Comparison of darbepoetin alfa dosed weekly (QW) vs. extended dosing schedule (EDS) in the treatment of anemia in patients receiving multicycle chemotherapy in a randomized, phase 2, open-label trial

BACKGROUND: Chemotherapy-induced anemia (CIA) is responsive to treatment with erythropoiesis-stimulating agents (ESAs) such as darbepoetin alfa. Administration of ESAs on a synchronous schedule with chemotherapy administration could benefit patients by reducing clinic visits and potentially enhancing on-time chemotherapy delivery. METHODS: This phase 2, 25-week, open-label study evaluated the noninferiority of darbepoetin alfa administered weekly vs. as an extended dosing schedule (every 2 or 3 weeks) in patients with CIA. Patients were randomized 1:1 to an extended dosing schedule (EDS: darbepoetin alfa 300 μg Q2W if chemotherapy was QW, Q2W, or Q4W or darbepoetin alfa 500 μg Q3W if chemotherapy was Q3W) or weekly (150 μg QW regardless of chemotherapy schedule). Stratification factors included chemotherapy cycle length, screening hemoglobin (<10 g/dL vs. ≥10 g/dL), and tumor type (lung/gynecological vs. other nonmyeloid malignancies). The primary endpoint was change in hemoglobin from baseline to Week 13. RESULTS: Seven hundred fifty-two patients (374 QW patients; 378 EDS patients) received ≥1 dose of darbepoetin alfa and were included in the analysis. Demographics and disease state were similar between groups. Seventy-one percent of patients in the EDS group and 76% in the QW group achieved the target hemoglobin of ≥11.0 g/dL. There was a minimal difference in the primary endpoint of mean change in hemoglobin (baseline to Week 13) between the QW and the EDS groups (-0.04 g/dL; 95% confidence interval: -0.26, 0.17 g/dL). The upper limit of the 95% confidence interval was less than the prespecified limit of <0.75 g/dL, supporting noninferiority of the EDS dosing schedule. Reported adverse events were similar between groups. A slight increase in transfusions was reported in the QW group. CONCLUSION: Darbepoetin alfa, when administered synchronously with chemotherapy, on an EDS appears to be similarly efficacious to darbepoetin alfa weekly dosing with no unexpected adverse events. This study provides prospective data on how multiple dosing regimens available with darbepoetin alfa can be synchronized with chemotherapy administered across a range of dosing schedules. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT00144131

Nunalleq, Stories from the Village of Our Ancestors:Co-designing a multivocal educational resource based on an archaeological excavation

This work was funded by the UK-based Arts and Humanities Research Council through grants (AH/K006029/1) and (AH/R014523/1), a University of Aberdeen IKEC Award with additional support for travel and subsistence from the University of Dundee, DJCAD Research Committee RS2 project funding. Thank you to the many people who contributed their support, knowledge, feedback, voices and faces throughout the project, this list includes members of the local community, colleagues, specialists, students, and volunteers. If we have missed out any names we apologize but know that your help was appreciated. Jimmy Anaver, John Anderson, Alice Bailey, Kieran Baxter, Pauline Beebe, Ellinor Berggren, Dawn Biddison, Joshua Branstetter, Brendan Body, Lise Bos, Michael Broderick, Sarah Brown, Crystal Carter, Joseph Carter, Lucy Carter, Sally Carter, Ben Charles, Mary Church, Willard Church, Daniele Clementi, Annie Cleveland, Emily Cleveland, Joshua Cleveland, Aron Crowell, Neil Curtis, Angie Demma, Annie Don, Julia Farley, Veronique Forbes, Patti Fredericks, Tricia Gillam, Sean Gleason, Sven Haakanson, Cheryl Heitman, Grace Hill, Diana Hunter, Joel Isaak, Warren Jones, Stephan Jones, Ana Jorge, Solveig Junglas, Melia Knecht, Rick Knecht, Erika Larsen, Paul Ledger, Jonathan Lim Soon, Amber Lincoln, Steve Luke, Francis Lukezic, Eva Malvich, Pauline Matthews, Roy Mark, Edouard Masson-MacLean, Julie Masson-MacLean, Mhairi Maxwell, Chuna Mcintyre, Drew Michael, Amanda Mina, Anna Mossolova, Carl Nicolai Jr, Chris Niskanen, Molly Odell, Tom Paxton, Lauren Phillips, Lucy Qin, Charlie Roberts, Chris Rowe, Rufus Rowe,Chris Rowland, John Rundall, Melissa Shaginoff, Monica Shah, Anna Sloan, Darryl Small Jr, John Smith, Mike Smith, Joey Sparaga, Hannah Strehlau, Dora Strunk, Larissa Strunk, Lonny Strunk, Larry Strunk, Robbie Strunk, Sandra Toloczko, Richard Vanderhoek, the Qanirtuuq Incorporated Board, the Quinhagak Dance Group and the staff at Kuinerrarmiut Elitnaurviat. We also extend our thanks to three anonymous reviewers for their valuable comments on our paper.Peer reviewedPublisher PD

From Sharks to The Big Ugly

This longitudinal case study explored one rural elementary art teacher’s praxis for two years after she participated in professional development sessions on place-based education (PBE). These sessions focused specifically on PBE within the discipline of art for K-12 art educators in a geographically-large southeastern school district. Through surveys, observations, interviews, and document analysis of curricular materials, the researchers investigated the teacher’s experiences with PBE as she taught art in a rural area of the district. Her curricular decisions transitioned from a focus on art reflecting her personal knowledge base to art that built on students’ expressions of, experiences in, and knowledge of, their rural setting. Implications for teacher professional development focused on rural education include strategies for promoting the contextualization of content and communicating the benefits of transitioning from place-neutral to place-based instruction

A two-case study of band broadening in liquid chromatography

The effects of band broadening in two chromatographic systems were studied. In the first study the adsorption isotherm of S - Tröger\u27s Base on microcrystalline cellulose triacetate was measured by frontal analysis at several flow rates between 0.2 and 1.2 ml/min. Two chromatographic models were used in order to study the kinetics of mass-transfer between the two phases and to derive plate height values, the equilibrium-dispersive model and the transport model of chromatography. The dependence of the plate height on the flow velocity and on the solute concentration was studied. A modified Van Deemter equation was used to separate the contributions due to slow mass transfer and axial dispersion. In the second study, column efficiency and plate height were calculated for polystyrene (MW: 1.87 x 106) on a silica column at several flow rates between 1.0 and 100 ml/min. Reduced linear velocities up to 1,000,000 were achieved. The classical Van Deemter equation and an HETP curve were used to analyze the data. The effects of the data acquisition and detector system on the results obtained were also studied

Architecture for active aging, reflections on the theoretical field

La manera de entender el envejecimiento determina su abordaje desde las distintas disciplinas que influyen en arquitectura, ya sea en lo que se refiere a la propuesta de alojamiento en la vejez (diseño y gestión de viviendas, centros de día o residencias para tercera edad), como en los espacios semi- públicos (accesos a edificios, galerías comerciales, comercios) o espacios públicos (instituciones, veredas, calles, parques, plazas). Se han aplicado diversos modelos para explicar y contextualizar el proceso de envejecimiento. El Envejecimiento Activo es el paradigma que hoy se propone como marco para mejorar la salud, los procesos de participación y la seguridad de los adultos mayores. La evolución de paradigmas implica que convivan en una realidad compleja distintas intervenciones que satisfacen en mayor o menor medida las necesidades y aspiraciones planteadas para este colectivo

Contribución al tema oficial de embarazo ectópico

Nuestra breve contribución al tema tratado se refiere a los datos tomados de las historias clínicas de los últimos 8 años (1946- 1953) de la Clínica Ginecológica del Ministerio de Salud Pública, Servicio del Prof. Luis P. Bottaro, a cargo del Dr. Ernesto J. Tarig