Parallel multicentre randomised trial of a clinical trial question prompt list in patients considering participation in phase 3 cancer treatment trials

Accepted 9 February 2017Objective: To evaluate the effect of a clinical trial question prompt list in patients considering enrolment in cancer treatment trials. Setting: Tertiary cancer referral hospitals in three state capital cities in Australia. Participants: 88 patients with cancer attending three cancer centres in Australia, who were considering enrolment in phase 3 treatment trials, were invited to enrol in an unblinded randomised trial of provision of a clinical trial question prompt list (QPL) before consenting to enrol in the treatment trial. Interventions: We developed and pilot tested a targeted QPL for patients with cancer considering clinical trial participation (the clinical trial QPL). Consenting patients were randomised to receive the clinical trial QPL or not before further discussion with their oncologist and/or trial nurse about the treatment trial. Primary and secondary outcomes: Questionnaires were completed at baseline and within 3â €..weeks of deciding on treatment trial participation. Main outcome measure: scores on the Quality of Informed Consent questionnaire (QuIC). Results: 88 patients of 130 sought for the study were enrolled (43 males), and 45 received the clinical trial QPL. 49% of trials were chemotherapy interventions for patients with advanced disease, 35% and 16% were surgical adjuvant and radiation adjuvant trials respectively. 70 patients completed all relevant questionnaires. 28 of 43 patients in the control arm compared with 39 of 45 patients receiving the clinical trial QPL completed the QuIC (p=0.0124). There were no significant differences in the QuIC scores between the randomised groups (QuIC part A p=0.08 and QuIC part B p=0.92). There were no differences in patient satisfaction with decisions or in anxiety levels between the randomised groups. Conclusions: Use of a question prompt list did not significantly change the QuIC scores in this randomised trial. ANZCTR 12606000214538 prospectively registered 31/5/2006. Trial registration number: Results, ACTRN12606000214538.Martin H N Tattersall, Michael Jefford, Andrew Martin, Ian Olver, John F Thompson, Richard F Brown, Phyllis N Buto

Quantification of single use plastics waste generated in clinical dental practice and hospital settings

Objectives To quantify (by number and mass) single use plastic waste generated from the provision of oral healthcare in primary and secondary care clinical dental settings in the UK. Methods An observational study of four dental practices and the clinics of a UK undergraduate dental teaching hospital was conducted. A range of routine common procedures were observed by trained and calibrated observers; these were: Examinations, endodontics, periodontics, direct placement restorations, fixed and removable prosthodontics and oral surgery. The PPE items used before and during the COVID-19 pandemic were also included. Results Routine ‘surgery set up’ generic items present a significant proportion of SUP plastic waste as these are used in every instance of patient treatment. An average of twenty-one (n=21) SUP plastic waste items are used for every procedure with a mean mass of 354g per procedure (including set up and clean up). The use of PPE increased from 14 items (pre-COVID -19) to 19 items during the pandemic. SUP items are constructed from a single plastic or from multiple plastics forming compound structures (heteropolymers); with an approximate 50:50 distribution. Conclusions The dental profession, at the point of care, uses a high volume of single use plastic that becomes clinical waste. The use of personal protective equipment (PPE) significantly increased during the COVID 19 pandemic and this accounts for the single greatest contribution of single use plastic, as this is used for every clinical procedure. Clinical Significance Manufacturers, distributors and oral healthcare providers have an opportunity to consider and implement approaches that include effective waste management with reduction, recovery and recycling at its core, towards transforming oral healthcare to a circular plastics economy

Nontuberculous Mycobacteria in Respiratory Tract Infections, Eastern Asia

To characterize the distribution of nontuberculous mycobacteria (NTM) species isolated from pulmonary samples from persons in Asia and their association with pulmonary infections, we reviewed the literature. Mycobacterium avium complex bacteria were most frequently isolated (13%–81%) and were the most common cause of pulmonary NTM disease (43%–81%). Also pathogenic were rapidly growing mycobacteria (M. chelonae, M. fortuitum, M. abscessus). Among all NTM isolated from pulmonary samples, 31% (582/1,744) were considered clinically relevant according to American Thoracic Society diagnostic criteria. Most patients were male (79%) and had a history of tuberculosis (37%). In Asia, high prevalence of rapidly growing mycobacteria and a history of tuberculosis are distinct characteristics of pulmonary NTM disease. This geographic variation is not well reflected in the American Thoracic Society criteria for NTM infections and could be incorporated in future guidelines

Inhomogeneous Magnetism in La-doped CaMnO3. (II) Mesoscopic Phase Separation due to Lattice-coupled FM Interactions

A detailed investigation of mesoscopic magnetic and crystallographic phase separation in Ca(1-x)La(x)MnO3, 0.00<=x<=0.20, is reported. Neutron powder diffraction and DC-magnetization techniques have been used to isolate the different roles played by electrons doped into the eg level as a function of their concentration x. The presence of multiple low-temperature magnetic and crystallographic phases within individual polycrystalline samples is argued to be an intrinsic feature of the system that follows from the shifting balance between competing FM and AFM interactions as a function of temperature. FM double-exchange interactions associated with doped eg electrons are favored over competing AFM interactions at higher temperatures, and couple more strongly with the lattice via orbital polarization. These FM interactions thereby play a privileged role, even at low eg electron concentrations, by virtue of structural modifications induced above the AFM transition temperatures.Comment: 8 pages, 7 figure

Heat Conduction and Magnetic Phase Behavior in Electron-Doped Ca_{1-x} La_x MnO_3(0 <= x <= 0.2)

Measurements of thermal conductivity (kappa) vs temperature are reported for a series of Ca_{1-x} La_x MnO_3(0 <= x <= 0.2) specimens. For the undoped (x=0), G-type antiferromagnetic compound a large enhancement of kappa below the Neel temperature (T_N ~ 125 K) indicates a strong coupling of heat-carrying phonons to the spin system. This enhancement exhibits a nonmonotonic behavior with increasing x and correlates remarkably well with the small ferromagnetic component of the magnetization reported previously [Neumeier and Cohn, Phys. Rev. B 61 14319 (2000).] Magnetoelastic polaron formation appears to underly the behavior of kappa and the magnetization at x <= 0.02.Comment: submitted to PRB; 4 pp., 4 Fig.'s, RevTex

Clinical Relevance of Nontuberculous Mycobacteria, Oman

Little is known about the clinical relevance of nontuberculous mycobacteria (NTM) in the Arabian Peninsula. We assessed the prevalence and studied a random sample of isolates at a reference laboratory in Muscat, Oman. NTM cause disease in this region, and their prevalence has increased

An efficient algorithm to calculate intrinsic thermoelectric parameters based on Landauer approach

The Landauer approach provides a conceptually simple way to calculate the intrinsic thermoelectric (TE) parameters of materials from the ballistic to the diffusive transport regime. This method relies on the calculation of the number of propagating modes and the scattering rate for each mode. The modes are calculated from the energy dispersion (E(k)) of the materials which require heavy computation and often supply energy relation on sparse momentum (k) grids. Here an efficient method to calculate the distribution of modes (DOM) from a given E(k) relationship is presented. The main features of this algorithm are, (i) its ability to work on sparse dispersion data, and (ii) creation of an energy grid for the DOM that is almost independent of the dispersion data therefore allowing for efficient and fast calculation of TE parameters. The inclusion of scattering effects is also straight forward. The effect of k-grid sparsity on the compute time for DOM and on the sensitivity of the calculated TE results are provided. The algorithm calculates the TE parameters within 5% accuracy when the K-grid sparsity is increased up to 60% for all the dimensions (3D, 2D and 1D). The time taken for the DOM calculation is strongly influenced by the transverse K density (K perpendicular to transport direction) but is almost independent of the transport K density (along the transport direction). The DOM and TE results from the algorithm are bench-marked with, (i) analytical calculations for parabolic bands, and (ii) realistic electronic and phonon results for $Bi_{2}Te_{3}$.Comment: 16 Figures, 3 Tables, submitted to Journal of Computational electronic

Constraining the SU(2)RSU(2)_R breaking scale in naturally R-parity conserving supersymmetric models

We obtain a relation between right-handed gauge boson mass and soft squark mass in naturally R-parity conserving general supersymmetric left-right models. This relation implies that either ${W_R}$ is lighter than twice the soft squark mass, or a ratio of vacuum expectation values (VEVs) in the model, denoted by $\tan\alpha$, is close to its value of unity in the limit of vanishing D-terms. Generally, we find that for heavy $W_R$ $\tan\alpha$ is larger than one, and that the right-handed sneutrino VEV, responsible for spontaneous R-parity breaking, is at most of the order $M_{SUSY}/h_{\Delta_R}$, where $M_{SUSY}$ is supersymmetry breaking scale and $h_{\Delta_R}$ is the Yukawa coupling in Majorana mass term for right-handed neutrinos. These constraints follow from $SU(3)_c$ and $U(1)_{em}$ gauge invariance of the ground state of the theory.Comment: 10 pages, LaTeX, no figures. Version to appear in Phys.Lett.

Determining the Drift Time of Charge Carriers in P-Type Point-Contact HPGe Detectors

An algorithm to measure the drift time of charge carriers in p-type point contact (PPC) high-purity germanium (HPGe) detectors from the signals processed with a charge-sensitive preamplifier is introduced. It is demonstrated that the drift times can be used to estimate the distance of charge depositions from the point contact and to characterize losses due to charge trapping. A correction for charge trapping effects over a wide range of energies is implemented using the measured drift times and is shown to improve the energy resolution by up to 30%.Comment: 16 pages, 8 figures, submitted to Nucl. Instrum. Meth.