bluuebunny/crossref_metadata_2025 huggingface dataset:
Symptomatic involvement of the stomach and duodenum as initial presentation of AL amyloidosis
Authors: Inayat Faisal , Ur Rahman Asad , Zahid Effa , Ali Nouman Safdar , Charles Roger
Published: January 2019

Primary systemic or amyloid light chain (AL) amyloidosis is a multisystem disorder with myriad presentations. Although it can involve the upper gastrointestinal tract in 8% of cases, symptomatic involvement is exceedingly rare. We chronicle here a case of postprandial epigastric pain associated with AL amyloidosis involving the stomach and duodenum. Pathological examination of endoscopic biopsy using Congo red staining confirmed the diagnosis. In order to establish the underlying aetiology of AL amyloidosis, the patient underwent extensive workup. Eventually, she was diagnosed with multiple myeloma based on the standard set of investigations. This paper underscores the importance of clinical suspicion of amyloidosis in patients presenting with non-specific gastrointestinal symptoms and highlights the role of endoscopic biopsy to confirm the amyloid deposition. Since gastrointestinal amyloidosis is a disease with a poor prognosis, early diagnosis and treatment are particularly warranted.
Symptoms of post-traumatic stress disorder and depression among Eritrean refugees in Ethiopia: identifying direct, meditating and moderating predictors from path analysis
Authors: Getnet Berhanie , Medhin Girmay , Alem Atalay
Published: January 2019

Objective

This study aimed at testing the significance of mediating and moderating roles of sense of coherence, adaptive coping styles and social support in the relationship between exposure to trauma and psychological symptoms in a refugee population in sub-Saharan Africa.

Methods

A cross-sectional survey design was employed to collect data. The study was carried out in Mai Aini refugee camp in Ethiopia. A total of 562 adult Eritrean refugees aged 18–74 years were selected randomly to screen for depression and post-traumatic stress disorder (PTSD) symptoms and to examine associated factors. Data were collected using the premigration and postmigration living difficulties checklist, Center for Epidemiologic Studies Depression (CES-D) scale, Primary Care PTSD Screener, coping style scale, Sense of Coherence scale and Oslo Social Support scale. Path modelling was used to test the mediation and moderation effects of prespecified factors.

Results

Premigration living difficulties were associated directly with symptoms of PTSD (β=0.09, p<0.05), and associated indirectly with PTSD symptoms in paths through duration of stay in the camp, sense of coherence, postmigration living difficulties, task-oriented coping style and depressive symptoms (β=0.26, p<0.01). Premigration and postmigration living difficulties were associated directly with depressive symptoms with standardised estimate of β=0.35(p<0.001) and β=0.23(p<0.05), respectively. Postmigration living difficulties were associated indirectly with PTSD through paths of sense of coherence, task-oriented coping style and depressive symptoms (β=0.13; p<0.01). Social support moderated the effect of postmigration living difficulties on depressive symptoms (p<0.05). Emotion-oriented coping style moderated the effect of premigration threat for abuse on PTSD (β=−0.18, p<0.001) and depressive (β=−0.12, p<0.01) symptoms, as well as moderating threat to life on PTSD symptoms (β=−0.13, p<0.001).

Conclusions

Sense of coherence and task-oriented coping style showed a partial mediating effect on the association between exposure to trauma and symptoms of PTSD. An emotion-oriented coping style and social support moderated the effect of premigration and postmigration living difficulties, respectively. Fostering social support, task-oriented and emotion-oriented coping styles may be beneficial for these refugees.
Normative growth charts for Shwachman-Diamond syndrome from Italian cohort of 0–8 years old
Authors: Cipolli Marco , Tridello Gloria , Micheletto Alessio , Perobelli Sandra , Pintani Emily , Cesaro Simone , Maserati Emanuela , Nicolis Elena , Danesino Cesare
Published: January 2019

Objectives

Shwachman-Diamond syndrome (SDS) is a rare autosomal recessive disorder. Its predominant manifestations include exocrine pancreatic insufficiency, bone marrow failure and skeletal abnormalities. Patients frequently present failure to thrive and susceptibility to short stature. Average birth weight is at the 25th percentile; by the first birthday, >50% of patients drop below the third percentile for height and weight.

The study aims at estimating the growth charts for patients affected by SDS in order to give a reference tool helpful for medical care and growth surveillance through the first 8 years of patient’s life.

Setting and participants

This retrospective observational study includes 106 patients (64 M) with available information from birth to 8 years, selected among the 122 patients included in the Italian National Registry of SDS and born between 1975 and 2016. Gender, birth date and auxological parameters at repeated assessment times were collected. The General Additive Model for Location Scale and Shape method was applied to build the growth charts. A set of different distributions was used, and the more appropriate were selected in accordance with the smallest Akaike information criterion.

Results

A total of 408 measurements was collected and analysed. The median number of observations per patient amounted to 3, range 1–11. In accordance with the methods described, specific SDS growth charts were built for weight, height and body mass index (BMI), separately for boys and girls.

The 50th and 3rd percentiles of weight and height of the healthy population (WHO standard references) respectively correspond to the 97th and 50th percentiles of the SDS population (SDS specific growth charts), while the difference is less evident for the BMI.

Conclusions

Specific SDS growth charts obtained through our analysis enable a more appropriate classification of patients based on auxological parameters, representing a useful reference tool for evaluating their growth during childhood.
Immigrant screening for latent tuberculosis infection: numbers needed to test and treat, a Norwegian population-based cohort study
Authors: Winje Brita Askeland , Grøneng Gry Marysol , White Richard Aubrey , Akre Peter , Aavitsland Preben , Heldal Einar
Published: January 2019

Objectives

To estimate the number needed to screen (NNS) and the number needed to treat (NNT) to prevent one tuberculosis (TB) case in the Norwegian immigrant latent tuberculosis infection (LTBI) screening programme and to explore the effect of delay of LTBI treatment initiation.

Design

Population-based, prospective cohort study.

Participants

Immigrants to Norway.

Outcome

Incident TB.

Methods

We obtained aggregated data on immigration to Norway in 2008–2011 and used data from the Norwegian Surveillance System for Infectious Diseases to assess the number of TB cases arising in this cohort within 5 years after arrival. We calculated the average NNS and NNT for immigrants from the top 10 source countries for TB in Norway and by estimated TB incidence rates in source countries. We explored the sensitivity of these estimates with regard to test performance, treatment efficacy and treatment adherence using an extreme value approach, and assessed the effects of emigration, time to TB diagnosis (to define incident TB) and intervention timing.

Results

NNS and NNT were overall high, with substantial variation. NNT showed numerically stronger negative correlation with TB notification rate in Norway (−0.75 [95% CI −1.00 to −0.44]) than with the WHO incidence rate (IR) (−0.32 [95% CI −0.93 to 0.29]). NNT was affected substantially by emigration and the definition of incident TB. Estimates were lowest for Somali (NNS 99 [70–150], NNT 27 [19–41]) and highest for Thai immigrants (NNS 585 [413–887], NNT 111 [79–116]). Implementing LTBI treatment in immigrants sooner after arrival may improve the effectiveness of the programme.

Conclusion

Using TB notifications in Norway, rather than IR in source countries, would improve targeting of immigrants for LTBI management. However, the overall high NNT is a concern and challenges the scale-up of preventive LTBI treatment for significant public health impact. Better data are urgently needed to monitor and evaluate NNS and NNT in countries implementing LTBI screening.
Development and validation protocol for an instrument to measure household water insecurity across cultures and ecologies: the Household Water InSecurity Experiences (HWISE) Scale
Authors: Young Sera L , Collins Shalean M , Boateng Godfred O , Neilands Torsten B , Jamaluddine Zeina , Miller Joshua D , Brewis Alexandra A , Frongillo Edward A , Jepson Wendy E , Melgar-Quiñonez Hugo , Schuster Roseanne C , Stoler Justin B , Wutich Amber
Published: January 2019

Introduction

A wide range of water-related problems contribute to the global burden of disease. Despite the many plausible consequences for health and well-being, there is no validated tool to measure individual- or household-level water insecurity equivalently across varying cultural and ecological settings. Accordingly, we are developing the Household Water Insecurity Experiences (HWISE) Scale to measure household-level water insecurity in multiple contexts.

Methods and analysis

After domain specification and item development, items were assessed for both content and face validity. Retained items are being asked in surveys in 28 sites globally in which water-related problems have been reported (eg, shortages, excess water and issues with quality), with a target of at least 250 participants from each site. Scale development will draw on analytic methods from both classical test and item response theories and include item reduction and factor structure identification. Scale evaluation will entail assessments of reliability, and predictive, convergent, and discriminant validity, as well as the assessment of differentiation between known groups.

Ethics and dissemination

Study activities received necessary ethical approvals from institutional review bodies relevant to each site. We anticipate that the final HWISE Scale will be completed by late 2018 and made available through open-access publication. Associated findings will be disseminated to public health professionals, scientists, practitioners and policymakers through peer-reviewed journals, scientific presentations and meetings with various stakeholders. Measures to quantify household food insecurity have transformed policy, research and humanitarian aid efforts globally, and we expect that an analogous measure for household water insecurity will be similarly impactful.
Automated oxygen administration versus conventional oxygen therapy after major abdominal or thoracic surgery: study protocol for an international multicentre randomised controlled study
Authors: L’her Erwan , Jaber Samir , Verzilli Daniel , Jacob Christophe , Huiban Brigitte , Futier Emmanuel , Kerforne Thomas , Pateau Victoire , Bouchard Pierre-Alexandre , Gouillou Maellen , Nowak Emmanuel , Lellouche François
Published: January 2019

Introduction

Hypoxemia and hyperoxia may occur after surgery with potential related complications. The FreeO2PostOp trial is a prospective, multicentre, randomised controlled trial that evaluates the clinical impact of automated O2administration versus conventional O2therapy after major abdominal or thoracic surgeries. The study is powered to demonstrate benefits of automated oxygen titration and weaning in term of oxygenation, which is an important surrogate for complications after such interventions.

Methods and analysis

After extubation, patients are randomly assigned to theStandard(manual O2administration) orFreeO2group (automated closed-loop O2administration). Stratification is performed for the study centre and a medical history of chronic obstructive pulmonary disease (COPD). Primary outcome is the percentage of time spent in the target zone of oxygen saturation, during a 3-day time frame. In both groups, patients will benefit from continuous oximetry recordings. The target zone of oxygen saturation is SpO2=88%–92% for patients with COPD and 92%–96% for patients without COPD. Secondary outcomes are the nursing workload assessed by the number of manual O2flow adjustments, the time spent with severe desaturation (SpO2<85%) and hyperoxia area (SpO2>98%), the time spent in a hyperoxia area (SpO2>98%), the VO2, the duration of oxygen administration during hospitalisation, the frequency of use of mechanical ventilation (invasive or non-invasive), the duration of the postrecovery room stay, the hospitalisation length of stay and the survival rate.

Ethics and dissemination

The FreeO2PostOp study is conducted in accordance with the declaration of Helsinki and was registered on 11 September 2015 (http://www.clinicaltrials.gov). First patient inclusion was performed on 14 January 2016. The results of the study will be presented at academic conferences and submitted to peer-reviewed journals.

Trial registration number

NCT02546830.
Study protocol for an open-label, single-arm, multicentre phase II trial to evaluate the efficacy and safety of combined triplet therapy and olanzapine for prevention of carboplatin-induced nausea and vomiting in gynaecological cancer patients
Authors: Iihara Hirotoshi , Shimokawa Mototsugu , Abe Masakazu , Hayasaki Yoh , Fujita Yukiyoshi , Nagasawa Yuki , Sakurai Michiru , Matsuoka Rie , Suzuki Akio , Morishige Kenichiro
Published: January 2019

Introduction

Carboplatin (CBDCA) administered at a dosage of 4 mg/mL/min or more area under the blood concentration-time curve (AUC) is considered to be ranked as the highest chemotherapy-induced nausea and vomiting (CINV) risk of the moderately emetogenic chemotherapy agents. The complete response (CR) rate for preventing overall CINV, defined as no emetic episodes and no use of rescue medication, for standard triplet antiemetic therapy (5-HT3RA, 5-hydroxytryptamine-3 receptor antagonist; NK1RA, neurokinin-1 receptor antagonist; DEX, dexamethasone) was approximately 60% in gynaecological cancer patients receiving CBDCA-based therapy. Further improvement in antiemetic treatment is needed to optimise care. This trial is to evaluate the efficacy and safety of using 5 mg olanzapine (OLZ) plus standard triplet antiemetic therapy for CINV after AUC ≥4 mg/mL/min CBDCA combination therapy in gynaecological cancer patients.

Methods and analysis

This trial is an open-label, single-arm, multicentre phase II trial. Patients who receive CBDCA (AUC ≥4)-based therapy and have never been administered moderate to high emetogenic chemotherapy will be enrolled. All patients will receive OLZ (5 mg oral administration on days 1–4, after supper) in combination with 5-HT3RA, NK1RA and DEX. The primary endpoint is the CR rate during the overall period (0–120 hours). Testing the hypothesis that this regimen can improve CR rate from 60% (null hypothesis) to 75% (alternative hypothesis) with a one-sided type I error of 0.1 and power of 0.8 will require 53 patients. Considering the dropout rate, the target sample size is set at 60.

Ethics and dissemination

The study protocol was approved by the institutional review board at each of the participating centres. Data will be presented at international conferences and published in peer-reviewed journals.

Trial registration number

UMIN000031646.
Depressive symptoms and quality of life after screening for cognitive impairment in patients with type 2 diabetes: observations from the Cog-ID cohort study
Authors: Janssen Jolien , Koekkoek Paula S , Biessels Geert-Jan , Kappelle Jaap L , Rutten Guy E H M
Published: January 2019

Objectives

To assess changes in depressive symptoms and health-related quality of life (HRQOL) after screening for cognitive impairment in people with type 2 diabetes.

Design

A prospective cohort study, part of the Cognitive Impairment in Diabetes (Cog-ID) study.

Setting

Participants were screened for cognitive impairment in primary care. People suspected of cognitive impairment (screen positives) received a standardised evaluation at a memory clinic.

Participants

Participants ≥70 years with type 2 diabetes were included in Cog-ID between August 2012 and September 2014, the current study includes 179 patients; 39 screen positives with cognitive impairment, 56 screen positives without cognitive impairment and 84 participants not suspected of cognitive impairment during screening (screen negatives).

Outcome measures

Depressive symptoms and HRQOL assessed with the Center for Epidemiologic Studies Depression Scale (CES-D), 36-Item Short-Form Health Survey, European Quality of Life-5 Dimensions questionnaire and the EuroQol Visual Analogue Scale. Outcomes were assessed before the screening, and 6 and 24 months after screening. An analysis of covariance model was fitted to assess differences in score changes among people diagnosed with cognitive impairment, screen negatives and screen positives without cognitive impairment using a factor group and baseline score as a covariate.

Results

Of all participants, 60.3% was male, mean age was 76.3±5.0 years, mean diabetes duration 13.0±8.5 years. At screening, participants diagnosed with cognitive impairment had significantly more depressive symptoms and a worse HRQOL than screen negatives. Scores of both groups remained stable over time. Screen positives without cognitive impairment scored between the other two groups at screening, but their depressive symptoms decreased significantly during follow-up (mean CES-D: −3.1 after 6 and −2.1 after 24 months); their HRQOL also tended to improve.

Conclusions

Depressive symptoms are common in older people with type 2 diabetes. Screening for and a subsequent diagnosis of cognitive impairment will not increase depressive symptoms.
Evaluation of an electronic health record structured discharge summary to provide real time adverse event reporting in thoracic surgery
Authors: Graham Andrew J , Ocampo Wrechelle , Southern Danielle A , Falvi Anthony , Sotiropoulos Dina , Wang Bruce , Lonergan Kevin , Vito Biraboneye , Ghali William A , McFadden Sean Daniel Patrick
Published: January 2019

Background

The reporting of adverse events (AE) remains an important part of quality improvement in thoracic surgery. The best methodology for AE reporting in surgery is unclear. An AE reporting system using an electronic discharge summary with embedded data collection fields, specifying surgical procedure and complications, was developed. The data are automatically transferred daily to a web-based reporting system.

Methods

We determined the accuracy and sustainability of this electronic real time data collection system (ERD) by comparing the completeness of record capture on procedures and complications with coded discharge data (administrative data), and with the standard of chart audit at two intervals. All surgical procedures performed for 2 consecutive months at initiation (Ti) and 1 year later (T1yr) were audited by an objective trained abstractor. A second abstractor audited 10% of the charts.

Results

The ERD captured 71/72 (99%) of charts at Ti and 56/65 (86%) at T1yr. Comparing the presence/absence of complications between ERD and chart audit demonstrated at Ti a high sensitivity and specificity, positive predictive value (PPV) of 95.5%, negative predictive value (NPV) of 93.9% with a kappa of 0.872 (95% CI 0.750 to 0.994), and at T1yr a sensitivity, specificity, PPV and NPV of 100% with a kappa of 1.0 (95% CI 1.0). Comparing the presence/absence of complications between administrative data and chart audit at Ti demonstrated a low sensitivity, high specificity and a kappa of 0.471 (95% CI 0.256 to 0.686), and at T1yr a low sensitivity, high specificity of 85% and a kappa of 0.479 (95% CI 0.245 to 0.714).

Conclusions

We found that the ERD can provide accurate real time AE reporting in thoracic surgery, has advantages over previous reporting methodologies and is an alternative system for surgical clinical teams developing AE reporting systems.
Effect of habitat loss and fragmentation on fruit-feeding butterflies in the Brazilian Atlantic Forest
Authors: Melo D.H.A. , Filgueiras B.K.C. , Iserhard C.A. , Iannuzzi L. , Freitas A.V.L. , Leal I.R.
Published: January 2019

Habitat loss and fragmentation have drastically altered the availability and quality of tropical forest habitats, but information on how such changes influence local biodiversity is still insufficient. Here, we examine the effects of both patch and landscape metrics on fruit-feeding butterfly assemblages in a fragmented landscape of the Brazilian Atlantic Forest. Our study was carried out in three habitat types: eight fragments (ranging from 8 to 126 ha), eight areas of forest edge (50 m from forest border), and eight areas of forest interior (>200 m from forest border) of the largest remnant (3500 ha) of the Atlantic Forest of northeast Brazil. Our results demonstrated that fragment area is negatively correlated with observed and estimated richness and abundance of butterflies, whereas habitat type is correlated with estimated richness and abundance of butterflies. Species composition responded to habitat type, fragment area, and distance between sample units. These findings illustrated (i) fruit-feeding butterfly sensitivity to habitat loss and fragmentation, (ii) that species composition and abundance are adequate parameters to access the responses of fruit-feeding butterflies to habitat loss and fragmentation, and (iii) the relevance of a heterogeneous and connected landscape for conservation of butterflies, where small fragments are important for generalist or open-habitat specialists and large remnants are key for disturbance-sensitive and threatened taxa.
A low-altitude unmanned aerial vehicle (UAV) created using 3D-printed bioplastic
Authors: Coe Justin , Dunbar Colin , Epps Keunta , Hagensee Joseph , Moore Arden L.
Published: January 2019

In this work, a four-person student team was given the challenge of designing, analysing, constructing, and testing a low-altitude unmanned aerial vehicle (UAV) prototype, which could meet or exceed a set of predefined performance requirements including range, altitude, time of flight, and load-carrying capability. In addition, the team was tasked with having their final design be composed of at least 70% sustainable material by volume. The final prototype took the form of a quadcopter with an airframe 3D printed from a plant-based bioplastic. This prototype was able to meet or exceed three of the four project performance targets, with time of flight being the lone failure. Besides serving as a proof-of-concept prototype of a functioning bioplastic-based UAV, this project is also a demonstration of 3D printing as an enabling technology that can allow even small design teams to realize complex geometries, enjoy enhanced design flexibility, and achieve high levels of UAV functionality with relatively limited resources. Finally, a discussion of important material parameters of 3D printed UAVs is presented.
Chutes and Ladders
Authors: Lyon Louise Ann , Denner Jill
Published: January 2019

Community colleges play a large role in educating students who are historically underrepresented in computer science (CS), including women, Latino men, and Black men, as well as post-traditional (older or working) students. In spite of this, there is a dearth of research on the institutional factors that influence whether or not community college students who are enrolled in CS classes and who express an interest in transferring and completing a bachelor’s degree in the field persist. The overused “pipeline” metaphor, which indicates a supply-side lack, has been replaced by many with that of a “pathway.” However, the “pathway” image suggests a general forward-moving trend that can be misleading. In this work, we draw from qualitative interviews with 14 CS students from groups traditionally underrepresented in the field who have studied introductory computer programming at a community college to investigate the following question: “What are the institutional barriers along a CS bachelor’s degree track that includes community college?” Our findings indicate that there are three categories of institutional barriers along the transfer pathway: setbacks that hinder student progression forward, discontinuities in which students leave and re-enter the pathway, and departures in which students leave computer science and/or leave college altogether. We describe specific examples of each and introduce the idea of student movement as a game of “chutes and ladders,” a convoluted trail where students can slide backwards or off the path (chutes), necessitating the implementation of targeted institutional supports that can boost student progress forward (ladders). We suggest institutional interventions that can help students facing each type of barrier to continue on course through community college and transfer to a four-year university.
Blockade of a Laminin-411–Notch Axis with CRISPR/Cas9 or a Nanobioconjugate Inhibits Glioblastoma Growth through Tumor-Microenvironment Cross-talk
Authors: Sun Tao , Patil Rameshwar , Galstyan Anna , Klymyshyn Dmytro , Ding Hui , Chesnokova Alexandra , Cavenee Webster K. , Furnari Frank B. , Ljubimov Vladimir A. , Shatalova Ekaterina S. , Wagner Shawn , Li Debiao , Mamelak Adam N. , Bannykh Serguei I. , Patil Chirag G. , Rudnick Jeremy D. , Hu Jethro , Grodzinski Zachary B. , Rekechenetskiy Arthur , Falahatian Vida , Lyubimov Alexander V. , Chen Yongmei L. , Leoh Lai S. , Daniels-Wells Tracy R. , Penichet Manuel L. , Holler Eggehard , Ljubimov Alexander V. , Black Keith L. , Ljubimova Julia Y.
Published: January 2019

There is an unmet need for the treatment of glioblastoma multiforme (GBM). The extracellular matrix, including laminins, in the tumor microenvironment is important for tumor invasion and progression. In a panel of 226 patient brain glioma samples, we found a clinical correlation between the expression of tumor vascular laminin-411 (α4β1γ1) with higher tumor grade and with expression of cancer stem cell (CSC) markers, including Notch pathway members, CD133, Nestin, and c-Myc. Laminin-411 overexpression also correlated with higher recurrence rate and shorter survival of GBM patients. We also showed that depletion of laminin-411 α4 and β1 chains with CRISPR/Cas9 in human GBM cells led to reduced growth of resultant intracranial tumors in mice and significantly increased survival of host animals compared with mice with untreated cells. Inhibition of laminin-411 suppressed Notch pathway in normal and malignant human brain cell types. A nanobioconjugate potentially suitable for clinical use and capable of crossing blood–brain barrier was designed to block laminin-411 expression. Nanobioconjugate treatment of mice carrying intracranial GBM significantly increased animal survival and inhibited multiple CSC markers, including the Notch axis. This study describes an efficient strategy for GBM treatment via targeting a critical component of the tumor microenvironment largely independent of heterogeneous genetic mutations in glioblastoma.

Significance: Laminin-411 expression in the glioma microenvironment correlates with Notch and other cancer stem cell markers and can be targeted by a novel, clinically translatable nanobioconjugate to inhibit glioma growth.
Postprogression Outcomes for Osimertinib versus Standard-of-Care EGFR-TKI in Patients with Previously Untreated EGFR-mutated Advanced Non–Small Cell Lung Cancer
Authors: Planchard David , Boyer Michael J. , Lee Jong-Seok , Dechaphunkul Arunee , Cheema Parneet K. , Takahashi Toshiaki , Gray Jhanelle E. , Tiseo Marcello , Ramalingam Suresh S. , Todd Alexander , McKeown Astrid , Rukazenkov Yuri , Ohe Yuichiro
Published: January 2019

Purpose:

In the phase III FLAURA study, third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) osimertinib significantly improved progression-free survival (PFS) versus standard-of-care (SoC) EGFR-TKI (gefitinib or erlotinib) in patients with previously untreated EGFR (exon 19 deletion or L858R) mutation-positive advanced non–small cell lung cancer (NSCLC). Interim overall survival (OS) data were encouraging, but not formally statistically significant at current maturity (25%). Here we report exploratory postprogression outcomes.

Patients and Methods:

Patients were randomized 1:1 to receive osimertinib (80 mg orally, once daily) or SoC EGFR-TKI (gefitinib 250 mg or erlotinib 150 mg, orally, once daily). Treatment beyond disease progression was allowed if the investigator judged ongoing clinical benefit. Patients receiving SoC EGFR-TKI could cross over to receive osimertinib after independently confirmed objective disease progression with documented postprogression T790M-positive mutation status.

Results:

At data cutoff (June 12, 2017), 138 of 279 (49%) and 213 of 277 (77%) patients discontinued osimertinib and SoC EGFR-TKI, respectively, of whom 82 (59%) and 129 (61%), respectively, started a subsequent treatment. Median time to discontinuation of any EGFR-TKI or death was 23.0 months [95% confidence interval (CI), 19.5–not calculable (NC)] in the osimertinib arm and 16.0 months (95% CI, 14.8–18.6) in the SoC EGFR-TKI arm. Median second PFS was not reached (95% CI, 23.7–NC) in the osimertinib arm and 20.0 months (95% CI, 18.2–NC) in the SoC EGFR-TKI arm [hazard ratio (HR), 0.58; 95% CI, 0.44–0.78; P = 0.0004].

Conclusions:

All postprogression endpoints showed consistent improvement with osimertinib versus SoC EGFR-TKI, providing further confidence in the interim OS data.
A Nationwide, Population-Based Prevalence Study of Genetic Muscle Disorders
Authors: Theadom Alice , Rodrigues Miriam , Poke Gemma , O’Grady Gina , Love Donald , Hammond-Tooke Graeme , Parmar Priya , Baker Ronelle , Feigin Valery , Jones Kelly , Te Ao Braden , Ranta Anna , Roxburgh Richard ,   On Behalf of the MDPrev Research Group
Published: January 2019

Background: Previous epidemiological studies of genetic muscle disorders have relied on medical records to identify cases and may be at risk of selection biases or have focused on selective population groups. Objectives: This study aimed to determine age-standardised prevalence of genetic muscle disorders through a nationwide, epidemiological study across the lifespan using the capture-recapture method. Methods: Adults and children with a confirmed clinical or molecular diagnosis of a genetic muscle disorder, resident in New Zealand on April 1, 2015 were identified using multiple overlapping sources. Genetic muscle disorders included the muscular dystrophies, congenital myopathies, ion channel myopathies, GNE myopathy, and Pompe disease. Prevalence per 100,000 persons by age, sex, disorder, ethnicity and geographical region with 95% CIs was calculated using Poisson distribution. Direct standardisation was applied to age-standardise prevalence to the world population. Completeness of case ascertainment was determined using capture-recapture modelling. Results: Age standardised minimal point prevalence of all genetic muscle disorders was 22.3 per 100,000 (95% CI 19.5–25.6). Prevalence in Europeans of 24.4 per 100,000, (95% CI 21.1–28.3) was twice that observed in NZ’s other 3 main ethnic groups; Māori (12.6 per 100,000, 95% CI 7.8–20.5), Pasifika (11.0 per 100,000, 95% CI 5.4–23.3), and Asian (9.13 per 100,000, 95% CI 5.0–17.8). Crude prevalence of myotonic dystrophy was 3 times higher in Europeans (10.5 per 100,000, 9.4–11.8) than Māori and Pasifika (2.5 per 100,000, 95% CI 1.5–4.2 and 0.7 per 100,000, 95% CI 0.1–2.7 respectively). There were considerable regional variations in prevalence, although there was no significant association with social deprivation. The final capture-recapture model, with the least deviance, estimated the study ascertained 99.2% of diagnosed cases. Conclusions: Ethnic and regional differences in the prevalence of genetic muscle disorders need to be considered in service delivery planning, evaluation, and decision making.
A prática do manual do proprietário da edificação: uma classificação conforme a NBR14037
Authors: Moreira Lorena Claudia de Souza , Tonoli Julio Gattei , Ruschel Regina Coeli
Published: January 2019

A qualificação da documentação técnica produzida é relevante para potencializar a comunicação no processo ao longo das etapas de projeto e execução. Neste contexto, o Manual de uso, operação e manutenção das edificações, também conhecido como Manual do Proprietário (MP), é o documento que contempla todas as informações necessárias para guiar as atividades de manutenibilidade e uso da edificação. Dessa forma, o Manual do Proprietário é um documento essencial para o esclarecimento de dúvidas relativas a edificação. De acordo com a Associação Brasileira de Normas Técnicas (ABNT) a NBR 14037 - Diretrizes para elaboração de manuais de uso, operação e manutenção das edificações - Requisitos para elaboração e apresentação dos conteúdos - tem por finalidade orientar os usuários da edificação sobre suas características técnicas; recomendar procedimentos no intuito de uma melhor utilização da edificação; propor atividades de manutenção; precaver o surgimento de falhas e acidentes decorrentes do mau uso e contribuir para a longevidade da edificação. Assim sendo, este artigo tem como objetivo classificar os manuais do proprietário segundo as recomendações da NBR 14037, sua forma de desenvolvimento, formato de entrega e tipo do manual de acordo com o uso e padrão da edificação. O método de pesquisa empregado foi o levantamento. Como contribuição, são apresentados os resultados do levantamento realizado por região do país, por padrão da edificação e por item da NBR 14037. Na verificação de aderência dos manuais à NBR 14037, constatou-se que os itens do manual não têm uma abordagem igualitária e, pontualmente, o quesito manutenção requer um maior cuidado por parte das construtoras e incorporadoras pesquisadas. Comprovou-se que o conteúdo que envolve garantias e assistência técnica obteve a melhor classificação, entre os manuais de proprietário apresentados, estando respaldado pelo Código de Defesa do Consumidor. Ademais, observou-se uma maior recorrência do manual impresso, desenvolvido pela própria construtora e uma distinção do manual de acordo com o uso e padrão da edificação.  Por fim, conclui-se que o manual do proprietário, no levantamento realizado, apresenta deficiências que demandam melhorias tanto na forma de apresentação, quanto na mídia e no seu conteúdo.
Dinâmicas de Apoio ao Processo de Projeto Arquitetônico: a experiência com o Baralho da Escola no ambiente de ensino de projeto.
Authors: Deliberador Marcella Savioli , Kowaltowski Doris Catharine Cornelie Knatz , Taralli Cibele H.
Published: January 2019

Os estudos sobre o processo de projeto em arquitetura permanecem como foco das pesquisas cujo enfoque é a melhoria da qualidade do edifício construído. Pesquisas recentes continuam avançando nos estudos sobre as questões cognitivas do cérebro humano e podem colaborar para o entendimento do processo criativo, inclusive na área de projeto arquitetônico. Diversas e novas formas de apoio às etapas do processo de projeto em arquitetura vem sendo estudadas, dando atenção às questões da cognição, da criatividade, da colaboração, da organização da informação e da produtividade e gestão das etapas, com o objetivo de melhorar a qualidade do produto final.  Este artigo apresenta um estudo desenvolvido como parte do doutorado de uma das autoras sobre a importância da utilização dessas novas formas de apoio ao processo de projeto, levantando dinâmicas capazes de colaborar com o ambiente de ensino de projeto. Tais dinâmicas mostram-se dispersas pela literatura e em formatos variados, como jogos de tabuleiro, de cartas, grupos focais, brainstormings, ferramentas eletrônicas, entre outras. Apresenta-se revisão bibliográfica sobre essas técnicas disponíveis e a experiência de uso do jogo Baralho da Escola- Desembaralhando a Arquitetura Escolar no ambiente de ensino foi selecionada como estudo de caso para esta pesquisa. Testes com essa ferramenta foram utilizados com alunos de terceiro ano de arquitetura e urbanismo, da Universidade de São Paulo e sua utilização mostrou-se muito favorável, facilitando o aprendizado de programa arquitetônico. O formato do jogo propiciou maior foco dos participantes, por meio de uma discussão ampla e bastante produtiva. A experiência com a ferramenta do Baralho da Escola demonstrou que dinâmicas desse tipo podem ser incluídas no ambiente de ensino, tornando mais efetivo o ensino de conceitos através de maneiras mais criativas e engajadoras, facilitam o aprendizado.
A permanência do dormitório da empregada nos apartamentos: estudo comparativo nas décadas de 1960 a 1990 em Maceió/AL
Authors: Lima Jéssica Caroline Rodrigues de , Toledo Alexandre Márcio
Published: January 2019

Morar nas cidades grandes representou uma transição lenta dos edifícios unifamiliares aos multifamiliares. As plantas iniciais dos apartamentos reproduziram a tripartição funcional da casa burguesa urbana e mantiveram a dependência completa de empregada, com acesso distinto pelo setor de serviço. A presença da empregada doméstica nas residências brasileiras constitui um fator cultural, sobretudo nas famílias nordestinas das classes média e alta. O objetivo do presente artigo é traçar uma trajetória da dependência de empregada nos edifícios de apartamentos construídos na cidade de Maceió, Estado de Alagoas, Brasil, nas décadas de 1960 a 1990. Utilizou-se como banco de dados pesquisas realizadas pelo Grupo de Estudos em Projeto de Arquitetura (gEPA) da Faculdade de Arquitetura e Urbanismo da Universidade Federal de Alagoas, que reúne 228 edifícios multifamiliares verticais de diversas tipologias. Observou-se que, nas décadas de 1960 e 1970, todos os apartamentos possuíam dependência de empregada, até mesmo os da tipologia de 02 dormitórios. Apenas na década de 1980, surgiram os apartamentos com o terceiro dormitório reversível, com indícios de flexibilização nas plantas. Na década de 1990, a dependência de empregada permanece somente nas tipologias de apartamentos de 3 e 4 dormitórios. Conclui-se que a presença da dependência de empregada prevaleceu sobre a oferta de apartamentos produzidos nas quatro décadas analisadas, sobretudo nas tipologias de 3 e 4 dormitórios; e que as mudanças anunciadas pela legislação trabalhista de 1988 não alteraram de maneira significativa os hábitos de morar das famílias alagoanas de renda mais elevada.
Taxonomic revision of the genus Xenogryllus Bolívar, 1890 (Orthoptera, Gryllidae, Eneopterinae, Xenogryllini)
Authors: JAISWARA RANJANA , DONG JIAJIA , MA LIBIN , YIN HAISHENG , ROBILLARD TONY
Published: January 2019

Subfamily Eneopterinae has been studied for its diversified acoustic modalities and disjunct distribution. The genus Xenogryllus Bolívar, 1890 is one of the oldest genera of the subfamily, and the first genus of the tribe Xenogryllini. Xenogryllus is known for its low-frequency calling songs and wide distribution across Africa and Asia. It is known from six species and has never been subject to formal taxonomic revision and description of acoustic features of their calling songs is lacking. Therefore, this study consists of a detailed taxonomic revision of all the species. We redescribe or append their taxonomic features using external morphological features and internal genitalic structures. We update the list of Xenogryllus by describing three new spe
Regional Decadal Climate Predictions Using an Ensemble of WRF Parameterizations Driven by the MIROC5 GCM
Authors: Strobach Ehud , Bel Golan
Published: January 2019

Regional climate models (RCMs) are expected to provide better representations of the climate dynamics because of their higher spatial resolutions. Here, we generated an ensemble of decadal (2006–36) RCM predictions for the area of Israel, which spans a considerable climatic gradient and comprises complex terrain. We used the WRF Model forced by the MIROC5 global climate model (GCM). The ensemble was generated by choosing different combinations of radiation, microphysics, surface layer, and planetary boundary layer parameterizations. The simulation results were compared with meteorological station data for the first simulated decade. For the minimum surface temperature, all the RCM configurations performed better than the driving GCM, while for the maximum surface temperature, only three out of eight configurations improved the predictions. The RCM configurations had higher errors in predicting the precipitation, but four configurations had comparable errors to the GCM. For the next two decades, the ensemble average predicts an increase of 0.51° and 0.40°C decade−1 for the average daily minimum and maximum surface temperatures, respectively. No significant change is predicted in the precipitation. We found that all the parameterizations affect the predictions of the surface temperatures and precipitation [e.g., the CAM radiation scheme simulates colder temperatures than the RRTM for GCMs (RRTMG)] but the PBL and surface layer scheme has the largest effect on the errors. Spectral nudging was found to have a considerable effect on the deviations of the precipitation predicted by the WRF configurations from the predictions of the GCM and a much smaller effect on the surface temperature predictions.
Digital Staining of High-Definition Fourier Transform Infrared (FT-IR) Images Using Deep Learning
Authors: Lotfollahi Mahsa , Berisha Sebastian , Daeinejad Davar , Mayerich David
Published: January 2019

Histological stains, such as hematoxylin and eosin (H&E), are routinely used in clinical diagnosis and research. While these labels offer a high degree of specificity, throughput is limited by the need for multiple samples. Traditional histology stains, such as immunohistochemical labels, also rely only on protein expression and cannot quantify small molecules and metabolites that may aid in diagnosis. Finally, chemical stains and dyes permanently alter the tissue, making downstream analysis impossible. Fourier transform infrared (FT-IR) spectroscopic imaging has shown promise for label-free characterization of important tissue phenotypes and can bypass the need for many chemical labels. Fourier transform infrared classification commonly leverages supervised learning, requiring human annotation that is tedious and prone to errors. One alternative is digital staining, which leverages machine learning to map IR spectra to a corresponding chemical stain. This replaces human annotation with computer-aided alignment. Previous work relies on alignment of adjacent serial tissue sections. Since the tissue samples are not identical at the cellular level, this technique cannot be applied to high-definition FT-IR images. In this paper, we demonstrate that cellular-level mapping can be accomplished using identical samples for both FT-IR and chemical labels. In addition, higher-resolution results can be achieved using a deep convolutional neural network that integrates spatial and spectral features.
Comparing clinical and counselling psychologists’ practitioner demographics, key activities, theoretical orientations, values, and career satisfaction: a contribution to the Scopes of Practice debate
Authors: Young Charles , Saville Young Lisa
Published: January 2019

This article conducts a secondary analysis of combined survey data collected from clinical and counselling psychologists in South Africa with a view to contributing to the debate about their respective Scope of Practice. A comparison of clinical and counselling psychologists’ activities, where and how they are doing these activities and with what emphasis, as well as the similarities and differences between these categories with respect to demographic variables of their practitioners, values and career satisfaction, and views of their respective Scopes of Practice should provide guidance for the future regulation of both categories. In total, 1105 participants’ (comprising 877 registered clinical psychologists and 228 registered counselling psychologists) survey responses were analysed. Findings suggest that counselling and clinical psychologists are more similar than they are different, with responses indicating shared demographic characteristics, areas of overlap in terms of their key activities and theoretical orientations, and their satisfaction with their training and careers. Significant differences, where they did occur, included the race and gender of practitioners; time spent on assessment and research; emphasis on psychodynamic orientations; endorsement of values; views on the Scopes of Practice regulations that were promulgated in 2011; and in each specialties sense of distinctiveness. Findings are discussed in the context of vigorous contestation over the Scopes of Practice in South Africa, where access to mental health services remains poor and the profession largely untransformed.
Coping strategies adopted by adolescents: A comparative study in relation to gifted status, gender, and family size
Authors: Breik Wisam Darwiesh , Zaza Haidar Ibrahim
Published: January 2019

This study examines differences in coping strategies (CSs) in relation to gifted status, gender, and family size. Two hundred gifted adolescents were selected from gifted schools, and 1000 non-gifted adolescents were selected from ordinary schools. One-way multivariate analysis of variance produced significant differences among the subjects in relation to gifted status, gender, and family size. Descriptive discriminant analysis revealed that the CS “Seeking Professional Support” was the most significant to distinguish between gifted and non-gifted adolescents among the selected variables (i.e. gifted status, gender, and family size). Moreover, “Investing in Close Friend” was the most significant to distinguish between the participants in relation to gender. On the other hand, “Ventilating Feelings” contributed the most in distinguishing between the subjects in relation to family size.
Development and Validation of the Real-World Progression in Diabetes (RAPIDS) Model
Authors: Basu Anirban , Sohn Min-Woong , Bartle Brian , Chan Kwun Chuen Gary , Cooper Jennifer M. , Huang Elbert
Published: January 2019

Introduction. To develop and validate the first real-world data-based type 2 diabetes progression model (RAPIDS) employing econometric techniques that can study the comparative effects of complex dynamic patterns of glucose-lowering drug use. Methods. The US Department of Veterans Affairs (VA) electronic medical record and claims databases were used to identify over 500,000 diabetes patients in 2003 with up to 9-year follow-up. The RAPIDS model contains interdependent first-order Markov processes over quarters for each of the micro- and macrovascular events, hypoglycemia, and death, as well as predictive models for 8 biomarker levels. Model parameters varied by static demographic factors and dynamic factors, such as age, duration of diabetes, 13 possible glucose-lowering treatment combinations, any blood pressure and any cholesterol-lowering medications, and cardiovascular history. To illustrate model capabilities, a simple comparative study was set up to compare observed treatment use patterns to alternate patterns if perfect adherence is assumed following initiating the use of any of these medications. Results. Data were randomly split into 307,288, 105,195, and 105,081 patients to perform estimation, out-of-sample calibration, and validation, respectively. Model predictions in the validation sample closely aligned with the observed longitudinal trajectory of biomarkers and outcomes. Perfect adherence among initiators increased proportion of days covered by only 6 months. Most of this increase came from increased adherence to monotherapies and did not lead to meaningful changes in any of the outcomes over the 9-year period. Conclusion. Future value of increasing medication adherence among VA patients with diabetes may lie among those who never initiate treatment or are late in initiating treatment. The first-of-its-kind real-world data-based model has the potential to carry out many complex comparative-effectiveness research (CER) studies of dynamic glucose-lowering drug regimens.