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IntroductionAlthough the previous lanreotide autogel/depot syringe had been well received, feedback indicated that improvements could be made to make it more user-friendly. Additionally, the view that patients should have greater involvement in the research and development process is echoed by the International Neuroendocrine Cancer Alliance. A series of studies aimed to develop and validate a new syringe that works better for patients, caregivers and healthcare professionals (HCPs) by involving these groups at key stages in the development and testing process.MethodsThe multicentre, international, human factor studies, consisted of four formative studies and one validation study. The formative studies collected patient, caregiver and HCP feedback on the lanreotide autogel/depot syringe on the market at the time, and on newly designed prototypes. The validation study was conducted to evaluate the final syringe to confirm that it can be used effectively and safely in the intended environment, by the intended user, for the intended purpose.ResultsOverall, 213 individuals participated in the studies; 145 contributed to the formative studies and 68 to the validation study. The validated new-generation syringe included several important updates compared with the lanreotide autogel/depot syringe currently on the market, including the flanges, which are now larger and have a better grip; the overcap, which is white, ridged, opaque and bigger; the plunger supports and the thermoformed tray. No participant hurt themselves or others during the validation study (although several misuses were reported), and all participants succeeded in delivering a complete dose and activating the safety system.ConclusionWith collaboration, a new syringe was developed to meet the needs of patients, caregivers and HCPs, whilst ensuring lanreotide was delivered effectively and safely. These studies highlight the importance of involving patients, caregivers and HCPs in clinical evaluation studies to develop medical products that address their concerns and meet their needs.FundingIpsen.Plain Language SummaryPlain language summary available for this article.Electronic Supplementary MaterialThe online version of this article (10.1007/s12325-019-01112-3) contains supplementary material, which is available to authorized users.

The effect of thermal annealing on layers of CuInS2 nanocrystals (NCs) stabilized with (NH4)2S was investigated using in situ transmission electron microscopy (TEM), in situ X-ray diffraction (XRD), thermogravimetric analysis combined with mass spectrometry (TGA-MS) and X-ray photoelectron spectroscopy (XPS). It is shown that these inorganic, chalcogen containing ligands inhibit NC sintering up to 450 °C in an inert atmosphere. On the other hand, sintering can be promoted by annealing in hydrogen gas. A similar behavior is found with Cu2ZnSnSe4 and CdSe NCs. We attribute the inhibited sintering to the oxidation of the S2− originally stabilizing the NCs to sulfite or sulfate moieties, where oxidation is possible either by exposure of the films to air or by thermal decomposition of residual solvent molecules present in the film under inert conditions

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127 Background: Neuroendocrine tumors (NETs) are rare and complex neoplasms with increasing incidence and prevalence worldwide. SCAN assessed global delivery of healthcare to NET patients. This analysis focused for the first time on healthcare quality evaluation by economic areas–Advanced Economies (AE) and Emerging and Developing Economies (EDE) classification used as per the International Monetary Fund. Methods: During Sept-Nov 2019, NET patients and healthcare professionals (HCPs) completed an online survey (available in 14 languages). Results: There were 2795 respondents from 68 countries across 6 continents. AE NET patients/carers were 88% [2076/2359], EDE were 12% [283/2359]. HCPs were evenly spread 51% AE [221/436] vs. 49% EDE [215/436]. The average evaluation score provided by NET patients to the healthcare received in the country they reside in for more than 6 months was 3.6 in AE, while one point lower 2.5 in EDE on a 5-point Likert scale (1-poor, 5-excellent). HCPs’ and NET patients’ scores were aligned: 3.9 as per AE HCPs (94% [208/221]), vs. 2.6 by EDE HCPs (68% [190/283]). The availability of top 3 most used NET treatments over the past 12 months was significantly lower in EDE: surgery in AE reached 85% (1765/2076) vs. EDE 71% (201/283) p<0.0001 [Chi-squared], somatostatin analogues - in AE 67% (1391/2076) vs. EDE 59% (167/283) p<0.0001, PRRT was 57% in AE countries (1183/2076), vs. EDE 33% (93/283) p<0.0001. Specialized services were of low usage globally and in deep disparity by economic areas, namely: NET specialist consultations (AE 55% [1143/2076] vs. EDE 40% [112/283] p<0.0001), multidisciplinary team care 34% (AE 34% [706/2076] vs. EDE 22% [63/283] p<0.0001), a clinical nurse specialized in NETs (AE 28% [589/2076] vs. EDE 7% [21/283] p<0.0001), psychological care (AE 13% [261/2076] vs. EDE 5% [15/283] p<0.0001), physical activities like yoga classes, trainings designed for cancer patients (AE 11% [220/2076] vs. EDE 3% [7/283] p<0.0001). State healthcare coverage was claimed by half of AE NET patients (51% [1064/2076]). National healthcare plan that covered NETs was mentioned by only a third of EDE NET patients (30% [85/283]. Conclusions: Availability of treatments and access to specialized NET healthcare is a global challenge and is in need of improvement. Additionally, the gap between AE and EDE in terms of treatments availability, support services usage, and state healthcare coverage is significant and manifests deep inequality.

We describe the synthesis of metal selenide nanocrystals, including CdSe, ZnSe, CuInSe2 and Cu2(Zn,Sn)Se4, by the hot injection of selenium powder dispersed in a carrier solvent. Since this results in a fast and high yield nanocrystal formation, we argue that the approach is well suited for the low cost, large volume production of nanocrystals.

In this work, calcium-modified lead titanate (Pb 1-x Ca x )TiO 3 (PCT) precursor solutions with different amounts of Ca 2+ substituting Pb 2+ (x ) 0.24 and 0.50) have been prepared for the first time by an entirely aqueous solution-gel route. The use of water as a nonhazardous and inexpensive solvent, together with the easy handling of the technique (no inert atmosphere is required), are the major advantages of this method. A stable citrato-peroxo complex of Ti(IV) was synthesized first and subsequently combined with the Pb 2+ and Ca 2+ reagents (citrates) in the desired molar ratio to obtain the aqueous precursor solutions. The stability of these solutions with time is slightly influenced by the amount of Ca 2+ introduced in the PCT system. Gels were obtained from these solutions and subjected to thermogravimetric analysis coupled on-line to Fourier transform infrared (TGA-FTIR) and mass spectroscopy (TGA-MS) techniques. To prepare thin films, we had to improve the hydrophilicity of the Pt/TiO x /SiO 2 /Si substrates and hence their wetting by the aqueous solutions using a wet chemical treatment of cleaning. Crystallization of the films was carried out by rapid thermal processing (RTP) in air at 650 °C. Films with a single perovskite phase and a homogeneous microstructure were thus obtained, as deduced by X-ray diffraction (XRD) and scanning electron microscopy (SEM). The ability of this solution method to obtain PCT films with ferroelectric and dielectric responses is also demonstrated in the present work.

Background: Neuroendocrine tumors (NETs) are rare and complex neoplasms with increasing incidence and prevalence worldwide. SCAN assessed global delivery of NET healthcare. Methods: During Sept-Nov 2019, NET patients and healthcare professionals (HCPs) completed an online survey, available in 14 languages, which was disseminated via social media and NET patient group networks. Results: There were 2795 respondents from 68 countries composed of 436 HCPs (of which medical oncologists (MO) comprised 25% [103/436]); 2359 NET patients/carers. The regions included: Europe (47%); North America (NA) (31%); Asia (12%); Oceania (9%]; South America & Africa (2%). Almost half (46% [1077/2359]) of patients had stage IV NETs. Mean time to diagnosis was 5 years and 1042 were misdiagnosed, lower in Asia and higher in NA (All: Europe 4.05 vs. NA 6.44 vs. Asia 2.28 vs. Oceania 4.81 (T-test, p<0.0001). The quality of healthcare provided was evaluated by NET patients at 3.5 (5points Likert scale) (All: Europe 3.61 vs. NA 3.61 vs. Asia 2.56, vs. Oceania 3.83) and by HCPs/MOs at 3.3/3.1 [All: 436, MO: 102]. Slightly over half of NET patients were consulted by a NET specialist in past 12 months (P12M), notably from Europe and Oceania (All: 53% [1273/2359]; Europe: 61% [672/1102], NA: 48% [348/727], Asia: 42% [118/ 280], Oceania: 53% [106/200], p<0.0001, Chi-squared). Only one third of patient cases were reviewed by a multidisciplinary team in P12M, less in NA and Asia (All: 33% [779/ 2359]; Europe: 38% [419/1102], NA: 29% [217/727], Asia: 22% [62/280], Oceania: 39% [70/200], p<0.0001. A MO was the most involved HCP in the follow-up in 60% of NET patients, particularly in NA and Oceania (All: Europe 54% [593/1102] vs. NA 75% [548/ 727] vs. Asia 34% [95/280], vs. Oceania 75% [150/200] p<0.0001). The most common recommendation to improve NET diagnosis and management, given by MO, was 'better access to NET experts/specialist centers (71% [77/103]). Conclusions:The delivery of healthcare to NET patients is in need of significant improvement globally to ensure proper and timely diagnosis and treatment. Improving access to multidisciplinary care should be a priority for healthcare systems when it comes to NETs.