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Background: The EORTC QLQ-STO22 (QLQ-STO22) is a firmly established and validated measure of health-related quality of life (HRQoL) for people with gastric cancer (GC), developed over two decades ago. Since then there have been dramatic changes in treatment options for GC. Also, East Asian patients were not involved in the development of QLQ-STO22, where GC is most prevalent and the QLQ-STO22 is widely used. A review with appropriate updating of the measure was planned. This study aims to capture HRQoL issues associated with new treatments and the perspectives of patients and health care professionals (HCPs) from different cultural backgrounds, including East Asia. Methods: A systematic literature review and open-ended interviews were preformed to identify potential new HRQoL issues relating to GC. This was followed by structured interviews where HCPs and patients reviewed the QLQ-STO22 alongside new issues regarding relevance, importance, and acceptability. Results: The review of 267 publications and interviews with 104 patients and 18 HCPs (48 and 9 from East Asia, respectively) generated a list of 58 new issues. Three of these relating to eating small amounts, flatulence, and neuropathy were recommended for inclusion in an updated version of the QLQ-STO22 and covered by five additional questions. Conclusions: This study supports the content validity of the QLQ-STO22, suggesting its continued relevance to patients with GC, including those from East Asia. The updated version with additional questions and linguistic changes will enhance its specificity, but further testing is required. [ABSTRACT FROM AUTHOR]

Objectives: Poor adherence to immunosuppressive treatment is common in patients with systemic lupus erythematosus and may identify those with lupus nephritis (LN) who have a poorer prognosis. Non-adherence has also been reported to be a potential adverse outcome predictor in renal transplantation (rTp). We investigated whether non-adherence is associated with increased rTp graft rejection and/or failure in patients with LN. Methods: Patients with LN undergoing rTp in two major London hospitals were retrospectively included. Medical and electronic records were reviewed for documented concerns of non-adherence as well as laboratory biochemical drug levels. The role of non-adherence and other potential predictors of graft rejection/failure including demographics, comorbidities, age at systemic lupus erythematosus and LN diagnosis, type of LN, time on dialysis prior to rTp and medication use were investigated using logistic regression. Results: Out of 361 patients with LN, 40 had rTp. During a median follow-up of 8.7 years, 17/40 (42.5%) of these patients had evidence of non-adherence. A total of 12 (30.0%) patients experienced graft rejection or failure or both. In the adherent group 2/23 (8.7%) had graft rejection, whilst in the non-adherent this rose to 5/17 (29.4%, p = 0.11). Graft failure was seen in 5/23 (21.7%) patients from the adherent group and 4/17 (23.5%) in the non-adherent group (p = 0.89). Non-adherent patients had a trend towards increased graft rejection, hazard ratio 4.38, 95% confidence interval = 0.73–26.12, p = 0.11. Patients who spent more time on dialysis prior to rTp were more likely to be adherent to medication, p = 0.01. Conclusion: Poor adherence to immunosuppressive therapy is common and has been shown to associate with a trend towards increased graft failure in patients with LN requiring rTp. This is the first paper to report that shorter periods on dialysis prior to transplantation might lead to increased non-adherence in lupus patients. [ABSTRACT FROM AUTHOR]

Abstract: Radiological and nuclear medicine imaging modalities used for assessing bone metastases treatment response include plain and digitalised radiography (XR), skeletal scintigraphy (SS), dual-energy X-ray absorptiometry (DEXA), computed tomography (CT), magnetic resonance imaging (MRI), [18F] fluorodeoxyglucose positron emission tomography (FDG-PET) and PET/CT. Here we discuss the advantages and disadvantages of these assessment modalities as evident through different clinical trials. Additionally, we present the more established response criteria of the International Union Against Cancer and the World Health Organization and compare them with newer MD Anderson criteria. Even though serial XR and SS have been used to assess the therapeutic response for decades, several months are required before changes are evident. Newer techniques, such as MRI or PET, may allow an earlier evaluation of response that may be quantified through monitoring changes in signal intensity and standard uptake value, respectively. Moreover, the application of PET/CT, which can follow both morphological and metabolic changes, has yielded interesting and promising results that give a new insight into the natural history of metastatic bone disease. However, only a few studies have investigated the application of these newer techniques and further clinical trials are needed to corroborate their promising results and establish the most suitable imaging parameters and evaluation time points. Last, but not least, there is an absolute need to adopt uniform response criteria for bone metastases through an international consensus in order to better assess treatment response in terms of accuracy and objectivity. [Copyright &y& Elsevier]

A letter to the editor is presented in response to the article "tumor response interpretation with new tumor response criteria vs the World Health Organization criteria in patients with bone-only metastatic breast cancer," by Hamaoka and colleagues in the 2010 issue.

Discusses change in methodology used by medical students with the help of a parable. Use of handwritten books by students in the past to learn medicine; Technologies available to students; Benefits of internet to the students.

Advancements in the field of wireless and mobile communication motivate academia, industry, and standardisation organisations to explore new technologies to improve overall efficiency, spectrum utilisation, power consumption, and security. One of the most essential technologies proposed for short-range communications, which will play a key role in 5G wireless networks, is device-to-device (D2D) communications. D2D communication enables direct communication between two devices when they are in close proximity without requiring the help of a fixed infrastructure like base stations. Despite the significant benefits provided by D2D communications, this new networking communication paradigm introduces unique security threats to D2D services that should be solved in order to limit any malicious attacks. Towards this end, in this paper, we focus on secure D2D communications and propose a protocol for establishing secure D2D communication using elliptic curve cryptography. The protocol utilises: (i) specific Mobile Identifiers acquired from the hardware of the mobile phone (i.e. IMEI) and the SIM card (i.e. IMSI, MSISDN) provided by the mobile operator and (ii) the SIM storage for saving private keys or signature data. The proposed security protocol is verified and validated with the help of the Scyther tool, and the performance is evaluated in terms of resiliency analysis. [ABSTRACT FROM AUTHOR]

Cyprus’ building stock energy saving potential is considerably high due to the absence of legislation and regulations governing the energy performance of buildings, prior to the country's accession to the European Union. In this study, a methodology is proposed and applied to a typical residential building to assess the financial attractiveness of alternative retrofit scenarios. An advanced simulation software tool is utilised to measure the energy performance of a typical residential building in terms of envelope characteristics, construction materials and Heating, Ventilation and Air Conditioning system. The thermal model is used to assess the impact of alternative retrofitting scenarios. Then, an economic model is developed to evaluate the financial impact over the investment horizon. Finally, a risk analysis is conducted to investigate the stochastic behaviour of key input variables. [ABSTRACT FROM AUTHOR]

Objective: To measure aortic stiffness and global left ventricular (LV) function in patients with ankylosing spondylitis (AS) and no clinical evidence of heart disease. Methods: Fifty-seven consecutive patients with AS (54 males, three females, mean age 41.78±10.02 years) without clinical evidence of cardiac involvement and 78 healthy subjects (73 males, five females, mean age 39.92±9.11 years) underwent complete echocardiographic study. Aortic stiffness was determined non-invasively by aortic distensibility (AoD) and the global LV function was evaluated by the myocardial performance index (the Tei index). Results: AoD in patients with AS [(2.21±0.24)×10-6 cm2 dyn-1] was decreased compared to controls [(2.58±0.19) )×10-6 cm2 dyn-1, p<0.01], confirming that aortic stiffness is increased in AS. The LV Tei index was significantly increased in the patient group compared to the control group (0.392±0.031 vs. 0.370±0.034, p<0.01). The ejection fraction (EF) did not differ between the two groups (p>0.05). In multivariate linear regression analysis, AoD was significantly associated with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and LV isovolumic relaxation time (IVRT) whereas the LV Tei index was associated with BASDAI and the LV mass index. Conclusions: Patients with AS and no clinical evidence of cardiac disease have increased stiffness of the aorta and decreased global myocardial performance and both of these abnormal measurements correlate with disease activity. The abnormal Tei index may reflect an early manifestation of cardiac dysfunction in these patients. [ABSTRACT FROM AUTHOR]

Advances in cancer care delivery require revision and further development of questionnaires assessing patients’ perceived quality of care. This study pre‐tested the revised EORTC satisfaction with cancer care core questionnaire applicable in both the cancer inpatient and outpatient settings, and its new, outpatient‐specific complementary module. The process of revision, development of the extended application, and pre‐testing of these questionnaires was based on phases I to III of the “EORTC Quality of Life Group Module Development Guidelines.” In phase III, patients in 11 countries in four European regions, South America and Asia completed provisional versions of the questionnaires. Fifty‐seven relevant issues selected from literature reviews and input from experts were operationalized into provisional items, and subsequently translated into ten languages. Assessment of understanding, acceptability, redundancy and relevance by patients (n = 151) from oncology inpatient wards, and outpatient chemotherapy, radiotherapy and consultation settings, led to retention of, deletion of and merging of 40, 14 and 6 items respectively. Cronbach's alpha coefficients for hypothesized questionnaire scales were above 0.80. Our results provide preliminary support for the 33‐item EORTC Satisfaction with cancer care core questionnaire and the 7‐item complementary module specific for the outpatient care setting. A large scale phase IV cross‐cultural psychometric study is now underway. [ABSTRACT FROM AUTHOR]

Background:Older people represent the majority of cancer patients but their specific needs are often ignored in the development of health-related quality of life (HRQOL) instruments. The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-ELD15 was developed to supplement the EORTC's core questionnaire, the QLQ-C30, for measuring HRQOL in patients aged >70 years in oncology studies.Methods:Patients (n=518) from 10 countries completed the QLQ-C30, QLQ-ELD15 and a debriefing interview. Eighty two clinically stable patients repeated the questionnaires 1 week later (test-retest analysis) and 107 others, with an expected change in clinical status, repeated the questionnaires 3 months later (response to change analysis, RCA).Results:Information from the debriefing interview, factor analysis and item response theory analysis resulted in the removal of one item (QLQ-ELD15QLQ-ELD14) and revision of the proposed scale structure to five scales (mobility, worries about others, future worries, maintaining purpose and illness burden) and two single items (joint stiffness and family support). Convergent validity was good. In known-group comparisons, the QLQ-ELD14 differentiated between patients with different disease stage, treatment intention, number of comorbidities, performance status and geriatric screening scores. Test-retest and RCA analyses were equivocal.Conclusion:The QLQ-ELD14 is a validated HRQOL questionnaire for cancer patients aged 70 years. Changes in elderly patients' self-reported HRQOL may be related to both cancer evolution and non-clinical events. [ABSTRACT FROM AUTHOR]

The article focuses on the GINSENG Project under the European Union's (EU) Framework 7 Programme. It notes that the project, led by the University of Cork, aimed to develop performance-controlled wireless sensor networks (WSNs) to be used in a real-world industrial environment, wherein performance is critical. It notes that various approaches and innovations on WSNs are necessary to achieve the goal of the project. These include the software components to be used and the performance debugging.