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Preclinical data suggest that combined gamma-tocotrienol with pentoxifylline ameliorates radiotherapy-induced gastrointestinal damage.To test whether gastrointestinal symptoms arising after radiotherapy, and persisting after maximal medical therapy, can be improved using Tocovid SupraBio 200 mg and pentoxifylline 400 mg orally twice daily for one year. Patients stratified by severity of symptoms, and randomised to active treatment or matched placebo were assessed after 12 months. The primary end point was improvement in gastrointestinal symptoms measured using the Inflammatory Bowel Disease Questionnaire, bowel subset score. Changes in bio-markers of fibrosis were assessed.62 patients, median age 66, 34(55%) treated for prostate, 21(34%) gynaecological, 6(10%) anal and one(1%) rectal cancer were recruited; 40(65%) randomised to treatment, 22(35%) to placebo, 39 months (median) after radiotherapy completion. Gamma tocotrienol was not detected in serum in 41% of treated patients, despite good compliance with study medication. Treatment was completed in 28(70%) and 17(77%) patients in the treatment and placebo groups respectively. No improvement in symptom scores nor in quality of life was identified. Thirteen serious adverse events occurred. A transient ischaemic attack, was possibly related to pentoxifylline, others were assessed as unlikely to be related to treatment. Levels of EGF, PDGF and FGF were significantly reduced and consistent trends in reduced inflammation were seen during treatment but were not sustained once treatment ended.This single centre study closed prematurely and therefore data interpretation is of necessity limited. No clinical benefit was demonstrated. However, biochemical data suggest that this intervention does have anti-inflammatory and anti-fibrotic effects.

Single-neutron states in the Z=30, N=49isotope 79Zn have been populated using the 78Zn(d,p)79Zn transfer reaction at REX-ISOLDE, CERN. The experimental setup allowed the combined detection of protons ejected in the reaction, and of γrays emitted by 79Zn. The analysis reveals that the lowest excited states populated in the reaction lie at approximately 1MeV of excitation, and involve neutron orbits above the N=50shell gap. From the analysis of γ-ray data and of proton angular distributions, characteristic of the amount of angular momentum transferred, a5/2+configuration was assigned to a state at 983keV. Comparison with large-scale-shell-model calculations supports a robust neutron N=50shell-closure for 78Ni. These data constitute an important step towards the understanding of the magicity of 78Ni and of the structure of nuclei in the region. publisher: Elsevier articletitle: Single-neutron orbits near 78Ni: Spectroscopy of the isotope 79Zn journaltitle: Physics Letters B articlelink: http://dx.doi.org/10.1016/j.physletb.2014.12.006 content_type: article copyright: Copyright © 2014 The Authors. Published by Elsevier B.V. ispartof: Physics Letters B vol:740 pages:298-302 status: published

New gastrointestinal symptoms are frequent after pelvic radiotherapy and can greatly affect the quality of life of cancer survivors. The effect of radiation on the intestinal microbiota, and the clinical implications of a modified microbial balance after radiotherapy are now beginning to emerge. In this Personal View, we show the importance of the microbiota for intestinal homoeostasis, and discuss the similarity between inflammatory bowel disease, which has been extensively researched, and radiation-induced gastrointestinal toxicity. By use of microbiota profiles for risk assessment and manipulation of the intestinal flora for prevention and treatment of radiation, enteropathy could become a reality and would be of substantial relevance to the increasing numbers of long-term cancer survivors.

Summary Background Chronic gastrointestinal symptoms after pelvic radiotherapy are common, multifactorial in cause, and affect patients' quality of life. We assessed whether such patients could be helped if a practitioner followed an investigative and management algorithm, and whether outcomes differed by whether a nurse or a gastroenterologist led this algorithm-based care. Methods For this three-arm randomised controlled trial we recruited patients (aged ≥18 years) from clinics in London, UK, with new-onset gastrointestinal symptoms persisting 6 months after pelvic radiotherapy. Using a computer-generated randomisation sequence, we randomly allocated patients to one of three groups (1:1:1; stratified by tumour site [urological, gynaecological, or gastrointestinal], and degree of bowel dysfunction [IBDQ-B score vs 60–70]): usual care (a detailed self-help booklet), gastroenterologist-led algorithm-based treatment, or nurse-led algorithm-based treatment. The primary endpoint was change in Inflammatory Bowel Disease Questionnaire–Bowel subset score (IBDQ-B) at 6 months, analysed by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00737230. Findings Between Nov 26, 2007, and Dec 12, 2011, we enrolled and randomly allocated 218 patients to treatment: 80 to the nurse group, 70 to the gastroenterologist group, and 68 to the booklet group (figure). Most had a baseline IBDQ-B score indicating moderate-to-severe symptoms. We recorded the following pair-wise mean difference in change in IBDQ-B score between groups: nurse versus booklet 4·12 (95% CI 0·04–8·19; p=0·04), gastroenterologist versus booklet 5·47 (1·14–9·81; p=0·01). Outcomes in the nurse group were not inferior to outcomes in the gastroenterologist group (mean difference 1·36, one sided 95% CI −1·48). Interpretation Patients given targeted intervention following a detailed clinical algorithm had better improvements in radiotherapy-induced gastrointestinal symptoms than did patients given usual care. Our findings suggest that, for most patients, this algorithm-based care can be given by a trained nurse. Funding The National Institute for Health Research.

Isotope shifts have been measured for the odd-A polonium isotopes 191–211Po and changes in the nuclear mean square charge radii δr2 have been deduced. The measurements were performed at CERN-ISOLDE using the in-source resonance-ionization spectroscopy technique. The combined analysis of these data and our recent results for even-A polonium isotopes indicates an onset of deformation already at 197,198Po, when going away from stability. This is significantly earlier than was suggested by previous theoretical and experimental studies of the polonium isotopes. Moreover and in contrast to the mercury isotopes, where a strong odd–even staggering of the charge radii of the ground states was observed by approaching the neutron mid-shell at N = 104, no such effect is present in polonium down to 191Po. Consequently the charge radii of both isomeric and ground states of the odd-A polonium isotopes follow the same trend as the even-A isotopes. ispartof: Physics Letters B vol:719 issue:4 pages:362-366 status: published

Aims About 17,000 patients receive radiotherapy for pelvic cancer in the UK annually. Up to 50% are left with altered bowel function affecting quality of life. The UK National Cancer Survivorship Initiative Vision acknowledges that the needs of cancer survivors are not being met and challenges professionals to develop new models of care. Materials and methods A prospective, observational qualitative study was carried out to assess whether nurse-delivered care is feasible for patients with radiotherapy-induced bowel dysfunction. The experience of a senior nurse, directed by an algorithm of investigation with a comprehensive treatment pathway, is reported. Results Over 12 months, 59 new and 103 follow-up appointments were managed by the nurse. In total, 37 women and 73 men, with a median age of 69 years, were seen; 9 had been treated for gastrointestinal, 33 for gynaecological and 68 for urological cancers, 26 months (median) previously. Sixty minutes (new consultations) (median, range 35–80) and 40minutes (follow-up consultations) (range 20–85) were required. Ordering investigations, treatment initiation, long-term care planning and discharge seemed to be manageable in 83% of patients. Conclusion An experienced nurse, working within a defined scope of practice, with medical support can manage care in patients with mild or moderate symptoms arising after pelvic radiotherapy. An ongoing randomised controlled trial is assessing patient outcomes.

Significant chronic symptoms following pelvic radiotherapy occur more frequently than commonly realized. Predictive factors for the development of late symptoms are poorly defined. Moderate sustained acute (cumulative) toxicity might predict severe late effects better than peak reaction.To determine prospectively whether peak or cumulative gastrointestinal (GI) acute symptoms better predict late symptoms in patients receiving pelvic radiotherapy. Symptom scores were measured weekly from the start of radiotherapy, and at 1 year using the Modified Inflammatory Bowel Disease Questionnaire-Bowel subset. The possible prognostic impact of patient-related factors was explored.Three hundred and eight patients were recruited. 100 were excluded due to lack of follow-up data at one year resulting from death, too ill, stoma, relapsed, non-response or withdrawal. A further 15 were excluded for incomplete data, leaving 193 patients with evaluable data. Of these, 28 had GI, 101 urological, and 64 gynecological cancers. Patients' median age was 65 years (range, 23-82), and they were treated with median 60 Gy dose for a median of 6 weeks. Univariate analysis revealed a significant association between cumulative acute symptom scores and scores at 1 year (p0.001), which was dose-independent (p0.001). Acute peak and 1-year scores were not associated (p = 0.431). The correlation coefficient between cumulative acute symptoms and symptoms at 1 year was 0.367 and for peak acute symptoms was weaker at 0.057. Patients with an abnormal body mass index and current smokers were more likely to experience worse symptoms at 1 year.Cumulative acute symptoms are more predictive of late symptoms than peak acute changes in score. This association is independent of the radiotherapy dose delivered and is suggestive of a consequential late effect.

The ground state structure of 9 Li has been investigated through the d( 9 Li ,t) 8 Li one-neutron transfer reaction at E/A = 1.68 MeV. The 8 Li sub-system in 9 Li was observed in its lowest three energy levels. The spectroscopic factors derived from a DWBA analysis are fairly consistent in trend with model calculations. The understanding of the N = 6 sub-shell closure from the spectroscopic information and neutron separation energies is discussed. © 2007 Elsevier B.V.

Tests of the performance of a 32-fold segmented HPGe clover detector coupled to a 20-fold segmented Compton-suppression shield, which form a prototype element of the TRIUMF-ISAC Gamma-Ray Escape-Suppressed Spectrometer (TIGRESS), have been made. Peak-to-total ratios and relative efficiencies have been measured for a variety of γ -ray energies. These measurements were used to validate a GEANT4 simulation of the TIGRESS detectors, which was then used to create a simulation of the full 12-detector array. Predictions of the expected performance of TIGRESS are presented. These predictions indicate that TIGRESS will be capable, for single 1 MeV γ rays, of absolute detection efficiencies of 17% and 9.4%, and peak-to-total ratios of 54% and 61% for the “high-efficiency” and “optimized peak-to-total” configurations of the array, respectively.

Aims Clinical trials in early prostate cancer (EPC) have used a variety of outcome measures, including patient-reported outcomes (PROs) and physician-reported data. We review published studies and suggest a set of outcome measures and a portfolio of more detailed questionnaire options to produce a more homologous data set for future clinical trials. Materials and methods A literature search combining the terms ‘quality of life' or ‘symptoms' and ‘prostate cancer' or ‘prostate adenocarcinoma' was carried out. Relevant papers were reviewed to assess key areas of toxicity and quality of life (QoL). These were discussed by a panel with a special interest in the assessment of QoL measures and PROs. Results Twenty-one validated candidate questionnaires were identified. The Short Form 12 was recommended due to its combination of brevity and assessment of pain, general and mental health, physical, social and emotional function. Specific questionnaires should assess localised symptoms after treatment, including sexual function, erectile dysfunction, bowel function and lower urinary tract symptoms (LUTS). The modular use of separate symptom indices was recommended. For sexual function, the International Index of Erectile Function and the International Continence Society questionnaire were considered the best available. The International Continence Society Male Short Form questionnaire best addressed LUTS. Incontinence of stool (solid, liquid or gas) and its effect on function should be assessed. The Vaizey questionnaire is recommended. The Radiation Therapy Oncology Group scale, which is physician administered, remains helpful in studies including radiotherapy, as it places current trials within appropriate historical context. Rates of procedures to treat complications and pharmaceutical interventions for treatment-related symptoms should be recorded at the time of each questionnaire follow-up. Conclusion Although novel therapies may produce different toxicities, the current recommendations should help to produce trial protocols that will allow comparable data to be generated within clinical trials comparing outcome from surgery, radiotherapy and other targeted ablative therapies for EPC.

This study examined whether staff working within a cancer centre treating patients with gastrointestinal malignancy routinely identified individuals from outpatients for referral to a dietitian. A nutrition screening tool is employed only for in-patient admissions. Height, current and usual weight were recorded prospectively in all patients referred for consideration of treatment. First appointment with the dietitian, first hospital admission, demographic and clinical details were obtained from hospital records. Time from first appointment to referral to a dietitian was examined. Between September 2002 and March 2004, 920 patients were included. Five hundred and seventeen patients had lost weight, of whom 223 patients had lost between 5% and 10% and 294 patients had lost more than 10% of their pre-morbid weight. Three hundred and twenty-seven patients (36%) were referred to dietitians. Twenty eight (9%) of referrals were made by staff in outpatients. Two hundred and ninety-nine were referred during or after an inpatient admission but only 39% of these occurred within the first seven days following admission. One third of patients with more than 10% weight loss were not referred for dietary assessment, even following admission. The likelihood of referral was significantly associated with the degree of weight loss (univariate analysis hazard ratio (HR) 1.75, 95% Confidence Interval (CI) 1.4-2.19, multivariate HR 1.65, 95% CI 1.22-2.23) and was independent of factors such as performance status and clinical setting. Few patients were identified early in their treatment for referral to a dietitian. Since most chemotherapy is now given on an outpatient basis, patients are unlikely to be referred if they do not require admission. This study suggests that an out-patient dietetic screening tool is urgently required. Such screening is likely to result in considerable improvements to the clinical care of cancer patients with weight loss.

A modified Inflammatory Bowel Disease Questionnaire and the Vaizey Incontinence questionnaire are more sensitive measures of acute gastrointestinal toxicity during pelvic radiotherapy than RTOG grading Purpose: Simple scales with greater sensitivity than Radiation Therapy Oncology Group (RTOG) grading to detect acute gastrointestinal toxicity during pelvic radiotherapy, could be clinically useful. Methods and Materials: Do questionnaires used in benign gastrointestinal diseases detect toxicity in patients undergoing radiotherapy? The patient-completed Inflammatory Bowel Disease (IBDQ) and Vaizey Incontinence questionnaires were compared prospectively at baseline and at Week 5 to physician-completed RTOG grading. Results: A total of 107 patients, median age 63 years, were recruited. After 5 weeks of treatment, patients with gynecologic and gastrointestinal cancer were more symptomatic than urologic patients (p = 0.012; p = 0.014). Overall, 94% had altered bowel habits, 80% loose stool, 74% frequency, 65% difficult gas, 60% pain, > 48% distress, 44% tenesmus, > 40% restrictions in daily activity, 39% urgency, 37% fecal incontinence, and 40% required antidiarrheal medication. The median RTOG score was 1 (range, 0-2), median IBDQ score 204.5 (range, 74-224), and median Vaizey score 5 (range, 0-20). Chemotherapy preceding radiotherapy increased fecal incontinence (p = 0.002). RTOG scores stabilized after 3 weeks, IBDQ scores peaked at Week 4, and Vaizey scores worsened throughout treatment. IBDQ and Vaizey scores distinguished between groups with different RTOG scores. Conclusion: The IBDQ and Vaizey questionnaires are reliable and sensitive, offering greater insight into the severity and range of symptoms compared with RTOG grading. (c) 2006 Elsevier Inc.

Summary Introduction Oral nutritional supplements may have a role in the management of weight loss in patients with cancer. Information on preference for different types of nutritional supplements and the influence of taste changes and chemotherapy is limited. Aims and methods This study aimed, in patients with gastrointestinal (GI) cancer, to determine the short-term preference for commonly used nutritional supplements compared with controls, to examine whether preference is altered by chemotherapy and to assess the reproducibility of taste assessments conducted using a Visual Analogue Scale (VAS). Patients with GI cancer and controls were asked to rate the acceptability of three oral nutritional supplements on a VAS before starting chemotherapy and after 6 weeks of chemotherapy. Supplements were presented in a random order in sealed containers and subjects were blinded to the type of product. One supplement was repeated at random within each set (four cups) to assess the reproducibility of responses. Results Sixty patients and 63 controls were included in the study, 47 patients and 47 controls were available for follow-up. Before the start of chemotherapy, patients had a higher mean preference for Calshake (5.9 cm) than Ensure plus (5.1 cm) and Fortijuce (3.2 cm) ( P = 0.025 and P 0.001 ). Calshake was the most preferred supplement in the control group (mean 6.6 cm), with no significant differences in preferences between patients and controls. There were no changes in preference for patients after 6 weeks of chemotherapy. The results for the control group similarly showed no change after 6 weeks. No significant differences were found between scores assigned to the supplement repeated in the random order for any product at either timepoint. Discussion Patients with GI cancers prefer the taste of fresh milk-based supplements and short-term preferences are not changed by chemotherapy. Preferences are similar between patients with GI cancers and people without cancer. A VAS is a reliable tool to assess taste preference. Further studies are needed to assess the patient compliance over longer periods and the reasons for non-compliance with prescriptions for nutritional supplements.

Two excited J(pi)=0(+) states in Pb-186 populated in the a-decay of Po-190 have been identified through alpha -particle/conversion electron coincidences in an experiment at the velocity filter SHIP ...

The production cross sections were measured for the xn, pxn, and αxn de-excitation channels of the 212Rn compound nuclei formed at excitation energies of 80–160 MeV in the reaction 22Ne + 190Os. The maximum cross sections obtained for the xn (x = 8–12), pxn (x = 8–11) and αxn (x = 8–11) reaction channels were fitted satisfactorily with the computer code HIVAP using its standard parameter set except that the single scaling parameter C = 0.65 was implemented to adjust the values of the liquid-drop fission barriers predicted by the Cohen-Plasil-Swiatecki (CPS) model. Additionally, an analysis of a large set of data on the formation cross sections of neutron-deficient Z = 83–92 nuclei showed that the whole body of data obtained for the nuclear region notable for the large variations of both the liquid-drop barrier and the shell effects, can be described well with practically the same parameter C = 0.55–0.68. One may take this observation as an indication that, though the CPS model overestimates the liquid-drop fission barriers, it reproduces well the relative behaviour of these barriers in the whole range of neutron-deficient Z = 83–92 nuclei.

Short-lived nickel isotopes have been studied using a chemically selective Ion Guide Laser Ion Source (IGLIS) based on resonance ionisation of atoms at the Leuven Isotope Separator On-Line (LISOL) separator. The decay properties of different Ni isotopes have been studied using β-γ-coincidences. Experimental production rates of proton induced fission of 238U are obtained for 69,71Ni. These numbers are in a strong disagreement with Silberg-Tsao calculations.

Excitation functions were obtained for the x n, p x n and αx n decay channels of 216,218,220 Ra compound nuclei produced in the reactions 22 Ne+ 194,196,198 Pt in the excitation energy range of 40–160 MeV. Due to the employment of three platinum isotope targets, the cross section ratios were measured with a high degree of accuracy for evaporation reaction channels resulting in the formation of fixed cold products after the termination of evaporation cascades of a different numbers of stages. Experimental values for the reduced neutron widths of highly excited compound nuclei were obtained from the measured cross section ratios. Evaporation reaction cross sections were well described in the framework of the statistical model taking into account shell effects according to Ignatyuk. Our present, and also earlier, investigations showed that calculations making use of one single set of the model parameters (the scaling factor to the liquid-drop fission barrier of Cohen, Plasil and Swiatecki, C = 0.6–0.7 and the ratio of the level density parameters, a f a v = 1.0 ) reproduces correctly the cross sections of the evaporation reactions in a wide range of compound nuclei extending from Bi to U. Moreover, the measured cross section ratios are exceptionally sensitive to the value of the parameter a f a v , i.e. are very suitable for a high accuracy estimation of this value. By fitting two sets of the experimental data — the absolute cross section values and cross section ratios — we were able to independently estimate the values of two principal parameters of the model, C and a f a y . Our calculations showed that a large part of the pre-fission neutrons is evaporated by hot pre-actinide compound nuclei before they reach the saddle point (50 to 100% of the total number of pre-fission neutrons are pre-saddle).

Excitation functions for xn-evaporation channels of the 22Ne+194,196,198Pt reactions have been measured in the compound nucleus excitation energy range of 45–110 MeV. The Γ n Γ tot = 0.88 ± 0.07 was obtained in the range of the excitation energy of 60–100 MeV from the analysis of the ratios of the formation cross sections for the same nuclides produced in reactions with different numbers of evaporated neutrons. From this value of Γ n Γ tot the fission time of (3–5)·10−20 s is derived for the compound nuclei.

Excitation functions are measured for the fusion reactions 27 Al+ 175 Lu and 31 P+ 169 Tm leading to the isotopes 192–198 Po. A comparison to the data for the reactions 100 Mo + 92–100 Mo shows that characteristics of the compound nucleus evaporation do not depend on the bombarding ion mass in the whole range of the entrance channel asymmetry up to the fully symmetrical systems. It is also shown that a satisfactory description of the experimental data is possible in the frame of the statistical deexcitation model only at an assumption involving, in comparison to theory predictions, a considerable reduction of macroscopic fission barriers for neutron-deficient isotopes of Bi.

The cross sections of the formation of Ac-, Ra- and Fr-evaporation residues in the 20 Ne + 197 Au reaction have been measured by means of the VASSILISSA kinematic separator in the range of the compound-nuclei excitation energies from 40 to 120 MeV. The experimental data have been analyzed on the basis of the statistical model of excited nuclei decay. The influence of different assumptions about the parameters of fission barriers on calculation results was considered.

The reduced probabilities of the delayed fission channels P s df for 188 Bi and 196 At are determined, from experimental data, to be 3.4 × 10 −4 and 8.8 × 10 −4 , respectively. The comparison of the obtained and calculated value of P β df allows to estimate the fission barriers for 188 Pb and 196 Po.

Construction and properties of a double ionization chamber (DIC) are described. Heavy ion fusion-evaporation reaction products obtained at the focal plane of the kinematic separator VASSILISSA enter the DIC volume through a thin plastic window. After their thermalization in the gas, they drift in the electric field to the DIC cathode. Their α-decay and/or spontaneous fission are detected in 4π-geometry in two ionization chambers, divided by the common cathode. Using DIC the α-decay of Bi and Pb isotopes produced in the fusion reactions 40 Ar + 159 Tb and 40 Ca + 153 Eu were detected. A new isomer, 189m Bi was observed.

The Vassilissa facility is described. The main component is an electrostatic separator of complete-fusion reaction products from the ion beam. The facility is capable of transmitting recoil nuclei emitted by the target in the beam direction within a solid angle of 10 −2 sr and has a ± 10% spread in energy and ionic charge. The time required to transport the nuclei to the detectors is 3 × 10 −6 s The separation of scattered ions is performed using a system of three electrostatic condensers. Separation factors obtained for Ar, P and Ne are equal to 10 10 , 10 11 and 10 12 , respectively.

International audience; The linear theory used to calculate the thermal quantities inside the stack in the classical thermoacousticrefrigerators always overestimates those measured. The causes of these discrepancies have to be found inthe complex processes of thermal exchanges. The analytical study of the transient response should pro-vide an interpretation of these complex processes. This present paper provides such analytical modelling.This modelling remains within the framework of the classical linear theory. It includes the effects of thethermoacoustic heat flux carried along the stack, the conductive heat flux returning in the solid walls ofthe stack and through the fluid inside the stack, the transverse heat conduction in the stack and the heatleakages through the duct walls, the heat generated by viscous losses in the stack, the heat generated byvorticity at the ends of the stack, and the heat transfer through both ends of the stack. A modal analyticalsolution for the temperature profile is proposed, assuming the usual approximations in such thermalproblems to avoid intricate calculations and expressions. The theoretical transient response of a thermoa-coustic refrigerator is compared with experimental data. A good qualitative agreement is obtainedbetween analytical and experimental results after fitting empirical coefficients.