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Kenneth J Obyrne - One of the best experts on this subject based on the ideXlab platform.
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extra pleural pneumonectomy versus no extra pleural pneumonectomy for patients with malignant pleural mesothelioma clinical outcomes of the mesothelioma and radical surgery mars randomised feasibility study
Lancet Oncology, 2011Co-Authors: Tom Treasure, Loic Langlazdunski, David A Waller, J M Bliss, James Entwisle, Michael Snee, Mary Obrien, Gill Thomas, Suresh Senan, Kenneth J ObyrneAbstract:Background The eff ects of extra-pleural pneumonectomy (EPP) on survival and quality of life in patients with malignant pleural mesothelioma have, to our knowledge, not been assessed in a randomised trial. We aimed to assess the clinical outcomes of patients who were randomly assigned to EPP or no EPP in the context of trimodal therapy in the Mesothelioma and Radical S urgery (MARS) feasibility study. Methods MARS was a multicentre randomised controlled trial in 12 UK hospitals. Patients aged 18 years or older who had pathologically confi rmed mesothelioma and were deemed fi t enough to undergo trimodal therapy were included. In a prerandomisation Registration Phase, all patients underwent induction platinum-based chemotherapy followed by clinical review. Af ter further consent, patients were randomly assigned (1:1) to EPP followed by postoperative hemithorax irradiation or to no EPP. Randomisation was done centrally with computer-generated permuted blocks stratifi ed by surgical centre. The main endpoints were feasibility of randomly assigning 50 patients in 1 year (results detailed in another report), proportion randomised who received treatment, proportion eligible (registered) who proceeded to randomisation, perioperative mortality, and quality of life. Patients and investigators were not masked to treatment allocation. This is the principal report of the MARS study; all patients have been recruited. Analyses were by intention to treat. This trial is registered, number ISRCTN95583524. Findings Between Oct 1, 2005, and Nov 3, 2008, 112 patients were registered and 50 were subsequently randomly assigned: 24 to EPP and 26 to no EPP. The main reasons for not proceeding to randomisation were disease progression (33 patients), inoperability (fi ve patients), and patient choice (19 patients). EPP was completed satisfactorily in 16 of 24 patients assigned to EPP; in fi ve patients EPP was not started and in three patients it was abandoned. Two patients in the EPP group died within 30 days and a further patient died without leaving hospital. One patient in the no EPP group died perioperatively af ter receiving EPP off trial in a non-MARS centre. The hazard ratio [HR] for overall survival between the EPP and no EPP groups was 1·90 (95% CI 0·92–3·93; exact p=0·082), and after adjustment for sex, histological subtype, stage, and age at randomisation the HR was 2·75 (1·21–6·26; p=0·016). Median survival was 14·4 months (5·3–18·7) for the EPP group and 19·5 months (13·4 to time not yet reached) for the no EPP group. Of the 49 randomly assigned patients who consented to quality of life assessment (EPP n=23; no EPP n=26), 12 patients in the EPP group and 19 in the no EPP group completed the quality of life questionnaires. Although median quality of life scores were lower in the EPP group than the no EPP group, no signifi cant diff erences between groups were reported in the quality of life analyses. There were ten serious adverse events reported in the EPP group and two in the no EPP group. Interpretation In view of the high morbidity associated with EPP in this trial and in other non-randomised studies a larger study is not feasible. These data, although limited, suggest that radical surgery in the form of EPP within trimodal therapy off ers no benefi t and possibly harms patients.
Duncan S. Wong - One of the best experts on this subject based on the ideXlab platform.
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Linkable Spontaneous Anonymous Group Signature for Ad Hoc Groups
Information Security and Privacy, 2004Co-Authors: Joseph K. Liu, Victor K. Wei, Duncan S. WongAbstract:We present a linkable spontaneously anonymous group (LSAG) signature scheme (alternatively known as linkable ring signature scheme) satisfying the following three properties. (1) Anonymity, or signer indistinguishability. (2) Linkability: That two signatures by the same signer can be linked. (3) Spontaneity: No group secret, therefore no group manager or group secret sharing setup. We reduce the security of our scheme to well-known problems under the random oracle model. Using the scheme, we construct a new efficient one-round e-voting system which does not have a Registration Phase. We also present a new efficient reduction of famous rewind simulation lemma which only relies on elementary probability theory. Threshold extensions of our scheme are also presented.
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linkable spontaneous anonymous group signature for ad hoc groups extended abstract
Australasian Conference on Information Security and Privacy, 2004Co-Authors: Joseph K. Liu, Victor K. Wei, Duncan S. WongAbstract:We present a linkable spontaneously anonymous group (LSAG) signature scheme (alternatively known as linkable ring signature scheme) satisfying the following three properties. (1) Anonymity, or signer indistinguishability. (2) Linkability: That two signatures by the same signer can be linked. (3) Spontaneity: No group secret, therefore no group manager or group secret sharing setup. We reduce the security of our scheme to well-known problems under the random oracle model. Using the scheme, we construct a new efficient one-round e-voting system which does not have a Registration Phase. We also present a new efficient reduction of famous rewind simulation lemma which only relies on elementary probability theory. Threshold extensions of our scheme are also presented.
Tom Treasure - One of the best experts on this subject based on the ideXlab platform.
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extra pleural pneumonectomy versus no extra pleural pneumonectomy for patients with malignant pleural mesothelioma clinical outcomes of the mesothelioma and radical surgery mars randomised feasibility study
Lancet Oncology, 2011Co-Authors: Tom Treasure, Loic Langlazdunski, David A Waller, J M Bliss, James Entwisle, Michael Snee, Mary Obrien, Gill Thomas, Suresh Senan, Kenneth J ObyrneAbstract:Background The eff ects of extra-pleural pneumonectomy (EPP) on survival and quality of life in patients with malignant pleural mesothelioma have, to our knowledge, not been assessed in a randomised trial. We aimed to assess the clinical outcomes of patients who were randomly assigned to EPP or no EPP in the context of trimodal therapy in the Mesothelioma and Radical S urgery (MARS) feasibility study. Methods MARS was a multicentre randomised controlled trial in 12 UK hospitals. Patients aged 18 years or older who had pathologically confi rmed mesothelioma and were deemed fi t enough to undergo trimodal therapy were included. In a prerandomisation Registration Phase, all patients underwent induction platinum-based chemotherapy followed by clinical review. Af ter further consent, patients were randomly assigned (1:1) to EPP followed by postoperative hemithorax irradiation or to no EPP. Randomisation was done centrally with computer-generated permuted blocks stratifi ed by surgical centre. The main endpoints were feasibility of randomly assigning 50 patients in 1 year (results detailed in another report), proportion randomised who received treatment, proportion eligible (registered) who proceeded to randomisation, perioperative mortality, and quality of life. Patients and investigators were not masked to treatment allocation. This is the principal report of the MARS study; all patients have been recruited. Analyses were by intention to treat. This trial is registered, number ISRCTN95583524. Findings Between Oct 1, 2005, and Nov 3, 2008, 112 patients were registered and 50 were subsequently randomly assigned: 24 to EPP and 26 to no EPP. The main reasons for not proceeding to randomisation were disease progression (33 patients), inoperability (fi ve patients), and patient choice (19 patients). EPP was completed satisfactorily in 16 of 24 patients assigned to EPP; in fi ve patients EPP was not started and in three patients it was abandoned. Two patients in the EPP group died within 30 days and a further patient died without leaving hospital. One patient in the no EPP group died perioperatively af ter receiving EPP off trial in a non-MARS centre. The hazard ratio [HR] for overall survival between the EPP and no EPP groups was 1·90 (95% CI 0·92–3·93; exact p=0·082), and after adjustment for sex, histological subtype, stage, and age at randomisation the HR was 2·75 (1·21–6·26; p=0·016). Median survival was 14·4 months (5·3–18·7) for the EPP group and 19·5 months (13·4 to time not yet reached) for the no EPP group. Of the 49 randomly assigned patients who consented to quality of life assessment (EPP n=23; no EPP n=26), 12 patients in the EPP group and 19 in the no EPP group completed the quality of life questionnaires. Although median quality of life scores were lower in the EPP group than the no EPP group, no signifi cant diff erences between groups were reported in the quality of life analyses. There were ten serious adverse events reported in the EPP group and two in the no EPP group. Interpretation In view of the high morbidity associated with EPP in this trial and in other non-randomised studies a larger study is not feasible. These data, although limited, suggest that radical surgery in the form of EPP within trimodal therapy off ers no benefi t and possibly harms patients.
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extra pleural pneumonectomy versus no extra pleural pneumonectomy for patients with malignant pleural mesothelioma clinical outcomes of the mesothelioma and radical surgery mars randomised feasibility study
Faculty of Health; Institute of Health and Biomedical Innovation, 2011Co-Authors: Tom Treasure, Loic Langlazdunski, J M Bliss, James Entwisle, Michael Snee, Mary Obrien, Gill Thomas, David Waller, Carol Tan, Suresh SenanAbstract:Background The effects of extra-pleural pneumonectomy (EPP) on survival and quality of life in patients with malignant pleural mesothelioma have, to our knowledge, not been assessed in a randomised trial. We aimed to assess the clinical outcomes of patients who were randomly assigned to EPP or no EPP in the context of trimodal therapy in the Mesothelioma and Radical Surgery (MARS) feasibility study. Methods MARS was a multicentre randomised controlled trial in 12 UK hospitals. Patients aged 18 years or older who had pathologically confirmed mesothelioma and were deemed fit enough to undergo trimodal therapy were included. In a prerandomisation Registration Phase, all patients underwent induction platinum-based chemotherapy followed by clinical review. After further consent, patients were randomly assigned (1:1) to EPP followed by postoperative hemithorax irradiation or to no EPP. Randomisation was done centrally with computer-generated permuted blocks stratified by surgical centre. The main endpoints were feasibility of randomly assigning 50 patients in 1 year (results detailed in another report), proportion randomised who received treatment, proportion eligible (registered) who proceeded to randomisation, perioperative mortality, and quality of life. Patients and investigators were not masked to treatment allocation. This is the principal report of the MARS study; all patients have been recruited. Analyses were by intention to treat. This trial is registered, number ISRCTN95583524. Findings Between Oct 1, 2005, and Nov 3, 2008, 112 patients were registered and 50 were subsequently randomly assigned: 24 to EPP and 26 to no EPP. The main reasons for not proceeding to randomisation were disease progression (33 patients), inoperability (five patients), and patient choice (19 patients). EPP was completed satisfactorily in 16 of 24 patients assigned to EPP; in five patients EPP was not started and in three patients it was abandoned. Two patients in the EPP group died within 30 days and a further patient died without leaving hospital. One patient in the no EPP group died perioperatively after receiving EPP off trial in a non-MARS centre. The hazard ratio [HR] for overall survival between the EPP and no EPP groups was 1·90 (95% CI 0·92-3·93; exact p=0·082), and after adjustment for sex, histological subtype, stage, and age at randomisation the HR was 2·75 (1·21-6·26; p=0·016). Median survival was 14·4 months (5·3-18·7) for the EPP group and 19·5 months (13·4 to time not yet reached) for the no EPP group. Of the 49 randomly assigned patients who consented to quality of life assessment (EPP n=23; no EPP n=26), 12 patients in the EPP group and 19 in the no EPP group completed the quality of life questionnaires. Although median quality of life scores were lower in the EPP group than the no EPP group, no significant differences between groups were reported in the quality of life analyses. There were ten serious adverse events reported in the EPP group and two in the no EPP group. Interpretation In view of the high morbidity associated with EPP in this trial and in other non-randomised studies a larger study is not feasible. These data, although limited, suggest that radical surgery in the form of EPP within trimodal therapy offers no benefit and possibly harms patients. Funding Cancer Research UK (CRUK/04/003), the June Hancock Mesothelioma Research Fund, and Guy's and St Thomas' NHS Foundation Trust. © 2011 Elsevier Ltd.
Suresh Senan - One of the best experts on this subject based on the ideXlab platform.
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extra pleural pneumonectomy versus no extra pleural pneumonectomy for patients with malignant pleural mesothelioma clinical outcomes of the mesothelioma and radical surgery mars randomised feasibility study
Lancet Oncology, 2011Co-Authors: Tom Treasure, Loic Langlazdunski, David A Waller, J M Bliss, James Entwisle, Michael Snee, Mary Obrien, Gill Thomas, Suresh Senan, Kenneth J ObyrneAbstract:Background The eff ects of extra-pleural pneumonectomy (EPP) on survival and quality of life in patients with malignant pleural mesothelioma have, to our knowledge, not been assessed in a randomised trial. We aimed to assess the clinical outcomes of patients who were randomly assigned to EPP or no EPP in the context of trimodal therapy in the Mesothelioma and Radical S urgery (MARS) feasibility study. Methods MARS was a multicentre randomised controlled trial in 12 UK hospitals. Patients aged 18 years or older who had pathologically confi rmed mesothelioma and were deemed fi t enough to undergo trimodal therapy were included. In a prerandomisation Registration Phase, all patients underwent induction platinum-based chemotherapy followed by clinical review. Af ter further consent, patients were randomly assigned (1:1) to EPP followed by postoperative hemithorax irradiation or to no EPP. Randomisation was done centrally with computer-generated permuted blocks stratifi ed by surgical centre. The main endpoints were feasibility of randomly assigning 50 patients in 1 year (results detailed in another report), proportion randomised who received treatment, proportion eligible (registered) who proceeded to randomisation, perioperative mortality, and quality of life. Patients and investigators were not masked to treatment allocation. This is the principal report of the MARS study; all patients have been recruited. Analyses were by intention to treat. This trial is registered, number ISRCTN95583524. Findings Between Oct 1, 2005, and Nov 3, 2008, 112 patients were registered and 50 were subsequently randomly assigned: 24 to EPP and 26 to no EPP. The main reasons for not proceeding to randomisation were disease progression (33 patients), inoperability (fi ve patients), and patient choice (19 patients). EPP was completed satisfactorily in 16 of 24 patients assigned to EPP; in fi ve patients EPP was not started and in three patients it was abandoned. Two patients in the EPP group died within 30 days and a further patient died without leaving hospital. One patient in the no EPP group died perioperatively af ter receiving EPP off trial in a non-MARS centre. The hazard ratio [HR] for overall survival between the EPP and no EPP groups was 1·90 (95% CI 0·92–3·93; exact p=0·082), and after adjustment for sex, histological subtype, stage, and age at randomisation the HR was 2·75 (1·21–6·26; p=0·016). Median survival was 14·4 months (5·3–18·7) for the EPP group and 19·5 months (13·4 to time not yet reached) for the no EPP group. Of the 49 randomly assigned patients who consented to quality of life assessment (EPP n=23; no EPP n=26), 12 patients in the EPP group and 19 in the no EPP group completed the quality of life questionnaires. Although median quality of life scores were lower in the EPP group than the no EPP group, no signifi cant diff erences between groups were reported in the quality of life analyses. There were ten serious adverse events reported in the EPP group and two in the no EPP group. Interpretation In view of the high morbidity associated with EPP in this trial and in other non-randomised studies a larger study is not feasible. These data, although limited, suggest that radical surgery in the form of EPP within trimodal therapy off ers no benefi t and possibly harms patients.
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extra pleural pneumonectomy versus no extra pleural pneumonectomy for patients with malignant pleural mesothelioma clinical outcomes of the mesothelioma and radical surgery mars randomised feasibility study
Faculty of Health; Institute of Health and Biomedical Innovation, 2011Co-Authors: Tom Treasure, Loic Langlazdunski, J M Bliss, James Entwisle, Michael Snee, Mary Obrien, Gill Thomas, David Waller, Carol Tan, Suresh SenanAbstract:Background The effects of extra-pleural pneumonectomy (EPP) on survival and quality of life in patients with malignant pleural mesothelioma have, to our knowledge, not been assessed in a randomised trial. We aimed to assess the clinical outcomes of patients who were randomly assigned to EPP or no EPP in the context of trimodal therapy in the Mesothelioma and Radical Surgery (MARS) feasibility study. Methods MARS was a multicentre randomised controlled trial in 12 UK hospitals. Patients aged 18 years or older who had pathologically confirmed mesothelioma and were deemed fit enough to undergo trimodal therapy were included. In a prerandomisation Registration Phase, all patients underwent induction platinum-based chemotherapy followed by clinical review. After further consent, patients were randomly assigned (1:1) to EPP followed by postoperative hemithorax irradiation or to no EPP. Randomisation was done centrally with computer-generated permuted blocks stratified by surgical centre. The main endpoints were feasibility of randomly assigning 50 patients in 1 year (results detailed in another report), proportion randomised who received treatment, proportion eligible (registered) who proceeded to randomisation, perioperative mortality, and quality of life. Patients and investigators were not masked to treatment allocation. This is the principal report of the MARS study; all patients have been recruited. Analyses were by intention to treat. This trial is registered, number ISRCTN95583524. Findings Between Oct 1, 2005, and Nov 3, 2008, 112 patients were registered and 50 were subsequently randomly assigned: 24 to EPP and 26 to no EPP. The main reasons for not proceeding to randomisation were disease progression (33 patients), inoperability (five patients), and patient choice (19 patients). EPP was completed satisfactorily in 16 of 24 patients assigned to EPP; in five patients EPP was not started and in three patients it was abandoned. Two patients in the EPP group died within 30 days and a further patient died without leaving hospital. One patient in the no EPP group died perioperatively after receiving EPP off trial in a non-MARS centre. The hazard ratio [HR] for overall survival between the EPP and no EPP groups was 1·90 (95% CI 0·92-3·93; exact p=0·082), and after adjustment for sex, histological subtype, stage, and age at randomisation the HR was 2·75 (1·21-6·26; p=0·016). Median survival was 14·4 months (5·3-18·7) for the EPP group and 19·5 months (13·4 to time not yet reached) for the no EPP group. Of the 49 randomly assigned patients who consented to quality of life assessment (EPP n=23; no EPP n=26), 12 patients in the EPP group and 19 in the no EPP group completed the quality of life questionnaires. Although median quality of life scores were lower in the EPP group than the no EPP group, no significant differences between groups were reported in the quality of life analyses. There were ten serious adverse events reported in the EPP group and two in the no EPP group. Interpretation In view of the high morbidity associated with EPP in this trial and in other non-randomised studies a larger study is not feasible. These data, although limited, suggest that radical surgery in the form of EPP within trimodal therapy offers no benefit and possibly harms patients. Funding Cancer Research UK (CRUK/04/003), the June Hancock Mesothelioma Research Fund, and Guy's and St Thomas' NHS Foundation Trust. © 2011 Elsevier Ltd.
Joseph K. Liu - One of the best experts on this subject based on the ideXlab platform.
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Linkable Spontaneous Anonymous Group Signature for Ad Hoc Groups
Information Security and Privacy, 2004Co-Authors: Joseph K. Liu, Victor K. Wei, Duncan S. WongAbstract:We present a linkable spontaneously anonymous group (LSAG) signature scheme (alternatively known as linkable ring signature scheme) satisfying the following three properties. (1) Anonymity, or signer indistinguishability. (2) Linkability: That two signatures by the same signer can be linked. (3) Spontaneity: No group secret, therefore no group manager or group secret sharing setup. We reduce the security of our scheme to well-known problems under the random oracle model. Using the scheme, we construct a new efficient one-round e-voting system which does not have a Registration Phase. We also present a new efficient reduction of famous rewind simulation lemma which only relies on elementary probability theory. Threshold extensions of our scheme are also presented.
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linkable spontaneous anonymous group signature for ad hoc groups extended abstract
Australasian Conference on Information Security and Privacy, 2004Co-Authors: Joseph K. Liu, Victor K. Wei, Duncan S. WongAbstract:We present a linkable spontaneously anonymous group (LSAG) signature scheme (alternatively known as linkable ring signature scheme) satisfying the following three properties. (1) Anonymity, or signer indistinguishability. (2) Linkability: That two signatures by the same signer can be linked. (3) Spontaneity: No group secret, therefore no group manager or group secret sharing setup. We reduce the security of our scheme to well-known problems under the random oracle model. Using the scheme, we construct a new efficient one-round e-voting system which does not have a Registration Phase. We also present a new efficient reduction of famous rewind simulation lemma which only relies on elementary probability theory. Threshold extensions of our scheme are also presented.
