Public health and clinical recommendations are established from systematic reviews and retrospective meta-analyses combining effect sizes, traditionally, from aggregate data and more recently, using ...individual participant data (IPD) of published studies. However, trials often have outcomes and other meta-data that are not defined and collected in a standardized way, making meta-analysis problematic. IPD meta-analysis can only partially fix the limitations of traditional, retrospective, aggregate meta-analysis; prospective meta-analysis further reduces the problems.
We developed an initiative including seven clinical intervention studies of balanced energy-protein (BEP) supplementation during pregnancy and/or lactation that are being conducted (or recently concluded) in Burkina Faso, Ethiopia, India, Nepal, and Pakistan to test the effect of BEP on infant and maternal outcomes. These studies were commissioned after an expert consultation that designed recommendations for a BEP product for use among pregnant and lactating women in low- and middle-income countries. The initiative goal is to harmonize variables across studies to facilitate IPD meta-analyses on closely aligned data, commonly called prospective meta-analysis. Our objective here is to describe the process of harmonizing variable definitions and prioritizing research questions. A two-day workshop of investigators, content experts, and advisors was held in February 2020 and harmonization activities continued thereafter. Efforts included a range of activities from examining protocols and data collection plans to discussing best practices within field constraints. Prior to harmonization, there were many similar outcomes and variables across studies, such as newborn anthropometry, gestational age, and stillbirth, however, definitions and protocols differed. As well, some measurements were being conducted in several but not all studies, such as food insecurity. Through the harmonization process, we came to consensus on important shared variables, particularly outcomes, added new measurements, and improved protocols across studies.
We have fostered extensive communication between investigators from different studies, and importantly, created a large set of harmonized variable definitions within a prospective meta-analysis framework. We expect this initiative will improve reporting within each study in addition to providing opportunities for a series of IPD meta-analyses.
Supernova (SN) explosions have been sought for decades as a possible source of dust in the Universe, providing the seeds of galaxies, stars, and planetary systems. SN 1987A offers one of the most ...promising examples of significant SN dust formation, but until the James Webb Space Telescope (JWST), instruments have traditionally lacked the sensitivity at both late times (>1 yr post-explosion) and longer wavelengths (i.e., >10 um) to detect analogous dust reservoirs. Here we present JWST/MIRI observations of two historic Type IIP SNe, 2004et and SN 2017eaw, at nearly 18 and 5 yr post-explosion, respectively. We fit the spectral energy distributions as functions of dust mass and temperature, from which we are able to constrain the dust geometry, origin, and heating mechanism. We place a 90% confidence lower limit on the dust masses for SNe 2004et and 2017eaw of >0.014 and >4e-4 M_sun, respectively. More dust may exist at even colder temperatures or may be obscured by high optical depths. We conclude dust formation in the ejecta to be the most plausible and consistent scenario. The observed dust is radiatively heated to ~100-150 K by ongoing shock interaction with the circumstellar medium. Regardless of the best fit or heating mechanism adopted, the inferred dust mass for SN 2004et is the second highest (next to SN 1987A) inferred dust mass in extragalactic SNe thus far, promoting the prospect of SNe as potential significant sources of dust in the Universe.
Background
Extended‐duration betrixaban showed a significant reduction in venous thromboembolism in the APEX trial (Acute Medically Ill VTE Prevention With Extended Duration Betrixaban Study). Given ...the variable clinical impact of different efficacy and safety events, one approach to assess net clinical outcomes is to include only those events that are either fatal or cause irreversible harm.
Methods and Results
This was a post hoc analysis of the APEX trial—a multicenter, double‐blind, randomized controlled trial comparing extended‐duration betrixaban versus standard‐of‐care enoxaparin. A composite of all fatal or irreversible safety (fatal bleeding or intracranial hemorrhage) and efficacy events (cardiopulmonary death, myocardial infarction, pulmonary embolism, and ischemic stroke) was evaluated in a time‐to‐first event analysis. In patients with positive D‐dimer results, betrixaban reduced fatal or irreversible events at 35 to 42 days (4.80% versus 3.54%; hazard ratio, 0.73; absolute risk reduction, 1.26%; number needed to treat, 79 P=0.033) and at study end at 77 days (6.27% versus 4.36%; hazard ratio, 0.70; absolute risk reduction, 1.91%; number needed to treat, 52 P=0.005) versus enoxaparin. In all patients, betrixaban reduced fatal or irreversible events at 35 to 42 days (4.08% versus 2.90%; hazard ratio, 0.71; absolute risk reduction, 1.18%; number needed to treat, 86 P=0.006) and 77 days (5.17% versus 3.64%; hazard ratio, 0.70; absolute risk reduction, 1.53%; number needed to treat, 65 P=0.002).
Conclusions
Among hospitalized medically ill patients, extended‐duration betrixaban demonstrated an ≈30% reduction in fatal or irreversible ischemic or bleeding events compared with standard‐duration enoxaparin. A total of 65 patients would require treatment with betrixaban to prevent 1 fatal or irreversible event versus enoxaparin.
Clinical Trial Registration
URL: http://www.ClinicalTrials.gov. Unique identifier: NCT01583218.
We present optical and near-infrared photometry and spectroscopy of SN 2009ib, a Type II-P supernova in NGC 1559. This object has moderate brightness, similar to those of the intermediate-luminosity ...SNe 2008in and 2009N. Its plateau phase is unusually long, lasting for about 130 days after explosion. The spectra are similar to those of the subluminous SN 2002gd, with moderate expansion velocities. We estimate the \(^{56}\)Ni mass produced as \(0.046 \pm 0.015\,{\rm M}_{\sun}\). We determine the distance to SN 2009ib using both the expanding photosphere method (EPM) and the standard candle method. We also apply EPM to SN 1986L, a type II-P SN that exploded in the same galaxy. Combining the results of different methods, we conclude the distance to NGC 1559 as \(D=19.8 \pm 3.0\) Mpc. We examine archival, pre-explosion images of the field taken with the Hubble Space Telescope, and find a faint source at the position of the SN, which has a yellow colour (\((V-I)_0 = 0.85\) mag). Assuming it is a single star, we estimate its initial mass as \(M_{\rm ZAMS}=20\,{\rm M}_{\sun}\). We also examine the possibility, that instead of the yellow source the progenitor of SN 2009ib is a red supergiant star too faint to be detected. In this case we estimate the upper limit for the initial zero-age main sequence mass of the progenitor to be \(\sim 14-17\,{\rm M}_{\sun}\). In addition, we infer the physical properties of the progenitor at the explosion via hydrodynamical modelling of the observables, and estimate the total energy as \(\sim 0.55 \times 10^{51}\)~erg, the pre-explosion radius as \(\sim 400\,{\rm R}_{\sun}\), and the ejected envelope mass as \(\sim 15\,{\rm M}_{\sun}\), which implies that the mass of the progenitor before explosion was \(\sim 16.5-17\,{\rm M}_{\sun}\).
We present infrared photometry of all 36 potential JWST calibrators for which there is archival Spitzer IRAC data. This photometry can then be used to inform stellar models necessary to provide ...absolute calibration for all JWST instruments. We describe in detail the steps necessary to measure IRAC photometry from archive retrieval to photometric corrections. To validate our photometry we examine the distribution of uncertainties from all detections in all four IRAC channels as well as compare the photometry and its uncertainties to those from models, ALLWISE, and the literature. 75% of our detections have standard deviations per star of all observations within each channel of less than three percent. The median standard deviations are 1.2, 1.3, 1.1, and 1.9% in 3.6 - 8.0 respectively. We find less than 8% standard deviations in differences of our photometry with ALLWISE, and excellent agreement with literature values (less than 3% difference) lending credence to our measured fluxes. JWST is poised to do ground-breaking science, and accurate calibration and cross-calibration with other missions will be part of the underpinnings of that science.
Strongly decelerated expansion of SN 1979C Marcaide, J. M.; Pérez-Torres, M. A.; Ros, E. ...
Astronomy & astrophysics,
03/2002, Letnik:
384, Številka:
2
Journal Article
Recenzirano
Odprti dostop
We observed SN 1979C in M100 on 4 June 1999, about twenty years after explosion, with a very sensitive four-antenna VLBI array at the wavelength of λ18 cm. The distance to M100 and the expansion ...velocities are such that the supernova cannot be fully resolved by our Earth-wide array. Model-dependent sizes for the source have been determined and compared with previous results. We conclude that the supernova shock was initially in free expansion for $6\pm2$ yrs and then experienced a very strong deceleration. The onset of deceleration took place a few years before the abrupt trend change in the integrated radio flux density curves. We estimate the shocked swept-up mass to be $M_{\rm sw} \sim 1.6~ M_{\odot}$, assuming a standard density profile for the CSM. Such a swept-up mass for SN 1979C suggests a mass of the hydrogen-rich envelope ejected at explosion no larger than $M_{\rm env} \sim 0.9 ~M_{\odot}$. If SN 1979C originated in a binary star, the low value of Menv suggests that the companion of the progenitor star stripped off most of the hydrogen-rich envelope mass of the presupernova star prior to the explosion.
Summary
This report describes the evolving use of transabdominal ultrasound (TAUS) as an imaging tool to verify tandem placement, localize the treatment volume and aid conformal brachytherapy ...planning for both cervical and uterine corpus cancers. Two patients, one with cancer of the cervix and one with cancer of the endometrium, are used as examples to illustrate the advantages of using TAUS. TAUS is used to guide applicator insertion and check the applicator in the treatment position. The dimensions of the uterus are recorded. Brachytherapy isodose plans are generated based on these measurements. Confirmation of uterine dimensions and isodose coverage is obtained using MRI taken after the initial fraction of treatment has been delivered. We illustrate how TAUS is successfully used to correct and verify tandem placement after the patient has been moved from insertion to treatment position. We also show how to use TAUS for conformal planning, based on individually derived target dimensions. TAUS has successfully been used to conformally plan treatment to the uterus and cervix, minimizing brachytherapy‐related toxicity to surrounding structures. Ultrasound is portable, inexpensive and simple to use and allows for accurate, conformal, reproducible and adaptive treatments.
Objective: To describe the quality of postoperative documentation of vital signs and of medical and nursing review and to identify the patient and hospital factors associated with incomplete ...documentation.
Design, setting and participants: Retrospective audit of medical records of 211 adult patients following major surgery in five Australian hospitals, August 2003 – July 2005.
Main outcome measures: Proportion of patients with complete documentation of medical review (each day) and nursing review and vital signs (heart rate, blood pressure, respiratory rate, temperature and oxygen saturation) (each nursing shift), and the proportion of available opportunities for medical and nursing review where documentation was incomplete. Univariate and multivariate odds ratios for the association between incomplete documentation and hospital and patient factors.
Results: During the first 3 postoperative ward days, 17% of medical records had complete documentation of vital signs and medical and nursing review. During the first 7 postoperative ward days, nursing review was undocumented for 5.6% of available shifts and medical review for 14.9% of available days. Respiratory rate was the most commonly undocumented observation (15.4% undocumented). Certain hospitals were significantly associated with incomplete documentation. Vital signs were more commonly undocumented in patients without epidural or patient‐controlled (PC) analgesia, during evening nursing shifts, and during successive postoperative ward days. Nursing review was more commonly undocumented in the evening and for patients without epidural or PC analgesia. Medical review was more commonly undocumented on weekends.
Conclusion: Hospital and patient factors are associated with incomplete documentation of clinical review and vital signs after major surgery.
Researchers often rely on self-report measures to assess sensitive health-risk behaviors in HIV+ individuals, yet the accuracy of self-report has been questioned, particularly when inquiring about ...behaviors that may be embarrassing, risky, and/or taboo. We compared an anonymous reporting method - the unmatched count technique (UCT) - to direct self-report (DSR) in order to assess reporting differences for several health-risk behaviors related to medication adherence and sexual risk. Contrary to hypotheses, the UCT only produced a significantly higher estimated base rate for one sensitive behavior: reporting medication adherence to one's physician, which may have been contextually primed by our study design. Our results suggest that anonymous reporting methods may not increase disclosure compared to DSR when assessing several health-risk behaviors in HIV+ research volunteers. However, our results also suggest that contextual factors should be considered and investigated further, as they may influence perception of sensitive behavior.
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