Patients' preferences for subcutaneous trastuzumab versus conventional intravenous infusion for the adjuvant treatment of HER2-positive early breast cancer: final analysis of 488 patients in the international, randomized, two-cohort PrefHer study

PrefHer revealed compelling and consistent patient preference for subcutaneous (s.c.) trastuzumab, regardless of delivery by single-use injection device or hand-held syringe. s.c. trastuzumab was well-tolerated and safety data, including immunogenicity, were consistent with previous reports. No new safety signals were identified compared with the known intravenous trastuzumab profile in early breast cance

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Health and Performances Machine Tool Monitoring Architecture

In order to face the high market competiveness, the Power-OMproject (http://power-om.eu/) aims at implementing a proactiveapproach for improving the machine tool performances. Forimplementing a proactive approach that helps monitoring machinetool performances, this paper presents a technical architecturewith two levels: the local and the remote one. In the local level,condition based maintenance strategy is implemented and realtime data is used for monitoring the local health of a machine. Afirst originality is to use the current analysis for assessing thehealth status of the machine. In the remote level, offline data isstored in an eMaintenance platform, which allows providing afleet dimension. This dimension allows to benefit of more dataand information allowing to make performances comparisonacross the fleet and along the time.This paper presents the advantages of the added-valuearchitecture. On one hand, there is the possibility to trackperformances to detect drifts locally and real-time based on thecurrent analysis, and on the other hand, to follow-up short andmid-term performances for deeper analysis of the fleetperformances in order to bring relevant information for decisionmakers.Godkänd; 2014; 20140619 (andbra

Magnetoencephalography With Optically Pumped He-4 Magnetometers at Ambient Temperature

WOS:000455110500009International audienceIn this paper, we present the first proof of concept confirming the possibility to record magnetoencephalographic (MEG) signals with Optically Pumped Magnetometers (OPMs) based on the parametric resonance of 4 He atoms. The main advantage of this kind of OPM is the possibility to provide a tri-axis vector measurement of the magnetic field at room-temperature (the 4 He vapor is neither cooled nor heated). The sensor achieves a sensitivity of 210 fT/√Hz in the bandwidth [2 Hz-300 Hz]. MEG simulation studies with a brain phantom were cross-validated with real MEG measurements on a healthy subject. For both studies, MEG signal was recorded consecutively with OPMs and Superconducting Quantum Interference Devices (SQUIDs) used as reference sensors. For healthy subject MEG recordings, three MEG proofs of concept were carried out: auditory and visual evoked fields (AEF, VEF), and spontaneous activity. M100 peaks have been detected on evoked responses recorded by both OPMs and SQUIDs with no significant difference in latency. Concerning spontaneous activity, an attenuation of the signal power between 8-12 Hz (alpha band) related to eyes opening has been observed with OPM similarly to SQUID. All these results confirm that the room temperature vector 4 He OPMs can record MEG signals and provide reliable information on brain activity. Index Terms-Optically pumped magnetometer, Helium 4, room temperature, vector measurement, magnetoencephalography, auditory evoked field, visual evoked field, spontaneous activity

Modelling climate change adaptation in European agriculture: challenges and priorities

Climate change presents major challenges for European agriculture, and the speed, nature and extent of the responses to such challenges will have far-reaching social, economic and environmental consequences. Agricultural modelling has an important role in helping decision makers better understand the costs and benefits of different adaptation strategies, as well as trade-offs and win-wins between those strategies, mitigation measures and other economic, social and environmental goals. Incorporating adaptation strategies into biophysical, bio-economic and economic model is essential to gaining a more holistic understanding of their impacts, beyond the context of specific changes and purposes. Here, the ability and potential of agricultural models to characterise different adaptation strategies was explored, using the expertise represented within the Modelling European Agriculture with Climate Change for Food Security (MACSUR) project. In two workshops, modellers identified adaptation strategies, modelling challenges and knowledge gaps. A survey was conducted to understand current modelling capacity. Challenges centred on knowledge gaps, data availability, technical issues, and stakeholder interaction (e.g. communication with, relevance for). For operational and tactical strategies (changes in practice in response to daily, monthly, or seasonal variation in conditions) most challenges were technical, relating to limitations in the processes and mechanisms represented in models. For longer term strategic climate change adaptation, uncertainty about future socio-economic context (e.g. prices and regulation) and the impact of new adaptation options (e.g. appearance of new technologies) were highlighted. Progressively novel and far-reaching strategies increasingly challenge the scope of existing models. Whilst models vary in capacity, most modellers reported a potential to better characterise adaptation. However, costs (e.g. trade-offs with processing speed) and the fact that adaptation lies beyond the initial remit of many models mean that strategic prioritisation of adaptation as a focus for modelling is key to facilitating model development to support effective stakeholder choices