Meta-analysis of individual patient data from randomized trials of chemotherapy plus cetuximab as first-line treatment for advanced non-small cell lung cancer

OBJECTIVES: Four randomized phase II/III trials investigated the addition of cetuximab to platinum-based, first-line chemotherapy in patients with advanced non-small cell lung cancer (NSCLC). A meta-analysis was performed to examine the benefit/risk ratio for the addition of cetuximab to chemotherapy. MATERIALS AND METHODS: The meta-analysis included individual patient efficacy data from 2018 patients and individual patient safety data from 1970 patients comprising respectively the combined intention-to-treat and safety populations of the four trials. The effect of adding cetuximab to chemotherapy was measured by hazard ratios (HRs) obtained using a Cox proportional hazards model and odds ratios calculated by logistic regression. Survival rates at 1 year were calculated. All applied models were stratified by trial. Tests on heterogeneity of treatment effects across the trials and sensitivity analyses were performed for all endpoints. RESULTS: The meta-analysis demonstrated that the addition of cetuximab to chemotherapy significantly improved overall survival (HR 0.88, p=0.009, median 10.3 vs 9.4 months), progression-free survival (HR 0.90, p=0.045, median 4.7 vs 4.5 months) and response (odds ratio 1.46, p<0.001, overall response rate 32.2% vs 24.4%) compared with chemotherapy alone. The safety profile of chemotherapy plus cetuximab in the meta-analysis population was confirmed as manageable. Neither trials nor patient subgroups defined by key baseline characteristics showed significant heterogeneity for any endpoint. CONCLUSION: The addition of cetuximab to platinum-based, first-line chemotherapy for advanced NSCLC significantly improved outcome for all efficacy endpoints with an acceptable safety profile, indicating a favorable benefit/risk ratio.

Coping strategies used by ballet dancers : effects of individual differences in competitive trait anxiety

The purpose of the present investigation was to examine relationships between coping strategies and competitive trait anxiety among ballet dancers. Participants were 104 classical ballet dancers from three professional ballet companies, two private dance schools, and two full-time, university dance courses in Australia. Coping strategies were assessed using the Modified COPE scale (MCOPE: Crocker & Graham, 1995), while competitive trait anxiety was assessed using the Sport Anxiety Scale (SAS: Smith, Smoll, & Schutz, 1990). Standard multiple regression analyses showed that trait anxiety scores were significant predictors of seven of the 12 coping strategies, with moderate to large effect sizes. High trait anxious dancers reported more frequent use of all categories of coping strategies. A two-way MANOVA showed no main effects for gender nor status (professional versus students) and no significant interaction effect. The present results emphasize the need for the effectiveness of specific coping strategies to be considered during the process of preparing young classical dancers for a career in professional ballet.

Colonizing while migrating : how do individual enteric neural crest cells behave?

Background Directed cell migration is essential for normal development. In most of the migratory cell populations that have been analysed in detail to date, all of the cells migrate as a collective from one location to another. However, there are also migratory cell populations that must populate the areas through which they migrate, and thus some cells get left behind while others advance. Very little is known about how individual cells behave to achieve concomitant directional migration and population of the migratory route. We examined the behavior of enteric neural crest-derived cells (ENCCs), which must both advance caudally to reach the anal end and populate each gut region. Results The behaviour of individual ENCCs was examined using live imaging and mice in which ENCCs express a photoconvertible protein. We show that individual ENCCs exhibit very variable directionalities and speed; as the migratory wavefront of ENCCs advances caudally, each gut region is populated primarily by some ENCCs migrating non-directionally. After populating each region, ENCCs remain migratory for at least 24 hours. Endothelin receptor type B (EDNRB) signaling is known to be essential for the normal advance of the ENCC population. We now show that perturbation of EDNRB principally affects individual ENCC speed rather than directionality. The trajectories of solitary ENCCs, which occur transiently at the wavefront, were consistent with an unbiased random walk and so cell-cell contact is essential for directional migration. ENCCs migrate in close association with neurites. We showed that although ENCCs often use neurites as substrates, ENCCs lead the way, neurites are not required for chain formation and neurite growth is more directional than the migration of ENCCs as a whole. Conclusions Each gut region is initially populated by sub-populations of ENCCs migrating non-directionally, rather than stopping. This might provide a mechanism for ensuring a uniform density of ENCCs along the growing gut.

Psychosocial and communication variables involved in mediating the individual experience of older adults following a severe weather event

The recent floods in south-east Queensland have focused policy, academic and community attention on the challenges associated with severe weather events (SWE), specifically pre-disaster preparation, disaster-response and post-disaster community resilience. Financially, the cost of SWE was $9 billion in the 2011 Australian Federal Budget (Swan 2011); psychologically and emotionally, the impact on individual mental health and community wellbeing is also significant but more difficult to quantify. However, recent estimates suggest that as many as one in five will subsequently experience major emotional distress (Bonanno et al. 2010). With climate change predicted to increase the frequency and intensity of a wide range of SWE in Australia (Garnaut 2011; The Climate Institute 2011), there is an urgent and critical need to ensure that the unique psychological and social needs of more vulnerable community members - such as older residents - are better understood and integrated into disaster preparedness and response policy, planning and protocols. Navigating the complex dynamics of SWE can be particularly challenging for older adults and their disaster experience is frequently magnified by a wide array of cumulative and interactive stressors, which intertwine to make them uniquely vulnerable to significant short and long-term adverse effects. This current article provides a brief introduction to the current literature in this area and highlights a gap in the research relating to communication tools during and after severe weather events.

Associations between individual and workplace risk factors for self-reported neck pain and disability among female office workers

A cross-sectional survey of female office workers (n=333) was undertaken to determine the level of neck pain and disability (Neck Disability Index—NDI) and to explore the relationship between individual and workplace risk factors with the NDI score and the presence of pain. Workers reported nil (32%), mild (53%), moderate (14%) and severe (1%) neck pain. There were more risk factors associated with the NDI score than the presence of neck pain. The presence of neck pain was associated with a history of neck trauma (OR: 4.8), using a graduated lens (OR: 4.6), and negative affectivity (OR: 2.7) in the multiple regression model. Factors associated with higher NDI score were using the computer mouse for more than 6 h per day, higher negative affectivity, older age and an uncomfortable workstation. These results suggest that measuring the level of neck pain and disability rather than just the presence of neck pain provides more specific directives for the prevention and management of this disorder.

Contribution of individual, workplace, psychosocial and physiological factors to neck pain in female office workers

This study investigated the relative contribution of individual, workplace, psychosocial and physiological features associated with neck pain in female office workers towards developing appropriate intervention programs. Workers without disability (Neck Disability Index (NDI) score≤8, n=33); workers with neck pain and disability (NDI≥9/100, n=52) and 22 controls (women who did not work and without neck pain) participated in this study. Two logistic regression models were constructed to test the association between various measures in (1) workers with and without disability, and (2) workers without disability and controls. Measures included those found to be significantly associated with higher NDI in our previous studies: psychosocial domains; individual factors; task demands; quantitative sensory measures and measures of motor function. In the final model, higher score on negative affectivity scale (OR=4.47), greater activity in the neck flexors during cranio-cervical flexion (OR=1.44), cold hyperalgesia (OR=1.27) and longer duration of symptoms (OR=1.19) remained significantly associated with neck pain in workers. Workers without disability and controls could only be differentiated by greater muscle activity in the cervical flexors and extensors during a typing task. No psychosocial domains remained in either regression model. These results suggest that impairments in the sensory and motor system should be considered in any assessment of the office worker with neck pain and may have stronger influences on the presenting symptoms than workplace and psychosocial features.

Methodology for developing real-time motorway traffic risk identification models using individual-vehicle data

Most of existing motorway traffic safety studies using disaggregate traffic flow data aim at developing models for identifying real-time traffic risks by comparing pre-crash and non-crash conditions. One of serious shortcomings in those studies is that non-crash conditions are arbitrarily selected and hence, not representative, i.e. selected non-crash data might not be the right data comparable with pre-crash data; the non-crash/pre-crash ratio is arbitrarily decided and neglects the abundance of non-crash over pre-crash conditions; etc. Here, we present a methodology for developing a real-time MotorwaY Traffic Risk Identification Model (MyTRIM) using individual vehicle data, meteorological data, and crash data. Non-crash data are clustered into groups called traffic regimes. Thereafter, pre-crash data are classified into regimes to match with relevant non-crash data. Among totally eight traffic regimes obtained, four highly risky regimes were identified; three regime-based Risk Identification Models (RIM) with sufficient pre-crash data were developed. MyTRIM memorizes the latest risk evolution identified by RIM to predict near future risks. Traffic practitioners can decide MyTRIM’s memory size based on the trade-off between detection and false alarm rates. Decreasing the memory size from 5 to 1 precipitates the increase of detection rate from 65.0% to 100.0% and of false alarm rate from 0.21% to 3.68%. Moreover, critical factors in differentiating pre-crash and non-crash conditions are recognized and usable for developing preventive measures. MyTRIM can be used by practitioners in real-time as an independent tool to make online decision or integrated with existing traffic management systems.

An examination of tax deductible donations made by individual Australian taxpayers in 2011–12

This study uses information based on published ATO material and represents the extent of tax-deductible donations made and claimed by Australian individual taxpayers (i.e. not including corporate entities or trusts) to DGRs, at Item D9 Gifts or Donations, in their income tax returns for the 2011-12 income year. The total amount claimed as tax-deductible donations in 2011-12 was $2.24 billion (compared to $2.21 billion in 2010-11), representing 6.85% of all personal taxpayer deductions. Since 1978-79, the actual total tax-deductible donations claimed by Australian individual taxpayers has outpaced inflation-adjusted total tax-deductible donations, measured against the Consumer Price Index. The average tax-deductible donation claimed in 2011-12 increased to $494.25, but the absolute number and percentage of taxpayers claiming donations dropped (to 4.54 million or 35.62%). Analysis is given of individual taxpayers' donation claiming by Gender, State of Residence, Postcode, Income Band, Industry of employment, and Occupation.

The IHR (2005), disease surveillance, and the individual in global health politics

Since the revisions to the International Health Regulations (IHR) in 2005, much attention has turned to two concerns relating to infectious disease control. The first is how to assist states to strengthen their capacity to identify and verify public health emergencies of international concern (PHEIC). The second is the question of how the World Health Organization (WHO) will operate its expanded mandate under the revised IHR. Very little attention has been paid to the potential individual power that has been afforded under the IHR revisions – primarily through the first inclusion of human rights principles into the instrument and the allowance for the WHO to receive non-state surveillance intelligence and informal reports of health emergencies. These inclusions mark the individual as a powerful actor, but also recognise the vulnerability of the individual to the whim of the state in outbreak response and containment. In this paper we examine why these changes to the IHR occurred and explore the consequence of expanding the sovereignty-as-responsibility concept to disease outbreak response. To this end our paper considers both the strengths and weaknesses of incorporating reports from non-official sources and including human rights principles in the IHR framework.

Sequential versus simultaneous viewing of an environment : effects of focal attention to individual object locations on visual spatial learning

We investigated memories of room-sized spatial layouts learned by sequentially or simultaneously viewing objects from a stationary position. In three experiments, sequential viewing (one or two objects at a time) yielded subsequent memory performance that was equivalent or superior to simultaneous viewing of all objects, even though sequential viewing lacked direct access to the entire layout. This finding was replicated by replacing sequential viewing with directed viewing in which all objects were presented simultaneously and participants’ attention was externally focused on each object sequentially, indicating that the advantage of sequential viewing over simultaneous viewing may have originated from focal attention to individual object locations. These results suggest that memory representation of object-to-object relations can be constructed efficiently by encoding each object location separately, when those locations are defined within a single spatial reference system. These findings highlight the importance of considering object presentation procedures when studying spatial learning mechanisms.

The importance of individual difference : examining anthropomorphic tendency and consumer responses to spokes-characters

This thesis comprised a series of online experiments to examine the influence of an individual's level of anthropomorphic tendency on responses to spokes-characters. It finds that an individual's level of anthropomorphic tendency does influence their responses to some types of spokes-characters. Further, those with high anthropomorphic tendency tend towards being younger and more creative in their thinking. This research contributes to anthropomorphic tendency theory; specifically it addresses how this tendency operates in a marketing context and thereby aids practitioners seeking to utilise such characters in achieving positive business outcomes.

Individual innovative use of ERP systems

Although many studies have discussed Enterprise Resource Planning (ERP) use at the organizational level, no study according to our knowledge, has identified the factors influencing innovative use of ERP by the end users (Sudzina, 2010). This research-in-progress paper describes the preliminary findings of a survey, which is designed to recognize the factors which can influence the end user innovative use of ERP systems. Moreover, this study argues that the innovative use on individual levels could impact the productivity of organizations.

Coping strategies used by ballet dancers: effects of individual differences in competitive trait anxiety

The world of classical ballet exerts considerable physical and psychological stress upon those who participate, and yet the process of coping with such stressors is not well understood. Relationships between coping strategies and competitive trait anxiety were investigated among 104 classical dancers (81 females and 23 males) from three professional ballet companies, two private dance schools, and two full-time, university dance courses in Australia. Coping strategies were assessed using the Modified COPE scale (MCOPE: Crocker & Graham, 1995), a 48-item measure of 12 dimensions of coping. Competitive trait anxiety was assessed using the Sport Anxiety Scale (SAS: Smith, Smoll, & Schutz, 1990), a 21-item measure of three anxiety dimensions. Trait anxiety scores, in particular for Somatic Anxiety and Worry, predicted seven of the 12 coping strategies (Suppression of Competing Activities: R2 = 27.1%; Venting of Emotions: R2 = 23.2%; Active Coping: R2 = 14.3%; Denial: R2 = 17.7%; Self-Blame: R2 = 35.7%; Effort: R2 = 16.6%; Wishful Thinking: R2 = 42.3%). High trait anxious dancers reported more frequent use of all categories of coping strategies, some of which are considered to be maladaptive. No effects of gender or status (professional versus students) were identified. Results emphasize the need for the effectiveness of specific coping strategies to be considered during the process of preparing young classical dancers for a career in professional ballet.