Prognostic factors in patients with advanced non-small cell lung cancer : data from the phase III FLEX study

The FLEX study demonstrated that the addition of cetuximab to chemotherapy significantly improved overall survival in the first-line treatment of patients with advanced non-small cell lung cancer (NSCLC). In the FLEX intention to treat (ITT) population, we investigated the prognostic significance of particular baseline characteristics. Individual patient data from the treatment arms of the ITT population of the FLEX study were combined. Univariable and multivariable Cox regression models were used to investigate variables with potential prognostic value. The ITT population comprised 1125 patients. In the univariable analysis, longer median survival times were apparent for females compared with males (12.7 vs 9.3 months); patients with an Eastern Cooperative Oncology Group performance status (ECOG PS) of 0 compared with 1 compared with 2 (13.5 vs 10.6 vs 5.9 months); never smokers compared with former smokers compared with current smokers (14.6 vs 11.1 vs 9.0); Asians compared with Caucasians (19.5 vs 9.6 months); patients with adenocarcinoma compared with squamous cell carcinoma (12.4 vs 9.3 months) and those with metastases to one site compared with two sites compared with three or more sites (12.4 months vs 9.8 months vs 6.4 months). Age (<65 vs ≥65 years), tumor stage (IIIB with pleural effusion vs IV) and percentage of tumor cells expressing EGFR (<40% vs ≥40%) were not identified as possible prognostic factors in relation to survival time. In multivariable analysis, a stepwise selection procedure identified age (<65 vs ≥65 years), gender, ECOG PS, smoking status, region, tumor histology, and number of organs involved as independent factors of prognostic value. In summary, in patients with advanced NSCLC enrolled in the FLEX study, and consistent with previous analyses, particular patient and disease characteristics at baseline were shown to be independent factors of prognostic value. The FLEX study is registered with ClinicalTrials.gov, number NCT00148798. © 2012 Elsevier Ireland Ltd.

Exploring the influences of country-level factors on mid-age women’s drink driving attitudes

Drink driving remains a major cause of serious and fatal car crashes in Australia and internationally. While this problem is more prevalent among male drivers, the rates of female intoxicated drivers have increased steadily over the past decades in many motorised countries. A combination of police enforcement, media awareness campaigns, and community initiatives has played a key role in reducing incidents of illegal drink driving by targeting public drink driving attitudes. However, important cultural differences in regards to the tolerance towards drink driving have been noted. While many countries, including Australia, have a legal Blood Alcohol Concentration (BAC) limit of .05 or higher, some countries have moved towards a zero –or low tolerance approach to drink driving; several European countries, including Sweden, Hungary, Slovakia, and Estonia currently enforce .00 or .02 BAC limits.

Does sustainable housing construction provide the home owner with a greater investment return?

Over the past 20 years there has been a considerable push at all three tiers of Government and private industry in Australia to improve the energy efficiency and sustainability levels of residential housing. A number of these initiatives have been voluntary, such as solar power and solar heating rebates, with other mandatory measures being incorporated into building standards and codes. Although the importance of energy efficiency and sustainable materials have been widely conveyed both at the academic and public level, it does not always reflect in the residential house purchase decision by typical house buyers, including residential property investors. This paper will analyse a range of housing markets in Brisbane to determine the investment performance of those markets over the past 3 years to determine any significant differences between new residential suburbs and older residential suburbs where houses have not been constructed to the current energy efficiency and sustainability guidelines. The range of suburbs to be analysed will focus on middle to lower high value suburbs, with a particular focus on residential housing in Master Planned Communities to determine if socio-economic factors and development size and scope have an impact of the purchase and investment performance of sustainable houses in comparison to older housing stock. The paper confirms that the residential property market shows a higher capital return for residential property built under stricter sustainability guidelines than similar located and type of property built prior to the BCA 2004 and older style project type homes erected prior to 2000.

Modelling the salient factors influencing retired business professionals' participation in episodic skilled volunteering in rural settings

Retired business professionals represent an unexplored source of skill support for struggling rural communities. This research examined the feasibility of drawing on this valuable pool of knowledge and experience by engaging retirees in short term, project based volunteering roles in rural, not for profit agencies. Using the theory of planned behaviour and the functional approach to volunteering, the program of study generated a model comprising the key psychological and contextual factors determining the volunteers' decision to provide skill assistance in rural settings. The model provides a useful resource for creating suitable volunteering opportunities and for informing volunteer recruitment strategies.

Factors influencing health professionals' response to victims of domestic violence

This thesis examined factors influencing health professional's response to victims of domestic violence in Vietnam. As this is the first time that this type of research has been conducted in Vietnam, it was expected that the results would contribute significantly to local knowledge and should add to global perspectives. Since it is the first questionnaire about this topic to be developed in Vietnam, the psychometric property of the questionnaire was primarily established, resulting in the questionnaire being recommended to use for further study. By explaining the factors that affect the intentions to respond of health workers, this project provides key data for authorities to design intervention strategies to improve the responses of health professionals to victims of domestic violence in Vietnam.

A Century of American Economic Review : Insights on Critical Factors in Journal Publishing

By using information collected from numerous American Economic Review publications from the last 100 years, Torgler and Piatti examine the top publishing institutions to determine their most renowned AER papers based on citation success. Areas of interest include how often an individual can publish in the AER, how equally successful citations are distributed and who the top AER publishing authors are. The book explores what the level of cooperation is among authors and what drives systems such as the alphabetical name ordering. Torgler and Piatti critically examine the individual characteristics of AER authors, editors, editorial board members and referees and even tackle more intricate details such as the frequency of female publications in the AER. The authors observe and analyse the relationship between academic age and publication performance to see if there is any pattern on these factors and citation success. The book then goes on to analyse data concerning awards, and whether awards can increase the probability of publishing in the AER at a later stage

Coexpression of epidermal growth factor receptor with related factors is associated with a poor prognosis in non-small-cell lung cancer

The epidermal growth factor receptor (EGFR) is commonly expressed in non-small-cell lung cancer (NSCLC) and promotes a host of mechanisms involved in tumorigenesis. However, EGFR expression does not reliably predict prognosis or response to EGFR-targeted therapies. The data from two previous studies of a series of 181 consecutive surgically resected stage I-IIIA NSCLC patients who had survived in excess of 60 days were explored. Of these patients, tissue was available for evaluation of EGFR in 179 patients, carbonic anhydrase (CA) IX in 177 patients and matrix metalloproteinase-9 (MMP-9) in 169 patients. We have previously reported an association between EGFR expression and MMP-9 expression. We have also reported that MMP-9 (P=0.001) and perinuclear (p)CA IX (P=0.03) but not EGFR expression were associated with a poor prognosis. Perinuclear CA IX expression was also associated with EGFR expression (P<0.001). Multivariate analysis demonstrated that coexpression of MMP-9 with EGFR conferred a worse prognosis than the expression of MMP-9 alone (P<0.001) and coexpression of EGFR and pCA IX conferred a worse prognosis than pCA IX alone (P=0.05). A model was then developed where the study population was divided into three groups: group 1 had expression of EGFR without coexpression of MMP-9 or pCA IX (number=21); group 2 had no expression of EGFR (number=75); and group 3 had coexpression of EGFR with pCA IX or MMP-9 or both (number=70). Group 3 had a worse prognosis than either groups 1 or 2 (P=0.0003 and 0.027, respectively) and group 1 had a better prognosis than group 2 (P=0.036). These data identify two cohorts of EGFR-positive patients with diametrically opposite prognoses. The group expressing either EGFR and or both MMP-9 and pCA IX may identify a group of patients with activated EGFR, which is of clinical relevance with the advent of EGFR-targeted therapies. © 2004 Cancer Research UK.

Exploring influencing factors of short-lived buildings in China's urban renewal : evidence from Chongqing

With the fast development of urban sprawl and renewal in China, many buildings are “non-nature” short-lived, i.e. demolished after only a few years. For this concern, this research explores the influencing factors of short-lived buildings and provides the scientific foundation for sustainable urban management and planning. Cases for this research are 1734 buildings demolished in Jiangbei district, the middle region of Chongqing City. Internal and external factors for the short-lived buildings are identified by applying logistic analysis. The results indicate that nine factors have significant influence on short-lived buildings. This research also find that buildings with low density, utilization and compensation while high land development potential are more likely to become short-lived buildings.

Role of electromechanical wave propagation in power systems

In a large interconnected power system, disturbances initiated by a fault or other events cause acceleration in the generator rotors with respect to their synchronous reference frame. This acceleration of rotors can be described by two different dynamic phenomena, as shown in existing literature. One of the phenomena is simultaneous acceleration and the other is electromechanical wave propagation, which is characterized by travelling waves in terms of a wave equation. This paper demonstrates that depending on the structure of the system, the exhibited dynamic response will be dominated by one phenomenon or the other or a mixture of both. Two system structures of choice are examined, with each structure exemplifying each phenomenon present to different degrees in their dynamic responses. Prediction of dominance of either dynamic phenomenon in a particular system can be determined by taking into account the relative sizes of the values of its reduced admittance matrix.

The power of hands-on exercises in SCADA cyber security education

For decades Supervisory Control and Data Acquisition (SCADA) and Industrial Control Systems (ICS) have used computers to monitor and control physical processes in many critical industries, including electricity generation, gas pipelines, water distribution, waste treatment, communications and transportation. Increasingly these systems are interconnected with corporate networks via the Internet, making them vulnerable and exposed to the same risks as those experiencing cyber-attacks on a conventional network. Very often SCADA networks services are viewed as a specialty subject, more relevant to engineers than standard IT personnel. Educators from two Australian universities have recognised these cultural issues and highlighted the gap between specialists with SCADA systems engineering skills and the specialists in network security with IT background. This paper describes a learning approach designed to help students to bridge this gap, gain theoretical knowledge of SCADA systems' vulnerabilities to cyber-attacks via experiential learning and acquire practical skills through actively participating in hands-on exercises.

Prevalence of risk factors for undiagnosed obstructive sleep apnoea is high in truck drivers on UK roads

Objectives To determine the prevalence of symptoms and risk factors of obstructive sleep apnoea (OSA) in truck drivers at a UK large truck stop. Methods Over a 5 day period, truck drivers completed a short questionnaire at a major UK ‘truck stop’. The questionnaire asked about OSA rist factors and symptoms, and included the Epworth Sleepiness Scale (ESS). Additionally, measurements of height, weight and collar size were taken. 148 truck drivers participated and within this random group the risk factors of OSA that were looked for were:men age over 40 y, obesity, parge neck circumference, smoking, high ESS and bed partner reporting snoring with witnessed apnoeas. Results Our sample were all men, with 82% aged over 40 y. 47% were obese (compared with 23% for UK men in general) and average neck circumference was 42 cm (compared with 38 cm for UK men in general – Martin et al 1997). 31% smoked (vs 21% for general population), and ESS averaged 2.1 points higher than expected for a healthy population (Johns et al 1997). Snoring was quite evident at 57% (compared wth 40% for men in general) and witnessed apnoeas were almost double (7%) compared with 3.8% given by Ohayon et al (1997) generally for men. Conclusion 8 key symptoms and risk factors of OSA have been found to be prevalent in a sample of truck drivers on UK roads, and to greater extent that for estimates in the general male population. Bed partners of truck drivers reporting witnessed apnoeas strongly suggests this group has a high potential for undiagnosed OSA. OSA sufferers are known to be at high risk of causing road traffi c accidents. This, together with the large size of trucks, then the potential for serious road crashes is great. Truck drivers, especially those who are obese, ought to be a high priority population for OSA screening.

Voltage unbalance improvement in low voltage residential feeders with rooftop PVs using custom power devices

Voltage unbalance is a major power quality problem in low voltage residential feeders due to the random location and rating of single-phase rooftop photovoltaic cells (PV). In this paper, two different improvement methods based on the application of series (DVR) and parallel (DSTATCOM) custom power devices are investigated to improve the voltage unbalance problem in these feeders. First, based on the load flow analysis carried out in MATLAB, the effectiveness of these two custom power devices is studied vis-à-vis the voltage unbalance reduction in urban and semi-urban/rural feeders containing rooftop PVs. Their effectiveness is studied from the installation location and rating points of view. Later, a Monte Carlo based stochastic analysis is carried out to investigate their efficacy for different uncertainties of load and PV rating and location in the network. After the numerical analyses, a converter topology and control algorithm is proposed for the DSTATCOM and DVR for balancing the network voltage at their point of common coupling. A state feedback control, based on pole-shift technique, is developed to regulate the voltage in the output of the DSTATCOM and DVR converters such that the voltage balancing is achieved in the network. The dynamic feasibility of voltage unbalance and profile improvement in LV feeders, by the proposed structure and control algorithm for the DSTATCOM and DVR, is verified through detailed PSCAD/EMTDC simulations.

Small signal stability analysis of power systems with high penetration of wind power

The integration of large amount of wind power into a power system imposes a new challenge for the secure and economic operation of the system. It is necessary to investigate the impacts of wind power generation on the dynamic behavior of the power system concerned. This paper investigates the impacts of large amount of wind power on small signal stability and the corresponding control strategies to mitigate the negative effects. The concepts of different types of wind turbine generators (WTGs) and the principles of the grid-connected structures of wind power generation systems are first briefly introduced. Then, the state-of-the-art of the studies on the impacts of WTGs on small signal stability as well as potential problems to be studied are clarified. Finally, the control strategies on WTGs to enhance power system damping characteristics are presented.

Sterilizing tissue-materials using pulsed power plasma

This paper investigates the potential of pulsed power to sterilize hard and soft tissues and its impact on their physico-mechanical properties. It hypothesizes that pulsed plasma can sterilize both vascular and avascular tissues and the transitive layers in between without deleterious effects on their functional characteristics. Cartilage/bone laminate was chosen as a model to demonstrate the concept, treated at low temperature, at atmospheric pressure, in short durations and in buffered environment using a purposed-built pulsed power unit. Input voltage and time of exposure were assigned as controlling parameters in a full factorial design of experiment to determine physical and mechanical alteration pre- and post-treatment. The results demonstrated that, discharges of 11 kV sterilized samples in 45 s, reducing intrinsic elastic modules from 1.4 ± 0.9 to 0.9 ± 0.6 MPa. There was a decrease of 14.1 % in stiffness and 27.8 % in elastic-strain energy for the top quartile. Mechanical impairment was directly proportional to input voltage (P value < 0.05). Bacterial inactivation was proportional to treatment time for input voltages above 32 V (P < 0.001; R Sq = 0.98). Thermal analysis revealed that helix-coil transition decelerated with exposure time and collagen fibrils were destabilized as denaturation enthalpy reduced by 200 μV. We concluded by presenting a safe operating threshold for pulsed power plasma as a feasible protocol for effective sterilization of connective tissues with varying level of loss in mechanical robustness which we argue to be acceptable in certain medical and tissue engineering application.

Sensorimotor and postural control factors associated with driving safety in a community-dwelling older driver population

Background. To establish whether sensorimotor function and balance are associated with on-road driving performance in older adults. Methods. The performance of 270 community-living adults aged 70–88 years recruited via the electoral roll was measured on a battery of peripheral sensation, strength, flexibility, reaction time, and balance tests and on a standardized measure of on-road driving performance. Results. Forty-seven participants (17.4%) were classified as unsafe based on their driving assessment. Unsafe driving was associated with reduced peripheral sensation, lower limb weakness, reduced neck range of motion, slow reaction time, and poor balance in univariate analyses. Multivariate logistic regression analysis identified poor vibration sensitivity, reduced quadriceps strength, and increased sway on a foam surface with eyes closed as significant and independent risk factors for unsafe driving. These variables classified participants into safe and unsafe drivers with a sensitivity of 74% and specificity of 70%. Conclusions. A number of sensorimotor and balance measures were associated with driver safety and the multivariate model comprising measures of sensation, strength, and balance was highly predictive of unsafe driving in this sample. These findings highlight important determinants of driver safety and may assist in developing efficacious driver safety strategies for older drivers.