Abiraterone in metastatic prostate cancer without previous chemotherapy

Background: Abiraterone acetate, an androgen biosynthesis inhibitor, improves overall survival in patients with metastatic castration-resistant prostate cancer after chemotherapy. We evaluated this agent in patients who had not received previous chemotherapy. Methods: In this double-blind study, we randomly assigned 1088 patients to receive abiraterone acetate (1000 mg) plus prednisone (5 mg twice daily) or placebo plus prednisone. The coprimary end points were radiographic progression-free survival and overall survival. Results: The study was unblinded after a planned interim analysis that was performed after 43% of the expected deaths had occurred. The median radiographic progressionfree survival was 16.5 months with abiraterone - prednisone and 8.3 months with prednisone alone (hazard ratio for abiraterone - prednisone vs. prednisone alone, 0.53; 95% confidence interval [CI], 0.45 to 0.62; P<0.001). Over a median follow-up period of 22.2 months, overall survival was improved with abiraterone - prednisone (median not reached, vs. 27.2 months for prednisone alone; hazard ratio, 0.75; 95% CI, 0.61 to 0.93; P = 0.01) but did not cross the efficacy boundary. Abiraterone - prednisone showed superiority over prednisone alone with respect to time to initiation of cytotoxic chemotherapy, opiate use for cancer-related pain, prostate-specific antigen progression, and decline in performance status. Grade 3 or 4 mineralocorticoid-related adverse events and abnormalities on liver-function testing were more common with abiraterone-prednisone. Conclusions: Abiraterone improved radiographic progression-free survival, showed a trend toward improved overall survival, and significantly delayed clinical decline and initiation of chemotherapy in patients with metastatic castration-resistant prostate cancer

Living for the Global City: Mobile Kits, Urban Interfaces, and Ubicomp

Abstract. Using ethnographic methods, 28 young professionals across the global cities of London, Los Angeles, and Tokyo were studied to understand in some detail what items they carried with them (their mobile kits) and how they used these items to access people, places, and services (through various urban interfaces). The findings are analyzed in terms of these cities as existing sites of ubiquitous information and communication technology (ICT) use. More specifically, findings are considered with respect to the prospects in these cities for ubicomp as a paradigm of trusted, environmentally embedded computing, as opposed to a wearable computing paradigm of individual self-sufficiency. Overall, at least for the young professional class studied, practices of urban interfacing were remarkably similar across all three cities studied, suggesting that ubicomp systems might be developed to address the range of urban concerns and to unburden and empower urbanites.

Instrumenting the city: developing methods for observing and understanding the digital cityscape

Abstract. We approach the design of ubiquitous computing systems in the urban environment as integral to urban design. To understand the city as a system encompassing physical and digital forms and their relationships with people’s behaviours, we are developing, applying and refining methods of observing, recording, modelling and analysing the city, physically, digitally and socially. We draw on established methods used in the space syntax approach to urban design. Here we describe how we have combined scanning for discoverable Bluetooth devices with two such methods, gatecounts and static snapshots. We report our experiences in developing, field testing and refining these augmented methods. We present initial findings on the Bluetooth landscape in a city in terms of patterns of Bluetooth presence and Bluetooth naming practices.