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  • Open Access
    Authors: 
    David A. Palma; Robert Olson; Stephen Harrow; Rohann J. M. Correa; Famke Schneiders; Cornelis J. A. Haasbeek; George B. Rodrigues; Michael Lock; Brian P. Yaremko; Glenn S. Bauman; +15 more
    Publisher: Scholarship@Western
    Countries: Canada, United Kingdom, Netherlands

    Background Stereotactic ablative radiotherapy (SABR) has emerged as a new treatment option for patients with oligometastatic disease. SABR delivers precise, high-dose, hypofractionated radiotherapy, and achieves excellent rates of local control for primary tumors or metastases. A recent randomized phase II trial evaluated SABR in a group of patients with a small burden of oligometastatic disease (mostly with 1–3 metastatic lesions), and found that SABR was associated with benefits in progression-free survival and overall survival. The goal of this phase III trial is to assess the impact of SABR in patients with 4–10 metastatic cancer lesions. Methods One hundred and fifty-nine patients will be randomized in a 1:2 ratio between the control arm (consisting of standard of care palliative-intent treatments), and the SABR arm (consisting of standard of care treatment + SABR to all sites of known disease). Randomization will be stratified by two factors: histology (Group 1: prostate, breast, or renal; Group 2: all others), and type of pre-specified systemic therapy (Group 1: immunotherapy/targeted; Group 2: cytotoxic; Group 3: observation). SABR is to be completed within 2 weeks, allowing for rapid initiation of systemic therapy. Recommended SABR doses are 20 Gy in 1 fraction, 30 Gy in 3 fractions, or 35 Gy in 5 fractions, chosen to minimize risks of toxicity. The primary endpoint is overall survival, and secondary endpoints include progression-free survival, time to development of new metastatic lesions, quality of life, and toxicity. Translational endpoints include assessment of circulating tumor cells, cell-free DNA, and tumor tissue as prognostic and predictive markers, including assessment of immunological predictors of response and long-term survival. Discussion This study will provide an assessment of the impact of SABR on clinical outcomes and quality of life, to determine if long-term survival can be achieved for selected patients with 4–10 oligometastatic lesions. Trial registration Clinicaltrials.gov identifier: NCT03721341. Date of registration: October 26, 2018. Electronic supplementary material The online version of this article (10.1186/s12885-019-5977-6) contains supplementary material, which is available to authorized users.

  • Publication . Other literature type . Review . Article . 2020
    Open Access
    Authors: 
    Carrie Anne Marshall; Leonie Boland; Lee Ann Westover; Roxanne Isard; Sharon A. Gutman;
    Publisher: Informa UK Limited
    Country: Canada

    Background: Although systematic and scoping reviews have identified a range of interventions for persons experiencing homelessness, no known reviews have captured the range and quality of intervention studies aimed at supporting a transition from homelessness. Objectives: To capture the range and quality of occupational therapy intervention studies aimed at supporting a transition to housing following homelessness. Method: Using Joanna Briggs Institute (JBI) guidelines, we conducted a systematic review including a critical appraisal and narrative synthesis of experimental studies. Results: Eleven studies were included. Critical appraisal scores ranged from 33.3 to 88.9 of a possible score of 100 (Mdn = 62.5; IQR = 33.4). The majority of studies evaluated interventions for the development of life skills (n = 9; 81.8%), and all were conducted in the USA. Several of the included studies were exploratory evaluation and feasibility studies, and all were quasi-experimental in design. Only three studies (27.2%) incorporated a control group. Intervention strategies included (1) integrated group and individual life skills interventions (n = 6); (2) group-based life skills interventions (n = 3); and (3) psychosocial and consultative interventions (n = 2). Conclusions: Research evaluating occupational therapy interventions aimed at supporting homeless individuals as they transition to housing is in an early stage of development. Significance: Implications for research and practice are discussed.

  • Open Access
    Authors: 
    Susan W. Hunter; Alison Divine; Humberto Omana; Edward Madou; Jeffrey D. Holmes;
    Publisher: Scholarship@Western
    Countries: Canada, United Kingdom

    Abstract Background Balance and gait problems are common and progressive in dementia. Use of a mobility aid provides physical support and confidence. Yet, mobility aid use in people with dementia increases falls three-fold. An assessment tool of mobility aid safety in people with dementia does not currently exist. The objectives of this study were: 1) to develop a tool for the evaluation of physical function and safe use of a 4-wheeled walker in people with dementia, and 2) to evaluate its construct and criterion validity, inter-rater and test-retest reliability and minimal detectable change. Methods Healthcare professionals (HCP) experienced in rehabilitation of people with dementia participated in focus groups for item generation of the new tool, The Safe Use of Mobility Aid Checklist (SUMAC). The SUMAC evaluates physical function (PF) and safe use of the equipment (EQ) on nine tasks of daily life. Reliability was evaluated by HCP (n = 5) scored participant videos of people with dementia (n = 10) using a 4-wheeled walker performing the SUMAC. Inter-rater and test-retest reliability was assessed using intra-class correlation coefficients (ICC). Construct validity evaluated scores of the HCPs to a consensus HCP panel using Spearman’s rank-order correlations. Criterion validity evaluated SUMAC-PF to the Performance-Oriented Mobility Assessment (POMA) gait subscale using Spearman’s rank-order correlations. Results Three focus groups (n = 17) generated a tool comprised of nine tasks and the components within each task for physical function and safe use. Inter-rater reliability was statistically significant for SUMAC-PF (ICC = 0.92, 95%CI (0.81, 0.98), p < 0.001) and SUMAC-EQ. (ICC = 0.82, 95%CI (0.54, 0.95), p < 0.001). Test-retest reliability was statistically significant for SUMAC-PF (ICC = 0.89, 95%CI (0.81, 0.94), p < 0.001) and SUMAC-EQ. (ICC = 0.88, 95%CI (0.79, 0.93), p < 0.001). As hypothesized, the POMA gait subscale correlated strongly with the SUMAC-PF (rs = 0.84), but not EQ (rs = 0.39). Conclusions The focus groups and research team developed a tool of nine tasks with evaluation on physical function and safe use of a 4-wheeled walker for people with dementia. The SUMAC tool has demonstrated content validity for the whole scale and good construct and criterion validity for the SUMAC-PF and SUMAC-EQ. The subscores of the SUMAC demonstrated excellent to good inter-rater and test-retest reliability.

  • Open Access English
    Authors: 
    Madiha Salman; Jason I. Gerhard; David W. Major; Paolo Pironi; Rory Hadden;
    Countries: United Kingdom, Canada

    Self-sustaining treatment for active remediation (STAR) is an innovative soil remediation approach based on smoldering combustion that has been demonstrated to effectively destroy complex hydrocarbon nonaqueous phase liquids (NAPLs) with minimal energy input. This is the first study to explore the smoldering remediation of sand contaminated by a volatile NAPL (trichloroethylene, TCE) and the first to consider utilizing vegetable oil as supplemental fuel for STAR. Thirty laboratory-scale experiments were conducted to evaluate the relationship between key outcomes (TCE destruction, rate of remediation) to initial conditions (vegetable oil type, oil: TCE mass ratio, neat versus emulsified oils). Several vegetable oils and emulsified vegetable oil formulations were shown to support remediation of TCE via self-sustaining smoldering. A minimum concentration of 14,000 mg/kg canola oil was found to treat sand exhibiting up to 80,000 mg/kg TCE. On average, 75% of the ICE mass was removed due to volatilization. This proof-of-concept study suggests that injection and smoldering of vegetable oil may provide a new alternative for driving volatile contaminants to traditional vapour extraction systems without supplying substantial external energy. (C) 2014 Elsevier B.V. All rights reserved.

  • Publication . Other literature type . Article . 2017
    Open Access
    Authors: 
    Jing Xu; Naveed Ejaz; Benjamin Hertler; Meret Branscheidt; Mario Widmer; Andreia V. Faria; Michelle D. Harran; Juan C. Cortes; Nathan Kim; Pablo Celnik; +4 more
    Publisher: Scholarship@Western
    Countries: Switzerland, Canada
    Project: WT

    Impaired hand function after stroke is a major cause of long-term disability. We developed a novel paradigm that quantifies two critical aspects of hand function, strength, and independent control of fingers (individuation), and also removes any obligatory dependence between them. Hand recovery was tracked in 54 patients with hemiparesis over the first year after stroke. Most recovery of strength and individuation occurred within the first 3 mo. A novel time-invariant recovery function was identified: recovery of strength and individuation were tightly correlated up to a strength level of ~60% of estimated premorbid strength; beyond this threshold, strength improvement was not accompanied by further improvement in individuation. Any additional improvement in individuation was attributable instead to a second process that superimposed on the recovery function. We conclude that two separate systems are responsible for poststroke hand recovery: one contributes almost all of strength and some individuation; the other contributes additional individuation. NEW & NOTEWORTHY We tracked recovery of the hand over a 1-yr period after stroke in a large cohort of patients, using a novel paradigm that enabled independent measurement of finger strength and control. Most recovery of strength and control occurs in the first 3 mo after stroke. We found that two separable systems are responsible for motor recovery of hand: one contributes strength and some dexterity, whereas a second contributes additional dexterity.

  • Open Access
    Authors: 
    Rieder, Michael; Hawcutt, Daniel;
    Publisher: Scholarship@Western
    Countries: Canada, United Kingdom

    It has historically been very difficult to conduct early phase drug studies in children for a number of reasons related to ethics, acceptability, rarity, standardization, end points, safety, dosing and feasibility. Over the past decade there have been a number of developments including novel clinical trial design, in silico pharmacology and microdosing that have significantly enhanced the ability of investigators to conduct early phase drug studies in children. While the evolution of drug therapy is creating a series of new challenges, there has never been a better time for conducting drug studies in children.

  • Open Access English
    Authors: 
    Andrew S Moriarty; Nicholas Meader; Kym I E Snell; Richard D Riley; Lewis William Paton; Carolyn Chew-Graham; Simon Gilbody; Rachel Churchill; Robert S. Phillips; Shehzad Ali; +1 more
    Countries: United Kingdom, United Kingdom, Canada

    BACKGROUND: Relapse (the re-emergence of depressive symptoms after some level of improvement but preceding recovery) and recurrence (onset of a new depressive episode after recovery) are common in depression, lead to worse outcomes and quality of life for patients and exert a high economic cost on society. Outcomes can be predicted by using multivariable prognostic models, which use information about several predictors to produce an individualised risk estimate. The ability to accurately predict relapse or recurrence while patients are well (in remission) would allow the identification of high-risk individuals and may improve overall treatment outcomes for patients by enabling more efficient allocation of interventions to prevent relapse and recurrence. \ud \ud OBJECTIVES: To summarise the predictive performance of prognostic models developed to predict the risk of relapse, recurrence, sustained remission or recovery in adults with major depressive disorder who meet criteria for remission or recovery. \ud \ud SEARCH METHODS: We searched the Cochrane Library (current issue); Ovid MEDLINE (1946 onwards); Ovid Embase (1980 onwards); Ovid PsycINFO (1806 onwards); and Web of Science (1900 onwards) up to May 2020. We also searched sources of grey literature, screened the reference lists of included studies and performed a forward citation search. There were no restrictions applied to the searches by date, language or publication status . \ud \ud SELECTION CRITERIA: We included development and external validation (testing model performance in data separate from the development data) studies of any multivariable prognostic models (including two or more predictors) to predict relapse, recurrence, sustained remission, or recovery in adults (aged 18 years and over) with remitted depression, in any clinical setting. We included all study designs and accepted all definitions of relapse, recurrence and other related outcomes. We did not specify a comparator prognostic model. \ud \ud DATA COLLECTION AND ANALYSIS: Two review authors independently screened references; extracted data (using a template based on the CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies (CHARMS)); and assessed risks of bias of included studies (using the Prediction model Risk Of Bias ASsessment Tool (PROBAST)). We referred any disagreements to a third independent review author. Where we found sufficient (10 or more) external validation studies of an individual model, we planned to perform a meta-analysis of its predictive performance, specifically with respect to its calibration (how well the predicted probabilities match the observed proportions of individuals that experience the outcome) and discrimination (the ability of the model to differentiate between those with and without the outcome). Recommendations could not be qualified using the GRADE system, as guidance is not yet available for prognostic model reviews. \ud \ud MAIN RESULTS: We identified 11 eligible prognostic model studies (10 unique prognostic models). Seven were model development studies; three were model development and external validation studies; and one was an external validation-only study. Multiple estimates of performance measures were not available for any of the models and, meta-analysis was therefore not possible. Ten out of the 11 included studies were assessed as being at high overall risk of bias. Common weaknesses included insufficient sample size, inappropriate handling of missing data and lack of information about discrimination and calibration. One paper (Klein 2018) was at low overall risk of bias and presented a prognostic model including the following predictors: number of previous depressive episodes, residual depressive symptoms and severity of the last depressive episode. The external predictive performance of this model was poor (C-statistic 0.59; calibration slope 0.56; confidence intervals not reported). None of the identified studies examined the clinical utility (net benefit) of the developed model.\ud \ud AUTHORS' CONCLUSIONS: Of the 10 prognostic models identified (across 11 studies), only four underwent external validation. Most of the studies (n = 10) were assessed as being at high overall risk of bias, and the one study that was at low risk of bias presented a model with poor predictive performance. There is a need for improved prognostic research in this clinical area, with future studies conforming to current best practice recommendations for prognostic model development/validation and reporting findings in line with the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) statement.

  • Open Access
    Authors: 
    Joo Ho Tai; Jean J. Tessier; Anderson J. Ryan; Lisa M. Hoffman; Xiaogang Chen; Ting-Yim Lee;
    Publisher: Scholarship@Western
    Countries: United Kingdom, Canada

    Tumor size is not a reliable marker for the assessment of early antivascular effects of antiangiogenics. In the present study, we used 200-μm in-plane high-resolution dynamic contrast-enhanced computed tomography (DCE-CT) to noninvasively assess the immediate antivascular effects of vandetanib in a subcutaneous human colon cancer (LoVo) xenograft model in nude rats and to investigate correlation between changes in CT perfusion parameters and tumor volume or immunohistochemical end points. At 3 to 4 weeks after LoVo cell implantation, the animal was gavaged with either vandetanib (50 mg/kg) or vehicle twice (22 hours apart) and scanned with a preclinical DCE-CT scanner before (0 hour) and after treatment (24 hours). Quantitative maps of blood flow (BF) and volume (BV) of the tumor were calculated from the acquired DCE-CT images. The rats were divided into nonhypovascular, hypovascular, and combined (regardless of vascularity) groups. In the nonhypovascular group, significant decreases in both tumor BF and BV were observed in the vandetanib-treated rats compared with increases in the vehicle-treated rats. A significant decrease in BV was detected in the vandetanib-treated rats in the combined group as well. No differences in tumor growth, vascular endothelial growth factor expression, microvessel density, or apoptosis were observed between vandetanib- and vehicle-treated rats in all three groups. These results demonstrate that BF and BV imaging biomarkers from DCE-CT imaging can be used for rapid monitoring of immediate (24 hours after) antimicrovascular effects of vandetanib on tumors, even in the absence of significant changes of tumor volume or clinically relevant immunohistochemical end points. © 2010 Neoplasia Press, Inc.

  • Open Access
    Authors: 
    Jörn Diedrichsen; Tobias Wiestler; Naveed Ejaz;
    Publisher: Elsevier BV
    Country: Canada
    Project: WT | Learning and recovery of ... (094874), WT | Core support for the Well... (091593)

    How do populations of neurons represent a variable of interest? The notion of feature spaces is a useful concept to approach this question: According to this model, the activation patterns across a neuronal population are composed of different pattern components. The strength of each of these components varies with one latent feature, which together are the dimensions along which the population represents the variable. Here we propose a new method to determine the number of feature dimensions that best describes the activation patterns. The method is based on Gaussian linear classifiers that use only the first d most important pattern dimensions. Using cross-validation, we can identify the classifier that best matches the dimensionality of the neuronal representation. We test this method on two datasets of motor cortical activation patterns measured with functional magnetic resonance imaging (fMRI), during (i) simultaneous presses of all fingers of a hand at different force levels and (ii) presses of different individual fingers at a single force level. As expected, the new method shows that the representation of force is low-dimensional; the neural activation for different force levels is scaled versions of each other. In comparison, individual finger presses are represented in a full, four-dimensional feature space. The approach can be used to determine an important characteristic of neuronal population codes without knowing the form of the underlying features. It therefore provides a novel tool in the building of quantitative models of neuronal population activity as measured with fMRI or other approaches. Highlights • Neural population activity represents external variables using multiple feature dimensions. • We present a general method to determine the dimensionality of this feature space. • Primary motor cortex represents force through a low-dimensional feature space. • Individual finger movements are represented using a four-dimensional feature space.

  • Open Access
    Authors: 
    Ruth Wright;
    Publisher: SelectedWorks
    Country: Canada

    This article originated from a research project examining pupils' perceptions of the GCSE Music examination (for pupils aged 15–16) in one large secondary school in the United Kingdom. The research explored the hypothesis that pupils considered it necessary to have additional instrumental or vocal tuition outside class music lessons in order to secure a high grade in the examination. The research also hypothesised that, despite the egalitarian philosophy underpinning the General Certificate of Secondary Education (GCSE) examination system, the music course was still viewed by pupils as being élitist. It was concluded that although there were some very positive comments from pupils, GCSE Music was still not the intended examination for all.

search
Include:
The following results are related to Canada. Are you interested to view more results? Visit OpenAIRE - Explore.
620 Research products, page 1 of 62
  • Open Access
    Authors: 
    David A. Palma; Robert Olson; Stephen Harrow; Rohann J. M. Correa; Famke Schneiders; Cornelis J. A. Haasbeek; George B. Rodrigues; Michael Lock; Brian P. Yaremko; Glenn S. Bauman; +15 more
    Publisher: Scholarship@Western
    Countries: Canada, United Kingdom, Netherlands

    Background Stereotactic ablative radiotherapy (SABR) has emerged as a new treatment option for patients with oligometastatic disease. SABR delivers precise, high-dose, hypofractionated radiotherapy, and achieves excellent rates of local control for primary tumors or metastases. A recent randomized phase II trial evaluated SABR in a group of patients with a small burden of oligometastatic disease (mostly with 1–3 metastatic lesions), and found that SABR was associated with benefits in progression-free survival and overall survival. The goal of this phase III trial is to assess the impact of SABR in patients with 4–10 metastatic cancer lesions. Methods One hundred and fifty-nine patients will be randomized in a 1:2 ratio between the control arm (consisting of standard of care palliative-intent treatments), and the SABR arm (consisting of standard of care treatment + SABR to all sites of known disease). Randomization will be stratified by two factors: histology (Group 1: prostate, breast, or renal; Group 2: all others), and type of pre-specified systemic therapy (Group 1: immunotherapy/targeted; Group 2: cytotoxic; Group 3: observation). SABR is to be completed within 2 weeks, allowing for rapid initiation of systemic therapy. Recommended SABR doses are 20 Gy in 1 fraction, 30 Gy in 3 fractions, or 35 Gy in 5 fractions, chosen to minimize risks of toxicity. The primary endpoint is overall survival, and secondary endpoints include progression-free survival, time to development of new metastatic lesions, quality of life, and toxicity. Translational endpoints include assessment of circulating tumor cells, cell-free DNA, and tumor tissue as prognostic and predictive markers, including assessment of immunological predictors of response and long-term survival. Discussion This study will provide an assessment of the impact of SABR on clinical outcomes and quality of life, to determine if long-term survival can be achieved for selected patients with 4–10 oligometastatic lesions. Trial registration Clinicaltrials.gov identifier: NCT03721341. Date of registration: October 26, 2018. Electronic supplementary material The online version of this article (10.1186/s12885-019-5977-6) contains supplementary material, which is available to authorized users.

  • Publication . Other literature type . Review . Article . 2020
    Open Access
    Authors: 
    Carrie Anne Marshall; Leonie Boland; Lee Ann Westover; Roxanne Isard; Sharon A. Gutman;
    Publisher: Informa UK Limited
    Country: Canada

    Background: Although systematic and scoping reviews have identified a range of interventions for persons experiencing homelessness, no known reviews have captured the range and quality of intervention studies aimed at supporting a transition from homelessness. Objectives: To capture the range and quality of occupational therapy intervention studies aimed at supporting a transition to housing following homelessness. Method: Using Joanna Briggs Institute (JBI) guidelines, we conducted a systematic review including a critical appraisal and narrative synthesis of experimental studies. Results: Eleven studies were included. Critical appraisal scores ranged from 33.3 to 88.9 of a possible score of 100 (Mdn = 62.5; IQR = 33.4). The majority of studies evaluated interventions for the development of life skills (n = 9; 81.8%), and all were conducted in the USA. Several of the included studies were exploratory evaluation and feasibility studies, and all were quasi-experimental in design. Only three studies (27.2%) incorporated a control group. Intervention strategies included (1) integrated group and individual life skills interventions (n = 6); (2) group-based life skills interventions (n = 3); and (3) psychosocial and consultative interventions (n = 2). Conclusions: Research evaluating occupational therapy interventions aimed at supporting homeless individuals as they transition to housing is in an early stage of development. Significance: Implications for research and practice are discussed.

  • Open Access
    Authors: 
    Susan W. Hunter; Alison Divine; Humberto Omana; Edward Madou; Jeffrey D. Holmes;
    Publisher: Scholarship@Western
    Countries: Canada, United Kingdom

    Abstract Background Balance and gait problems are common and progressive in dementia. Use of a mobility aid provides physical support and confidence. Yet, mobility aid use in people with dementia increases falls three-fold. An assessment tool of mobility aid safety in people with dementia does not currently exist. The objectives of this study were: 1) to develop a tool for the evaluation of physical function and safe use of a 4-wheeled walker in people with dementia, and 2) to evaluate its construct and criterion validity, inter-rater and test-retest reliability and minimal detectable change. Methods Healthcare professionals (HCP) experienced in rehabilitation of people with dementia participated in focus groups for item generation of the new tool, The Safe Use of Mobility Aid Checklist (SUMAC). The SUMAC evaluates physical function (PF) and safe use of the equipment (EQ) on nine tasks of daily life. Reliability was evaluated by HCP (n = 5) scored participant videos of people with dementia (n = 10) using a 4-wheeled walker performing the SUMAC. Inter-rater and test-retest reliability was assessed using intra-class correlation coefficients (ICC). Construct validity evaluated scores of the HCPs to a consensus HCP panel using Spearman’s rank-order correlations. Criterion validity evaluated SUMAC-PF to the Performance-Oriented Mobility Assessment (POMA) gait subscale using Spearman’s rank-order correlations. Results Three focus groups (n = 17) generated a tool comprised of nine tasks and the components within each task for physical function and safe use. Inter-rater reliability was statistically significant for SUMAC-PF (ICC = 0.92, 95%CI (0.81, 0.98), p < 0.001) and SUMAC-EQ. (ICC = 0.82, 95%CI (0.54, 0.95), p < 0.001). Test-retest reliability was statistically significant for SUMAC-PF (ICC = 0.89, 95%CI (0.81, 0.94), p < 0.001) and SUMAC-EQ. (ICC = 0.88, 95%CI (0.79, 0.93), p < 0.001). As hypothesized, the POMA gait subscale correlated strongly with the SUMAC-PF (rs = 0.84), but not EQ (rs = 0.39). Conclusions The focus groups and research team developed a tool of nine tasks with evaluation on physical function and safe use of a 4-wheeled walker for people with dementia. The SUMAC tool has demonstrated content validity for the whole scale and good construct and criterion validity for the SUMAC-PF and SUMAC-EQ. The subscores of the SUMAC demonstrated excellent to good inter-rater and test-retest reliability.

  • Open Access English
    Authors: 
    Madiha Salman; Jason I. Gerhard; David W. Major; Paolo Pironi; Rory Hadden;
    Countries: United Kingdom, Canada

    Self-sustaining treatment for active remediation (STAR) is an innovative soil remediation approach based on smoldering combustion that has been demonstrated to effectively destroy complex hydrocarbon nonaqueous phase liquids (NAPLs) with minimal energy input. This is the first study to explore the smoldering remediation of sand contaminated by a volatile NAPL (trichloroethylene, TCE) and the first to consider utilizing vegetable oil as supplemental fuel for STAR. Thirty laboratory-scale experiments were conducted to evaluate the relationship between key outcomes (TCE destruction, rate of remediation) to initial conditions (vegetable oil type, oil: TCE mass ratio, neat versus emulsified oils). Several vegetable oils and emulsified vegetable oil formulations were shown to support remediation of TCE via self-sustaining smoldering. A minimum concentration of 14,000 mg/kg canola oil was found to treat sand exhibiting up to 80,000 mg/kg TCE. On average, 75% of the ICE mass was removed due to volatilization. This proof-of-concept study suggests that injection and smoldering of vegetable oil may provide a new alternative for driving volatile contaminants to traditional vapour extraction systems without supplying substantial external energy. (C) 2014 Elsevier B.V. All rights reserved.

  • Publication . Other literature type . Article . 2017
    Open Access
    Authors: 
    Jing Xu; Naveed Ejaz; Benjamin Hertler; Meret Branscheidt; Mario Widmer; Andreia V. Faria; Michelle D. Harran; Juan C. Cortes; Nathan Kim; Pablo Celnik; +4 more
    Publisher: Scholarship@Western
    Countries: Switzerland, Canada
    Project: WT

    Impaired hand function after stroke is a major cause of long-term disability. We developed a novel paradigm that quantifies two critical aspects of hand function, strength, and independent control of fingers (individuation), and also removes any obligatory dependence between them. Hand recovery was tracked in 54 patients with hemiparesis over the first year after stroke. Most recovery of strength and individuation occurred within the first 3 mo. A novel time-invariant recovery function was identified: recovery of strength and individuation were tightly correlated up to a strength level of ~60% of estimated premorbid strength; beyond this threshold, strength improvement was not accompanied by further improvement in individuation. Any additional improvement in individuation was attributable instead to a second process that superimposed on the recovery function. We conclude that two separate systems are responsible for poststroke hand recovery: one contributes almost all of strength and some individuation; the other contributes additional individuation. NEW & NOTEWORTHY We tracked recovery of the hand over a 1-yr period after stroke in a large cohort of patients, using a novel paradigm that enabled independent measurement of finger strength and control. Most recovery of strength and control occurs in the first 3 mo after stroke. We found that two separable systems are responsible for motor recovery of hand: one contributes strength and some dexterity, whereas a second contributes additional dexterity.

  • Open Access
    Authors: 
    Rieder, Michael; Hawcutt, Daniel;
    Publisher: Scholarship@Western
    Countries: Canada, United Kingdom

    It has historically been very difficult to conduct early phase drug studies in children for a number of reasons related to ethics, acceptability, rarity, standardization, end points, safety, dosing and feasibility. Over the past decade there have been a number of developments including novel clinical trial design, in silico pharmacology and microdosing that have significantly enhanced the ability of investigators to conduct early phase drug studies in children. While the evolution of drug therapy is creating a series of new challenges, there has never been a better time for conducting drug studies in children.

  • Open Access English
    Authors: 
    Andrew S Moriarty; Nicholas Meader; Kym I E Snell; Richard D Riley; Lewis William Paton; Carolyn Chew-Graham; Simon Gilbody; Rachel Churchill; Robert S. Phillips; Shehzad Ali; +1 more
    Countries: United Kingdom, United Kingdom, Canada

    BACKGROUND: Relapse (the re-emergence of depressive symptoms after some level of improvement but preceding recovery) and recurrence (onset of a new depressive episode after recovery) are common in depression, lead to worse outcomes and quality of life for patients and exert a high economic cost on society. Outcomes can be predicted by using multivariable prognostic models, which use information about several predictors to produce an individualised risk estimate. The ability to accurately predict relapse or recurrence while patients are well (in remission) would allow the identification of high-risk individuals and may improve overall treatment outcomes for patients by enabling more efficient allocation of interventions to prevent relapse and recurrence. \ud \ud OBJECTIVES: To summarise the predictive performance of prognostic models developed to predict the risk of relapse, recurrence, sustained remission or recovery in adults with major depressive disorder who meet criteria for remission or recovery. \ud \ud SEARCH METHODS: We searched the Cochrane Library (current issue); Ovid MEDLINE (1946 onwards); Ovid Embase (1980 onwards); Ovid PsycINFO (1806 onwards); and Web of Science (1900 onwards) up to May 2020. We also searched sources of grey literature, screened the reference lists of included studies and performed a forward citation search. There were no restrictions applied to the searches by date, language or publication status . \ud \ud SELECTION CRITERIA: We included development and external validation (testing model performance in data separate from the development data) studies of any multivariable prognostic models (including two or more predictors) to predict relapse, recurrence, sustained remission, or recovery in adults (aged 18 years and over) with remitted depression, in any clinical setting. We included all study designs and accepted all definitions of relapse, recurrence and other related outcomes. We did not specify a comparator prognostic model. \ud \ud DATA COLLECTION AND ANALYSIS: Two review authors independently screened references; extracted data (using a template based on the CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies (CHARMS)); and assessed risks of bias of included studies (using the Prediction model Risk Of Bias ASsessment Tool (PROBAST)). We referred any disagreements to a third independent review author. Where we found sufficient (10 or more) external validation studies of an individual model, we planned to perform a meta-analysis of its predictive performance, specifically with respect to its calibration (how well the predicted probabilities match the observed proportions of individuals that experience the outcome) and discrimination (the ability of the model to differentiate between those with and without the outcome). Recommendations could not be qualified using the GRADE system, as guidance is not yet available for prognostic model reviews. \ud \ud MAIN RESULTS: We identified 11 eligible prognostic model studies (10 unique prognostic models). Seven were model development studies; three were model development and external validation studies; and one was an external validation-only study. Multiple estimates of performance measures were not available for any of the models and, meta-analysis was therefore not possible. Ten out of the 11 included studies were assessed as being at high overall risk of bias. Common weaknesses included insufficient sample size, inappropriate handling of missing data and lack of information about discrimination and calibration. One paper (Klein 2018) was at low overall risk of bias and presented a prognostic model including the following predictors: number of previous depressive episodes, residual depressive symptoms and severity of the last depressive episode. The external predictive performance of this model was poor (C-statistic 0.59; calibration slope 0.56; confidence intervals not reported). None of the identified studies examined the clinical utility (net benefit) of the developed model.\ud \ud AUTHORS' CONCLUSIONS: Of the 10 prognostic models identified (across 11 studies), only four underwent external validation. Most of the studies (n = 10) were assessed as being at high overall risk of bias, and the one study that was at low risk of bias presented a model with poor predictive performance. There is a need for improved prognostic research in this clinical area, with future studies conforming to current best practice recommendations for prognostic model development/validation and reporting findings in line with the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) statement.

  • Open Access
    Authors: 
    Joo Ho Tai; Jean J. Tessier; Anderson J. Ryan; Lisa M. Hoffman; Xiaogang Chen; Ting-Yim Lee;
    Publisher: Scholarship@Western
    Countries: United Kingdom, Canada

    Tumor size is not a reliable marker for the assessment of early antivascular effects of antiangiogenics. In the present study, we used 200-μm in-plane high-resolution dynamic contrast-enhanced computed tomography (DCE-CT) to noninvasively assess the immediate antivascular effects of vandetanib in a subcutaneous human colon cancer (LoVo) xenograft model in nude rats and to investigate correlation between changes in CT perfusion parameters and tumor volume or immunohistochemical end points. At 3 to 4 weeks after LoVo cell implantation, the animal was gavaged with either vandetanib (50 mg/kg) or vehicle twice (22 hours apart) and scanned with a preclinical DCE-CT scanner before (0 hour) and after treatment (24 hours). Quantitative maps of blood flow (BF) and volume (BV) of the tumor were calculated from the acquired DCE-CT images. The rats were divided into nonhypovascular, hypovascular, and combined (regardless of vascularity) groups. In the nonhypovascular group, significant decreases in both tumor BF and BV were observed in the vandetanib-treated rats compared with increases in the vehicle-treated rats. A significant decrease in BV was detected in the vandetanib-treated rats in the combined group as well. No differences in tumor growth, vascular endothelial growth factor expression, microvessel density, or apoptosis were observed between vandetanib- and vehicle-treated rats in all three groups. These results demonstrate that BF and BV imaging biomarkers from DCE-CT imaging can be used for rapid monitoring of immediate (24 hours after) antimicrovascular effects of vandetanib on tumors, even in the absence of significant changes of tumor volume or clinically relevant immunohistochemical end points. © 2010 Neoplasia Press, Inc.

  • Open Access
    Authors: 
    Jörn Diedrichsen; Tobias Wiestler; Naveed Ejaz;
    Publisher: Elsevier BV
    Country: Canada
    Project: WT | Learning and recovery of ... (094874), WT | Core support for the Well... (091593)

    How do populations of neurons represent a variable of interest? The notion of feature spaces is a useful concept to approach this question: According to this model, the activation patterns across a neuronal population are composed of different pattern components. The strength of each of these components varies with one latent feature, which together are the dimensions along which the population represents the variable. Here we propose a new method to determine the number of feature dimensions that best describes the activation patterns. The method is based on Gaussian linear classifiers that use only the first d most important pattern dimensions. Using cross-validation, we can identify the classifier that best matches the dimensionality of the neuronal representation. We test this method on two datasets of motor cortical activation patterns measured with functional magnetic resonance imaging (fMRI), during (i) simultaneous presses of all fingers of a hand at different force levels and (ii) presses of different individual fingers at a single force level. As expected, the new method shows that the representation of force is low-dimensional; the neural activation for different force levels is scaled versions of each other. In comparison, individual finger presses are represented in a full, four-dimensional feature space. The approach can be used to determine an important characteristic of neuronal population codes without knowing the form of the underlying features. It therefore provides a novel tool in the building of quantitative models of neuronal population activity as measured with fMRI or other approaches. Highlights • Neural population activity represents external variables using multiple feature dimensions. • We present a general method to determine the dimensionality of this feature space. • Primary motor cortex represents force through a low-dimensional feature space. • Individual finger movements are represented using a four-dimensional feature space.

  • Open Access
    Authors: 
    Ruth Wright;
    Publisher: SelectedWorks
    Country: Canada

    This article originated from a research project examining pupils' perceptions of the GCSE Music examination (for pupils aged 15–16) in one large secondary school in the United Kingdom. The research explored the hypothesis that pupils considered it necessary to have additional instrumental or vocal tuition outside class music lessons in order to secure a high grade in the examination. The research also hypothesised that, despite the egalitarian philosophy underpinning the General Certificate of Secondary Education (GCSE) examination system, the music course was still viewed by pupils as being élitist. It was concluded that although there were some very positive comments from pupils, GCSE Music was still not the intended examination for all.