Randomised controlled trial of fish oil supplement to treat cancer cachexia

Patients with advanced cancer often suffer from cachexia, a debilitating and complex extreme weight loss syndrome which is also associated with shorter survival times. A pragmatic randomised controlled trial was conducted to determine whether an oral nutritional supplement containing the omega-3 fatty acid eicosapentaenoic acid (EPA) was able to improve quality of life and survival times of patients with advanced solid tumour cancer in a mixed tumour cancer type population

Randomised controlled trial of fish oil supplement to treat cancer cachexia

This is the protocol for a review and there is no abstract. The objectives are as follows: Our overall aim is to provide an overview of interventions for preventing falls in older people by summarising the evidence from multiple Cochrane intervention reviews that evaluate the effects (primarily, rate of falls and number of fallers) of these interventions in different populations of older people, such as those defined by setting or by specific medical conditions. Fall prevention interventions will include those in the following categories: supervised or unsupervised exercises; medication; surgery; management of urinary incontinence; fluid or nutrition therapy; psychological; environment and assistive technologies; social environment; knowledge/education interventions and any other interventions that do not fall into one of these categories (Lamb 2007). Interventions tested may belong to one category ('single' intervention), or more than one category ('multiple' and 'multifactorial' interventions)

Promoting good academic practice through the curriculum and project work

This paper outlines a University wide initiative introduced at City University London, the underlying aim of which is to develop good academic practice skills amongst students and discourage them from undertaking plagiarism or other forms of academic misconduct. The initiative is organised under three projects, which are being undertaken by a set of eight Educational Development Associates (EDAs) - existing academics acting as ‘change agents’ within their Schools. The paper focuses on the first project that EDAs undertook, that being the Learning Activity Project. This involved EDAs working with staff within their Schools to develop new, formative, programme-specific learning activities, to be undertaken by all students in the first term of their studies, and with the aim of providing students with practice in the study skills that they need to demonstrate in subsequent assessments of that programme. After reviewing relevant literature on academic conduct issues, the main body of the paper provides three case studies, each of which details the development of a learning activity in one of the Schools of the University. These learning activities share a common element, in that they are all delivered using a piece of software called OLIVIA. However, for purposes of this paper, each case study details specific aspects of the relevant learning activity, such that readers are provided with a broad perspective of the experiences of implementation of the project through the lenses of different Schools. The last section of the paper details the evaluative mechanism that is being used for the initiative as a whole

General practice performance in referral for suspected cancer: influence of number of cases and case-mix on publicly reported data

Background:Publicly available data show variation in GPs’ use of urgent suspected cancer (USC) referral pathways. We investigated whether this could be due to small numbers of cancer cases and random case-mix, rather than due to true variation in performance. Methods:We analysed individual GP practice USC referral detection rates (proportion of the practice's cancer cases that are detected via USC) and conversion rates (proportion of the practice's USC referrals that prove to be cancer) in routinely collected data from GP practices in all of England (over 4 years) and northeast Scotland (over 7 years). We explored the effect of pooling data. We then modelled the effects of adding random case-mix to practice variation. Results:Correlations between practice detection rate and conversion rate became less positive when data were aggregated over several years. Adding random case-mix to between-practice variation indicated that the median proportion of poorly performing practices correctly identified after 25 cancer cases were examined was 20% (IQR 17 to 24) and after 100 cases was 44% (IQR 40 to 47). Conclusions:Much apparent variation in GPs’ use of suspected cancer referral pathways can be attributed to random case-mix. The methods currently used to assess the quality of GP-suspected cancer referral performance, and to compare individual practices, are misleading. These should no longer be used, and more appropriate and robust methods should be develope

Longitudinal assessment of demographic representativeness in the Medical Imaging and Data Resource Center open data commons

Purpose: The Medical Imaging and Data Resource Center (MIDRC) open data commons was launched to accelerate the development of artificial intelligence (AI) algorithms to help address the COVID-19 pandemic. The purpose of this study was to quantify longitudinal representativeness of the demographic characteristics of the primary MIDRC dataset compared to the United States general population (US Census) and COVID-19 positive case counts from the Centers for Disease Control and Prevention (CDC). Approach: The Jensen-Shannon distance (JSD), a measure of similarity of two distributions, was used to longitudinally measure the representativeness of the distribution of (1) all unique patients in the MIDRC data to the 2020 US Census and (2) all unique COVID-19 positive patients in the MIDRC data to the case counts reported by the CDC. The distributions were evaluated in the demographic categories of age at index, sex, race, ethnicity, and the combination of race and ethnicity. Results: Representativeness of the MIDRC data by ethnicity and the combination of race and ethnicity was impacted by the percentage of CDC case counts for which this was not reported. The distributions by sex and race have retained their level of representativeness over time. Conclusion: The representativeness of the open medical imaging datasets in the curated public data commons at MIDRC has evolved over time as the number of contributing institutions and overall number of subjects have grown. The use of metrics, such as the JSD support measurement of representativeness, is one step needed for fair and generalizable AI algorithm development.</p

Development of a Single Vector System that Enhances Trans-Splicing of SMN2 Transcripts

RNA modalities are developing as a powerful means to re-direct pathogenic pre-mRNA splicing events. Improving the efficiency of these molecules in vivo is critical as they move towards clinical applications. Spinal muscular atrophy (SMA) is caused by loss of SMN1. A nearly identical copy gene called SMN2 produces low levels of functional protein due to alternative splicing. We previously reported a trans-splicing RNA (tsRNA) that re-directed SMN2 splicing. Now we show that reducing the competition between endogenous splices sites enhanced the efficiency of trans-splicing. A single vector system was developed that expressed the SMN tsRNA and a splice-site blocking antisense (ASO-tsRNA). The ASO-tsRNA vector significantly elevated SMN levels in primary SMA patient fibroblasts, within the central nervous system of SMA mice and increased SMN-dependent in vitro snRNP assembly. These results demonstrate that the ASO-tsRNA strategy provides insight into the trans-splicing mechanism and a means of significantly enhancing trans-splicing activity in vivo

Supporting the role of universities in leading individual and societal transformation through education for sustainable development

There is growing recognition of the value of Education for Sustainable Development (ESD) for all learners, and of the unique role that universities play in the transformation of individuals, institutions and societies towards more sustainable futures. Universities engage and even lead in several areas: education, research and community engagement, all of which are essential in this transformation. Further, given their focus and influence, universities are pivotal to action needed to realise the UN Sustainable Development Goals (SDGs) but, to date, UK university integration of ESD and engagement with the SDGs is relatively limited. In recognition that a more urgent and meaningful response is needed to deliver the 2030 targeted socio-economic transformation outlined by the SDGs, the UK ESD Guidance has been comprehensively revised to support universities to deliver education which enables students to acquire sustainability competencies, equipping them to play leadership roles in an increasingly uncertain world. In this case study, we critically analyse the role of universities and explore why ESD needs to be more urgently integrated in teaching and learning. We review the barriers to achieving ESD in UK universities at political and institutional levels. Finally, we explore the policy-practice interface and outline how the new UK ESD Guidance can support universities in leading individual and societal transformation through ESD and act as a stimulus for embedding ESD in university curricula in both UK and international contexts. We conclude that universities have as yet unfulfilled potential to explore and facilitate ESD for sustainability leadership

Randomized controlled trial of live lactobacillus acidophilus plus bifidobacterium bifidum in prophylaxis of diarrhea during radiotherapy in cervical cancer patients

<p>Abstract</p> <p>Background</p> <p>Radiation-induced diarrhea is frequently observed during pelvic radiotherapy. This study was performed to determine the ability of a probiotic containing live lactobacillus acidophilus plus bifidobacterium bifidum to reduce the incidence of radiation-induced diarrhea in locally advanced cervical cancer patients.</p> <p>Methods</p> <p>Patients who were undergoing pelvic radiotherapy concurrent with weekly cisplatin were randomly assigned to a study drug or placebo, in a double-blind study. Diarrhea was graded weekly according the Common Toxicity Criteria (CTC) system. Stool consistency and white and red blood cell count in stool were also assessed. The primary endpoint was to reduce the incidence of diarrhea, defined by a CTC grade 2 or more, and the need for anti-diarrheal medication.</p> <p>Results</p> <p>A total of 63 patients were enrolled. Grade 2 -3 diarrhea was observed in 45% of the placebo group (n = 31) and 9% of the study drug group (n = 32) (p = 0.002). Anti-diarrheal medication use was significantly reduced in the placebo group (p = 0.03). The patients in the study drug group had a significantly improved stool consistency (p < 0.001).</p> <p>Conclusions</p> <p>Live lactobacillus acidophilus plus bifidobacterium bifidum reduced the incidence of radiation-induced diarrhea and the need for anti-diarrheal medication and had a significant benefits on stool consistency.</p

The National Awareness and Early Diagnosis Initiative in England: assembling the evidence

A National Awareness and Early Diagnosis Initiative (NAEDI) has been established in England as part of the Government's strategy to improve cancer outcomes. One of the early priorities for this initiative has been to assemble the diverse evidence linking late diagnosis with poor survival and avoidable deaths. This supplement brings together new perspectives on existing research in this area together with findings from recently commissioned research. This paper describes a provisional model, the ‘NAEDI pathway', for testing hypotheses relating to late diagnosis and its impact. Key findings from other papers in this supplement are also highlighted