially higher accuracy as compared to the previous ones. For muonic atoms, the contribution is obtained for the first time with the high accuracy in whole region of Z.Comment: 10 pages, 3 figures, RevTe