A randomised controlled trial of a cognitive behavioural intervention for men who have hot flushes following prostate cancer treatment (MANCAN):trial protocol

Background:- This randomised controlled trial (RCT) aims to evaluate the effectiveness of a guided self-help cognitive behavioural intervention to alleviate problematic hot flushes (HF) and night sweats (NS) in men who are undergoing prostate cancer treatment. The trial and the self-help materials have been adapted from a previous RCT, which showed that a cognitive behavioural intervention reduced the self-reported problem-rating of hot flushes in women with menopausal symptoms, and in women undergoing breast cancer treatment. We hypothesize that guided self-help will be more effective than usual care in reducing HF/NS problem-rating at post treatment assessment. Methods/Design:- Seventy men who are undergoing treatment for prostate cancer and who have been experiencing more than ten HF/NS weekly for over a month are recruited into the trial from urology clinics in London. They are randomly allocated to either a four-week self-help cognitive behavioural therapy (CBT) treatment or to their usual care (control group). The treatment includes information and discussion about hot flushes and night sweats in the context of prostate cancer, monitoring and modifying precipitants, relaxation and paced respiration, stress management, cognitive therapy for unhelpful thoughts and beliefs, managing sleep and night sweats, and advice on maintaining these changes.Prior to randomisation, men attend a clinical interview, undergo 24-48-hour sternal skin conductance monitoring, and complete pre-treatment questionnaires (e.g., problem-rating and frequency of hot flushes and night sweats; quality of life; mood; hot flush beliefs and behaviours). Post-treatment measures (sternal skin conductance and the above questionnaires) are collected four-six weeks later, and again at a six-month follow-up. Discussion:- MANCAN is the first randomised controlled trial of cognitive behavioural therapy for HF/NS for men that measures both self-reported and physiologically indexed symptoms. The results will inform future clinical practice by evaluating an evidence-based, non-medical treatment, which can be delivered by trained health professionals. Trial registration:- UK Clinical Research Network UKCRN10904

Differentially Private Exponential Random Graphs

We propose methods to release and analyze synthetic graphs in order to protect privacy of individual relationships captured by the social network. Proposed techniques aim at fitting and estimating a wide class of exponential random graph models (ERGMs) in a differentially private manner, and thus offer rigorous privacy guarantees. More specifically, we use the randomized response mechanism to release networks under $\epsilon$-edge differential privacy. To maintain utility for statistical inference, treating the original graph as missing, we propose a way to use likelihood based inference and Markov chain Monte Carlo (MCMC) techniques to fit ERGMs to the produced synthetic networks. We demonstrate the usefulness of the proposed techniques on a real data example.Comment: minor edit

Back-flow ripples in troughs downstream of unit bars: Formation, preservation and value for interpreting flow conditions

Back-flow ripples are bedforms created within the lee-side eddy of a larger bedform with migration directions opposed or oblique to that of the host bedform. In the flume experiments described in this article, back-flow ripples formed in the trough downstream of a unit bar and changed with mean flow velocity; varying from small incipient back-flow ripples at low velocities, to well-formed back-flow ripples with greater velocity, to rapidly migrating transient back-flow ripples formed at the greatest velocities tested. In these experiments back-flow ripples formed at much lower mean back-flow velocities than predicted from previously published descriptions. This lower threshold mean back-flow velocity is attributed to the pattern of velocity variation within the lee-side eddy of the host bedform. The back-flow velocity variations are attributed to vortex shedding from the separation zone, wake flapping and increases in the size of, and turbulent intensity within, the flow separation eddy controlled by the passage of superimposed bedforms approaching the crest of the bar. Short duration high velocity packets, whatever their cause, may form back-flow ripples if they exceed the minimum bed shear stress for ripple generation for long enough or, if much faster, may wash them out. Variation in back-flow ripple cross-lamination has been observed in the rock record and, by comparison with flume observations, the preserved back-flow ripple morphology may be useful for interpreting formative flow and sediment transport dynamics

PCN77 – Cost-effectiveness of cognitive-behavioral therapy and physical exercise for alleviating treatment-induced menopausal symptoms in breast cancer patients

Objectives Many breast cancer patients suffer from (severe) menopausal symptoms after an early onset of menopause caused by cancer treatment. The standard treatment for these complaints is hormone replacement therapy, which, however, is contraindicated for this group, as it may have tumor-promoting effects. The aim of this study was to assess the cost-effectiveness of three interventions aimed at alleviating these symptoms: cognitive-behavioral therapy (CBT), physical exercise (PE), and the combination of both (CBT+PE). Methods A cost-effectiveness analysis was performed from a health care system perspective. The primary outcome was incremental health care costs (IHCC) per patient with a clinically relevant improvement after six months of treatments. The secondary outcome was incremental costs per quality-adjusted life years (QALYs) gained over a five-year time period. This was assessed using a Markov model, populated with data from a recent randomized controlled trial evaluating the effectiveness of CBT, PE, and CBT+PE in the clinical setting and additional cost data. The robustness of the results was analyzed through one-way and probabilistic sensitivity analyses. Results IHCCs for alleviating one patient of the perceived symptom burden by a clinically relevant difference after six months of treatment were EUR€605 for CBT, EUR€1,847 for CBT+PT, and EUR€1,250 for PE alone, compared to the waiting list control group. CBT generated 0.009 additional QALYs at an additional cost of EUR€162, compared to the control group, leading to an Incremental Cost Utility Ratio (ICUR) of EUR€18,655 per QALY gained and The ICUR of CBT+PE was EUR€42,375 per QALY in comparison to the control group. CBT had a high probability (circa 61%) of being cost-effective at prevailing ceiling ratios. Conclusions CBT is likely the most cost-effective of the three interventions investigated for alleviating treatment-induced menopausal symptoms in breast cancer patient

Plant and algal chlorophyll synthases function in Synechocystis and interact with the YidC/Alb3 membrane insertase

In the model cyanobacteriumSynechocystissp. PCC 6803, the terminalenzyme of chlorophyll biosynthesis, chlorophyll synthase (ChlG), forms acomplex with high light-inducible proteins, the photosystem II assembly fac-tor Ycf39 and the YidC/Alb3/OxaI membrane insertase, co-ordinatingchlorophyll delivery with cotranslational insertion of nascent photosystempolypeptides into the membrane. To gain insight into the ubiquity of thisassembly complex in higher photosynthetic organisms, we produced functionalforeign chlorophyll synthases in a cyanobacterial host. Synthesis of algal andplant chlorophyll synthases allowed deletion of the otherwise essential nativecyanobacterial gene. Analysis of purified protein complexes shows that theinteraction with YidC is maintained for both eukaryotic enzymes, indicatingthat a ChlG-YidC/Alb3 complex may be evolutionarily conserved in algaeand plants

The possible involvement of immunosuppression caused by a lentivirus in the aetiology of jaagsiekte and pasteurellosis in sheep

A South African isolate of ovine lentivirus was shown to cause a mild immunosuppression in sheep, reflected by a reduced delayed hypersensitivity reaction. This effect, measured in terms of skin swelling after intradermal inoculation with tuberculin, showed a positive linear relationship with the latency period before the appearance of jaagsiekte symptoms in animals co-infected with JSRV, as well as with the activity of monocytes. In a parallel study, increased susceptibility of lentivirus-infected sheep to infection with Pasteurella haemolytica was demonstrated. It is concluded that the lentivirus may play an enhancing role in both viral and bacterial infections of sheep by compromising the host's cellular immune response.The articles have been scanned in colour with a HP Scanjet 5590; 600dpi. Adobe Acrobat XI Pro was used to OCR the text and also for the merging and conversion to the final presentation PDF-format.lmchunu2014mn201