34,285 research outputs found
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published trials and the unpublished sponsor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
Performance of a 28-inch ramjet utilizing gaseous hydrogen at a mach number of 3.6, angles of attack up to 12 deg, and pressure altitudes up to 110,000 feet
Combustion efficiency of gaseous hydrogen fuel for ramjets at very high altitudes and high distortio
Transformative learning through university and prison partnerships: reflections from ‘Learning Together’ pedagogical practice
This paper critically discusses two London-based “Learning Together” prison university partnerships—Middlesex University with Her Majesty’s Prison (HMP) Wandsworth and London South Bank University (LSBU) with HMP Pentonville. The paper documents how students experienced the shared classroom learning approach designed on principles of “transformative pedagogy”, and how students interpret their personal development and the knowledge and skills gained as a result. We share the steps taken to bring the learning together pedagogical philosophy to life and use evidence from module evaluation findings and critical reflections to demonstrate the transformations that happen. We interpret our findings through the lens of a transformative ripples model. In addition to exploring personal transformation, the wider transformations that occur within the public institutions at the centre of these collaborations—the prisons and the universities —are discussed. We argue that for prison and university partnerships to be truly effective, they must embed transformative pedagogic practices at their heart, ensuring the “how”we teach is as important, and deliberately considered, as the “what” we teach
From 2D Integrable Systems to Self-Dual Gravity
We explain how to construct solutions to the self-dual Einstein vacuum
equations from solutions of various two-dimensional integrable systems by
exploiting the fact that the Lax formulations of both systems can be embedded
in that of the self-dual Yang--Mills equations. We illustrate this by
constructing explicit self-dual vacuum metrics on , where
is a homogeneous space for a real subgroup of SL(2, \C) associated
with the two-dimensional system.Comment: 9 pages, LaTex, no figure
Yeah, Right, Uh-Huh: A Deep Learning Backchannel Predictor
Using supporting backchannel (BC) cues can make human-computer interaction
more social. BCs provide a feedback from the listener to the speaker indicating
to the speaker that he is still listened to. BCs can be expressed in different
ways, depending on the modality of the interaction, for example as gestures or
acoustic cues. In this work, we only considered acoustic cues. We are proposing
an approach towards detecting BC opportunities based on acoustic input features
like power and pitch. While other works in the field rely on the use of a
hand-written rule set or specialized features, we made use of artificial neural
networks. They are capable of deriving higher order features from input
features themselves. In our setup, we first used a fully connected feed-forward
network to establish an updated baseline in comparison to our previously
proposed setup. We also extended this setup by the use of Long Short-Term
Memory (LSTM) networks which have shown to outperform feed-forward based setups
on various tasks. Our best system achieved an F1-Score of 0.37 using power and
pitch features. Adding linguistic information using word2vec, the score
increased to 0.39
Calculating photonic Green's functions using a non-orthogonal finite difference time domain method
In this paper we shall propose a simple scheme for calculating Green's
functions for photons propagating in complex structured dielectrics or other
photonic systems. The method is based on an extension of the finite difference
time domain (FDTD) method, originally proposed by Yee, also known as the
Order-N method, which has recently become a popular way of calculating photonic
band structures. We give a new, transparent derivation of the Order-N method
which, in turn, enables us to give a simple yet rigorous derivation of the
criterion for numerical stability as well as statements of charge and energy
conservation which are exact even on the discrete lattice. We implement this
using a general, non-orthogonal co-ordinate system without incurring the
computational overheads normally associated with non-orthogonal FDTD.
We present results for local densities of states calculated using this method
for a number of systems. Firstly, we consider a simple one dimensional
dielectric multilayer, identifying the suppression in the state density caused
by the photonic band gap and then observing the effect of introducing a defect
layer into the periodic structure. Secondly, we tackle a more realistic example
by treating a defect in a crystal of dielectric spheres on a diamond lattice.
This could have application to the design of super-efficient laser devices
utilising defects in photonic crystals as laser cavities.Comment: RevTex file. 10 pages with 8 postscript figures. Submitted to Phys
Rev
Kink dynamics in a novel discrete sine-Gordon system
A spatially-discrete sine-Gordon system with some novel features is
described. There is a topological or Bogomol'nyi lower bound on the energy of a
kink, and an explicit static kink which saturates this bound. There is no
Peierls potential barrier, and consequently the motion of a kink is simpler,
especially at low speeds. At higher speeds, it radiates and slows down.Comment: 10 pages, 7 figures, archivin
Scalar--Flat Lorentzian Einstein--Weyl Spaces
We find all three-dimensional Einstein--Weyl spaces with the vanishing scalar
curvatureComment: 4 page
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