Stepping Stones to Information Literacy: a PebblePad case study

Aston University has recently made PebblePad, an e-portfolio or personal learning system, available to all students within the University. The customisable Profiles within PebblePad allow students to self-declare their skills in particular areas, attaching evidence of their skills or an action plan for improvement to each statement. Formal Information Literacy (IL) teaching within Aston University is currently limited to Library & Information Services (LIS) Information Specialists delivering a maximum of one session to each student during each level of their degree. However, many of the skills are continually developed by students during the course of their academic studies. For this project, an IL skills profile was created within PebblePad, which was then promoted to groups of staff and students to complete during the academic session 2009-10. Functionality within PebblePad allowed students to share their IL skills profile, evidence, action plans or any other items they felt were appropriate with an LIS Information Specialist who was able to add comments and offer suggestions for activities to help the student to develop further. Activities were closely related to students’ coursework where possible: suggesting a student kept a short reflective log of their information searching and evaluating process for an upcoming essay, for example. Feedback on the usefulness of the IL Profile will be sought from students through focus groups and the communication tools in PebblePad. In this way, we hope to make students more aware of their IL skills and to offer IL skills support over a longer period of time than a single session can provide. We will present preliminary conclusions about the practicalities and benefits of a self-declaration approach to developing IL skills in students at Aston University

A Statistical Analysis of the Solar Phenomena Associated with Global EUV Waves

Solar eruptions are the most spectacular events in our solar system and are associated with many different signatures of energy release including solar flares, coronal mass ejections, global waves, radio emission and accelerated particles. Here, we apply the Coronal Pulse Identification and Tracking Algorithm (CorPITA) to the high cadence synoptic data provided by the Solar Dynamic Observatory (SDO) to identify and track global waves observed by SDO. 164 of the 362 solar flare events studied (45%) are found to have associated global waves with no waves found for the remaining 198 (55%). A clear linear relationship was found between the median initial velocity and the acceleration of the waves, with faster waves exhibiting a stronger deceleration (consistent with previous results). No clear relationship was found between global waves and type II radio bursts, electrons or protons detected in-situ near Earth. While no relationship was found between the wave properties and the associated flare size (with waves produced by flares from B to X-class), more than a quarter of the active regions studied were found to produce more than one wave event. These results suggest that the presence of a global wave in a solar eruption is most likely determined by the structure and connectivity of the erupting active region and the surrounding quiet solar corona rather than by the amount of free energy available within the active region.Comment: 33 pages, 6 figures, 1 table. Accepted for publication in Solar Physic

A nitrocarburising and low-temperature chromising duplex surface treatment

A duplex surface treatment has been developed involving the pre-treatment of hardened and tempered AISI H13 chromium hot-work tool steel by a ferritic nitrocarburising process, and a subsequent treatment of the nitrocarburised surface by a low-temperature chromium thermo-reactive deposition process.&nbsp; The process formed a thin and hard chromium carbonitride surface layer above a hardened diffusion zone, and the low processing temperature allowed the properties of the core material to be retained. It is expected this surface treatment will find application in the treatment&nbsp; of tooling used for aluminium forming operations. <br /

Patients’ informational needs while undergoing brachytherapy for cervical cancer

Published ArticleTo identify informational needs of South African women receiving intracavitary brachytherapy for locally advanced cervical cancer as part of a process to develop guidelines for quality patient-centred care. Design: A prospective, qualitative study with a phenomenological approach. Setting: Brachytherapy Unit, Department Oncology, Universitas Hospital, Bloemfontein, South Africa. Participants: Purposive sampling was utilized to recruit patients undergoing brachytherapy for cervical cancer from July to December 2012. Main Outcome Measures: Semi-structured, one-to-one interviews were conducted, guided by a theme list. Audio-recorded interviews were conducted in Sesotho, Afrikaans and English by an unaffiliated, multilingual interviewer. The interviews were transcribed, translated and thematic analysis performed. Results: Data saturation was achieved having interviewed 28 participants, aged 30–73 years. Four themes with sub-themes were identified: (i) informational needs, (ii) patient disposition towards treatment, (iii) psychological experience and (iv) physical experience. Findings on patients’ informational needs were the overarching theme and form the focus of this article. These informational needs included: providing patients with disease- and treatment-related information in their home language; adequate information concerning possible side-effects, sexual intercourse and pre-treatment preparation; and providing patients with informative material as standard procedure. Conclusion: The article has identified women’s informational needs providing a focus for patientcentred care. Providing patients with sufficient and understandable information could lessen feelings of fear and anxiety towards treatment delivery. Guidelines with a patient-centred approach could thus be developed to be used as a tool to assist members of multidisciplinary teams in providing quality care to this group of women

Interleukin-6 blockade for prophylaxis and management of immune-related adverse events in cancer immunotherapy

Background Immune checkpoint inhibitors (ICIs) have activity across many tumor types, but activation of the immune system may also lead to significant, often steroid-refractory immune-related adverse events (irAEs). We sought to determine the activity of tocilizumab, an anti-interleukin-6 receptor monoclonal antibody, in treatment or prevention of auto-immune irAE in ICI-treated patients. Methods Institutional databases from 2 melanoma centers were reviewed for patients treated with ICIs and tocilizumab. Longitudinal assessment of C-reactive protein (CRP) and assessment of clinical improvement or prevention of flare of pre-existing auto-immune conditions were utilised to evaluate the benefit of tocilizumab. Results Twenty-two patients were identified. Two were treated prophylactically. Twenty were treated for management of irAEs. Median time to irAE onset from ICI start was 48 days (range 8–786) and from irAE onset to tocilizumab 32 days (range 1–192). Median time to irAE resolution from tocilizumab was 6.5 days (range 1–93). Clinical improvement/benefit was demonstrated in 21/22 patients. Median CRP prior to ICI administration was 32 mg/l (range 0.3–99), at the onset of irAE 49.5 mg/L (range 0.3–251, P = 0.047) and after tocilizumab 18 mg/L (range 0.3–18, P = 0.0011). Tocilizumab was well tolerated with self-limiting and transient toxicities in 11 (50%) patients. From start of ICI, median progression-free survival was 6 months (range 3.9–18.8) and median overall survival was not reached. Conclusions Tocilizumab was a well-tolerated and effective steroid-sparing treatment for both management of irAEs, as well as prevention of flare of pre-existing auto-immune disorders. Prospective trials to evaluate its efficacy and impact on cancer outcomes compared with standard strategies are required

Randomized, Double-Blind, Placebo-Controlled, Global Phase III Trial of Talimogene Laherparepvec Combined With Pembrolizumab for Advanced Melanoma

Purpose: The combination of talimogene laherparepvec (T-VEC) and pembrolizumab previously demonstrated an acceptable safety profile and an encouraging complete response rate (CRR) in patients with advanced melanoma in a phase Ib study. We report the efficacy and safety from a phase III, randomized, double-blind, multicenter, international study of T-VEC plus pembrolizumab (T-VEC-pembrolizumab) versus placebo plus pembrolizumab (placebo-pembrolizumab) in patients with advanced melanoma. Methods: Patients with stage IIIB-IVM1c unresectable melanoma, naïve to antiprogrammed cell death protein-1, were randomly assigned 1:1 to T-VEC-pembrolizumab or placebo-pembrolizumab. T-VEC was administered at ≤ 4 × 106 plaque-forming unit (PFU) followed by ≤ 4 × 108 PFU 3 weeks later and once every 2 weeks until dose 5 and once every 3 weeks thereafter. Pembrolizumab was administered intravenously 200 mg once every 3 weeks. The dual primary end points were progression-free survival (PFS) per modified RECIST 1.1 by blinded independent central review and overall survival (OS). Secondary end points included objective response rate per mRECIST, CRR, and safety. Here, we report the primary analysis for PFS, the second preplanned interim analysis for OS, and the final analysis. Results: Overall, 692 patients were randomly assigned (346 T-VEC-pembrolizumab and 346 placebo-pembrolizumab). T-VEC-pembrolizumab did not significantly improve PFS (hazard ratio, 0.86; 95% CI, 0.71 to 1.04; P = .13) or OS (hazard ratio, 0.96; 95% CI, 0.76 to 1.22; P = .74) compared with placebo-pembrolizumab. The objective response rate was 48.6% for T-VEC-pembrolizumab (CRR 17.9%) and 41.3% for placebo-pembrolizumab (CRR 11.6%); the durable response rate was 42.2% and 34.1% for the arms, respectively. Grade ≥ 3 treatment-related adverse events occurred in 20.7% of patients in the T-VEC-pembrolizumab arm and in 19.5% of patients in the placebo-pembrolizumab arm. Conclusion: T-VEC-pembrolizumab did not significantly improve PFS or OS compared with placebo-pembrolizumab. Safety results of the T-VEC-pembrolizumab combination were consistent with the safety profiles of each agent alone

Mark Garry : a New Quiet

A survey of ten years practice

Bempegaldesleukin Plus Nivolumab in Untreated Advanced Melanoma: The Open-Label, Phase III PIVOT IO 001 Trial Results

Nivolumab; Advanced melanomaNivolumab; Melanoma avanzadoNivolumab; Melanoma avançatPURPOSE Despite marked advances in the treatment of unresectable or metastatic melanoma, the need for novel therapies remains. Bempegaldesleukin (BEMPEG), a pegylated interleukin-2 (IL-2) cytokine prodrug, demonstrated efficacy in the phase II PIVOT-02 trial. PIVOT IO 001 (ClinicalTrials.gov identifier: NCT03635983) is a phase III, randomized, open-label study that builds on the PIVOT-02 results in first-line melanoma. METHODS Patients with previously untreated, unresectable, or metastatic melanoma were randomly assigned 1:1 to receive BEMPEG plus nivolumab (NIVO) or NIVO monotherapy. Primary end points were objective response rate (ORR) and progression-free survival (PFS) by blinded independent central review and overall survival (OS). Secondary and exploratory end points included additional efficacy measures, safety, and pharmacokinetics (PKs) and pharmacodynamics analyses. RESULTS In 783 patients (n = 391, BEMPEG plus NIVO; n = 392, NIVO monotherapy), the median follow-up was 11.6 months in the intent-to-treat population. The ORR with BEMPEG plus NIVO was 27.7% versus 36.0% with NIVO (two-sided P = .0311). The median PFS with BEMPEG plus NIVO was 4.17 months (95% CI, 3.52 to 5.55) versus 4.99 months (95% CI, 4.14 to 7.82) with NIVO (hazard ratio [HR], 1.09; 97% CI, 0.88 to 1.35; P = .3988). The median OS was 29.67 months (95% CI, 22.14 to not reached [NR]) with BEMPEG plus NIVO versus 28.88 months (95% CI, 21.32 to NR) with NIVO (HR, 0.94; 99.929% CI, 0.59 to 1.48; P = .6361). Grade 3-4 treatment-related adverse events (AEs) and serious AE rates were higher with the combination (21.7% and 10.1%, respectively) versus NIVO (11.5% and 5.5%, respectively). BEMPEG PK exposure and absolute lymphocyte count changes after BEMPEG plus NIVO were comparable between PIVOT IO 001 and PIVOT-02. CONCLUSION The PIVOT IO 001 study did not meet its primary end points of ORR, PFS, and OS. Increased toxicity was observed with BEMPEG plus NIVO versus NIVO