Background Adjuvant trastuzumab significantly improves outcomes for patients with HER2-positive early breast cancer. The standard treatment duration is 12 months but shorter treatment could provide similar efficacy while reducing toxicities and cost. We aimed to investigate whether 6-month adjuvant trastuzumab treatment is noninferior to the standard 12-month treatment regarding disease-free survival. Methods This study is an open-label, randomised phase 3 non-inferiority trial. Patients were recruited from 152 centres in the UK. We randomly assigned patients with HER2-positive early breast cancer, aged 18 years or older, and with a clear indication for chemotherapy, by a computerised minimisation process (1:1), to receive either 6-month or 12-month trastuzumab delivered every 3 weeks intravenously (loading dose of 8 mg/kg followed by maintenance doses of 6 mg/kg) or subcutaneously (600 mg), given in combination with chemotherapy (concurrently or sequentially). The primary endpoint was disease-free survival, analysed by intention to treat, with a non-inferiority margin of 3% for 4-year disease-free survival. Safety was analysed in all patients who received trastuzumab. This trial is registered with EudraCT (number 2006-007018-39), ISRCTN (number 52968807), and ClinicalTrials.gov (number NCT00712140).

No abstract

The emerald ash borer, Agrilus planipennis Fairmaire (Coleoptera: Buprestidae), a phloem-feeding insect from Asia, was identified in 2002 as the cause of widespread ash (Fraxinus sp.) mortality in southeastern Michigan and Essex County, Ontario. Most larvae overwinter as nonfeeding prepupae in the outer sapwood or thick bark of large trees. In a series of studies, we evaluated effects of grinding, chipping, and heat treatment on survival of A. planipennis prepupae in ash material. Heavily infested ash bolts containing roughly 8,700 prepupae were processed by a horizontal grinder with either a 2.5- or 10-cm screen. There was no evidence of A. planipennis survival in chips processed with the 2.5-cm screen, but eight viable prepupae were recovered from chips processed with the 10-cm screen. We chiseled additional sentinel chips with prepupae from ash logs and buried 45 in each chip pile. In total, six prepupae in sentinel chips survived the winter, but we found no sign of adult A. planipennis emergence from the processed chips. Subsequently, we assessed prepupal survival in chips processed by a chipper or a horizontal grinder fit with 5-, 10-, or 12.7-cm screens. An estimated 1,565 A. planipennis prepupae were processed by each treatment. Chips from the chipper were shorter than chips from the grinder regardless of the screen size used. No live prepupae were found in chips produced by the chipper, but 21 viable prepupae were found in chips from the grinder. Infested wood and bark chips chiseled from logs were held in ovens at 25, 40, or 60 degrees C for 8, 24, or 48 h. Prepupal survival was consistently higher in wood chips than bark chips at 40 degrees C, whereas no prepupae survived exposure to 60 degrees C for eight or more hours. In a second study, prepupae in wood chips were exposed to 40, 45, 50, 55, or 60 degrees C for 20 or 120 min. Some prepupae survived 20 min of exposure to all temperatures. No prepupae survived exposure to 60 degrees C for 120 min, but 17% survived exposure to 55 degrees C for 120 min, suggesting that some fraction of the population may survive internationally recognized phytosanitary standards (ISPM-15) for treatment of wood packing material.

We present new evidence on the effect of grants on charities' incomes. We employ a novel identification strategy, focusing on charities that applied for lottery grant funding and comparing outcomes for successful and unsuccessful applicants. Overall, grants do not crowd out other income but the effect of grant-funding is not uniform. Looking in more detail we show first, that the positive effects of receiving a grant can persist for several years post-award; second, that grants have a stronger positive effect for small charities; and, third, that grants may have a more positive effect when they provide seed funding.

In a fast-moving world where technology has become intertwined with our daily lives, meaning information is available at our fingertips, information overload (Khabsa and Giles, 2014) is just one of many challenges that this technological overhaul has presented.Drawing on key literature in the fields of education and academia and adopting the analogy of a journey to represent lifelong learning, this bipartite paper explores how both primary school pupils and university students are required to access information in their very own information journeys in this 'Information Age'. The similarities and differences between child and adult learners are considered.This article shares practical strategies for promoting the smarter use of information-and a shorter journey-for these 'travellers' along the way. This article essentially aims to raise questions in the minds of educators as they help to prepare their learners to learn.