No abstract

Background: The tumor-initiating capacity of many cancers is considered to reside in a small subpopulation of cells (cancer stem cells). We have previously shown that rare prostate epithelial cells with a CD133 + /α 2 β 1 hi phenotype have the properties of prostate cancer stem cells. We have compared gene expression in these cells relative to their normal and differentiated (CD133 -/ α 2 β 1 low ) counterparts, resulting in an informative cancer stem cell gene-expression signature.

UK energy policy promotes biomass energy crops as potentially significant contributors to renewable energy targets, but few farmers have planted these crops. Amongst the many possible explanations for this disconnect between policy ambitions and delivery on the ground, the role of farmers' socio-cultural identity has received little attention. This study focuses on the Lockerbie area in southwest Scotland, a potentially favourable location for perennial energy crops because (i) it is biophysically suitable for short rotation coppice (SRC) willow, and (ii) Britain's first wood-fueled power station provides a significant local market. A survey in 2009 explored farmers' perceptions of SRC willow, and the key reasons why they adopt or reject perennial energy crops. The results show that most farmers regard SRC willow as a financially risky, overly committing and inappropriate crop for their farms. Whilst financial factors are influential, even large potential profits would be insufficient to persuade many farmers to adopt SRC. Non-financial factors related to identity, lifestyle, farming culture and the perceived priority of food production powerfully shape the overwhelmingly negative attitudes of farmers to SRC. These findings suggest that biomass energy policy, especially regarding woody crops like SRC willow, needs to be more precisely tailored to influential social factors such as socio-cultural identity and local producer culture.

BackgroundIn recent years, meters for continuous monitoring of interstitial fluid glucose have been introduced to help people with type 1 diabetes mellitus (T1DM) to achieve better control of their disease.ObjectiveThe objective of this project was to summarise the evidence on the clinical effectiveness and cost-effectiveness of the MiniMed®Paradigm™ Veo system (Medtronic Inc., Northridge, CA, USA) and the Vibe™ (Animas®Corporation, West Chester, PA, USA) and G4®PLATINUM CGM (continuous glucose monitoring) system (Dexcom Inc., San Diego, CA, USA) in comparison with multiple daily insulin injections (MDIs) or continuous subcutaneous insulin infusion (CSII), both with either self-monitoring of blood glucose (SMBG) or CGM, for the management of T1DM in adults and children.Data sourcesA systematic review was conducted in accordance with the principles of the Centre for Reviews and Dissemination guidance and the National Institute for Health and Care Excellence Diagnostic Assessment Programme manual. We searched 14 databases, three trial registries and two conference proceedings from study inception up to September 2014. In addition, reference lists of relevant systematic reviews were checked. In the absence of randomised controlled trials directly comparing Veo or an integrated CSII + CGM system, such as Vibe, with comparator interventions, indirect treatment comparisons were performed if possible.MethodsA commercially available cost-effectiveness model, the IMS Centre for Outcomes Research and Effectiveness diabetes model version 8.5 (IMS Health, Danbury, CT, USA), was used for this assessment. This model is an internet-based, interactive simulation model that predicts the long-term health outcomes and costs associated with the management of T1DM and type 2 diabetes. The model consists of 15 submodels designed to simulate diabetes-related complications, non-specific mortality and costs over time. As the model simulates individual patients over time, it updates risk factors and complications to account for disease progression.ResultsFifty-four publications resulting from 19 studies were included in the review. Overall, the evidence suggests that the Veo system reduces hypoglycaemic events more than other treatments, without any differences in other outcomes, including glycated haemoglobin (HbA1c) levels. We also found significant results in favour of the integrated CSII + CGM system over MDIs with SMBG with regard to HbA1clevels and quality of life. However, the evidence base was poor. The quality of the included studies was generally low, often with only one study comparing treatments in a specific population at a specific follow-up time. In particular, there was only one study comparing Veo with an integrated CSII + CGM system and only one study comparing Veo with a CSII + SMBG system in a mixed population. Cost-effectiveness analyses indicated that MDI + SMBG is the option most likely to be cost-effective, given the current threshold of £30,000 per quality-adjusted life-year gained, whereas integrated CSII + CGM systems and Veo are dominated and extendedly dominated, respectively, by stand-alone, non-integrated CSII with CGM. Scenario analyses did not alter these conclusions. No cost-effectiveness modelling was conducted for children or pregnant women.ConclusionsThe Veo system does appear to be better than the other systems considered at reducing hypoglycaemic events. However, in adults, it is unlikely to be cost-effective. Integrated systems are also generally unlikely to be cost-effective given that stand-alone systems are cheaper and, possibly, no less effective. However, evidence in this regard is generally lacking, in particular for children. Future trials in specific child, adolescent and adult populations should include longer term follow-up and ratings on the European Quality of Life-5 Dimensions scale at various time points with a view to informing improved cost-effectiveness modelling.Study registrationPROSPERO Registration Number CRD42014013764.FundingThe National Institute for Health Research Health Technology Assessment programme.

Energy issues are crucial for Scotland. This paper reviews the environmental, social and political questions surrounding energy and environment in general, and analyses the passionate arguments surrounding onshore wind farm developments in Scotland in particular. Scotland has the best onshore and offshore wind resources in Europe, with almost a quarter of the total resource, and onshore wind is now rapidly overtaking hydropower as the renewable technology with the greatest generating capacity. This development has proved highly controversial, with many schemes attracting vociferous public opposition. This review explores the main issues involved and shows that whilst some of the controversy centres on factual issues such as job creation, intermittency or bird mortality, a primary reason why consensus is so elusive is that conflicting values lie at the core of the debate. Issues such as landscape aesthetics, community (dis)empowerment and the relative importance of global and local factors are perceptual, unquantifiable and shaped by personal world views. Consequently, even if all the misinformation provided by those supporting or opposing wind farms was removed, profound disagreements would remain about the appropriate choices for securing Scotland's future power supply. The paper highlights the need to deepen our understanding of the social construction of public attitudes, to develop better criteria for strategic locational guidance and to investigate the potential of emerging development models such as community-scale wind power schemes.

BackgroundThis was an indirect comparison of the effectiveness of intravitreal aflibercept (IVT-AFL) 2 mg every 8 weeks after 5 initial monthly doses (or if different periods, after an initial monthly dosing period) (2q8) and other diabetic macular edema (DME) therapies at doses licensed outside the USA.MethodsA comprehensive search was undertaken to source relevant studies. Feasibility networks were prepared to identify viable comparisons of 12-month outcomes between IVT-AFL 2q8 and therapies licensed outside the USA, which were assessed for clinical and statistical homogeneity. Pooled effect sizes (mean difference [MD] and relative risk/risk ratio [RR]) were calculated using fixed- and random-effects models. Indirect comparisons were performed using Bucher analysis. If at least one ‘head-to-head’ study was found then a mixed treatment comparison (MTC) was performed using Bayesian methods. Two 12-month comparisons could be undertaken based on indirect analyses: IVT-AFL 2q8 versus intravitreal ranibizumab (IVR) 0.5 mg as needed (PRN) (10 studies) and IVT-AFL 2q8 versus dexamethasone 0.7 mg implants (three studies).ResultsThere was an increase in mean best-corrected visual acuity (BCVA) with IVT-AFL 2q8 over IVR 0.5 mg PRN by 4.67 letters [95% credible interval (CrI): 2.45–6.87] in the fixed-effect MTC model (10 studies) and by 4.82 letters [95% confidence interval (CI): 2.52–7.11] in the Bucher indirect analysis (four studies). IVT-AFL 2q8 doubled the proportion of patients gaining ≥ 10 Early Treatment Diabetic Retinopathy Study letters at 12 months compared with dexamethasone 0.7 mg implants (RR = 2.10 [95% CI: 1.29–3.40]) in the fixed-effect model. There were no significant differences in safety outcomes between IVT-AFL 2q8 and IVR 0.5 mg PRN or dexamethasone 0.7 mg implants.ConclusionsStudies of IVT-AFL 2q8 showed improved 12-month visual acuity measures compared with studies of IVR 0.5 mg PRN and dexamethasone 0.7 mg implants based on indirect comparisons. These analyses are subject to a number of limitations which are inherent in indirect data comparisons.Electronic supplementary materialThe online version of this article (doi:10.1186/s12886-015-0035-x) contains supplementary material, which is available to authorized users.

Ice-marginal features in South Georgia include minor moraine ridges running approximately parallel to the ice margin and developed as superficial forms in various depths of till. It is suggested that these developed as ice-contact landforms, some being created by the interaction of the ice edge and abutting marginal snow bank, whilst the glacier is advancing. This advance is essentially short-term, being part of a seasonal variation in the position of the ice margin. “Snow-bank push” is the term proposed to describe this mechanism of ridge formation.

No abstract