Clinical trial designs of new medicinal products for treating schizophrenia: discussion of EMA's Guideline and a Better Long Term Trial Design

Background and Objectives: Schizophrenia is a severe chronic disease. Endpoint variables lack objectivity and the diagnostic criteria have evolved with time. In order to guide the development of new drugs, European Medicines Agency (EMA) issued a guideline on the clinical investigation of medicinal products for the treatment of schizophrenia. Methods: Authors reviewed and discussed the efficacy trial part of the Guideline. Results: The Guideline divides clinical efficacy trials into short-term trials and long-term trials. The short-term three-arm trial is recommended to replace the short-term two-arm active-controlled non-inferiority trial because the latter has sensitivity issues. The Guideline ultimately makes that three-arm trial a superiority trial. The Guideline discusses four types of long-term trial designs. The randomized withdrawal trial design has some disadvantages. Long-term two-arm active-controlled non-inferiority trial is not recommended due to the sensitivity issue. Extension of the short-term trial is only suitable for extension of the short-term two-arm active-controlled superiority trial. The Guideline suggests that a hybrid design of a randomized withdrawal trial incorporated into a long-term parallel trial might be optimal. However, such a design has some disadvantages and might be too complex to be carried out. Authors suggest instead a three-group long-term trial design, which could provide comparison between test drug and active comparator along with comparison between the test drug and placebo. This alternative could arguably be much easier to carry out compared with the hybrid design. Conclusions: The three-group long-term design merits further discussion and evaluation.

Journal publishing with Acrobat: the CAJUN project

The publication of material in electronic form should ideally preserve, in a unified document representation, all of the richness of the printed document while maintaining enough of its underlying structure to enable searching and other forms of semantic processing. Until recently it has been hard to find a document representation which combined these attributes and which also stood some chance of becoming a de facto multi-platform standard. This paper sets out experience gained within the Electronic Publishing Research Group at the University of Nottingham in using Adobe Acrobat software and its underlying PDF (Portable Document Format) notation. The CAJUN project1 (CD-ROM Acrobat Journals Using Networks) began in 1993 and has used Acrobat software to produce electronic versions of journal papers for network and CD-ROM dissemination. The paper describes the project's progress so far and also gives a brief assessment of PDF's suitability as a universal document interchange standard.

Efetividade da vacina antigripal sazonal na época 2015/2016: resultados do projeto EuroEVA

O projeto EuroEVA pretende obter estimativas da efetividade da vacina antigripal (EV), para a população geral e para o grupo-alvo para o qual é recomendada. Os resultados apresentados correspondem à sua implementação na época 2015/2016. Utilizou-se um delineamento caso-controlo teste negativo, onde os casos, indivíduos com síndrome gripal (SG) e com diagnóstico laboratorial positivo para o vírus da gripe, foram comparados com os controlos, indivíduos com SG e diagnóstico laboratorial negativo para o vírus da gripe. Os participantes foram selecionados entre os doentes com SG observados em consulta de cuidados de saúde primários. Foi recolhida informação clinica e epidemiológica e um exsudado da nasofaringe para diagnóstico laboratorial. A EV foi estimada através de 1- odd ratio de estar vacinado nos casos vs. controlos, ajustado para a idade, presença de doença crónica, número de consultas com médico de família (MF) nos últimos 12 meses, número de coabitantes, nível de escolaridade, sexo e mês de início de sintomas. Entre as semanas 48/2015 e 17/2016, foram recrutados 310 indivíduos com SG sendo que, após exclusão de 26 indivíduos por não cumprirem os critérios de inclusão, foram incluídos 124 casos e 186 controlos. De entre os casos, 89,5% eram positivos para o vírus da gripe do subtipo A(H1) pdm09 e 8,9% para o tipo B/Victoria. Relativamente à vacina antigripal, a cobertura era de 10,5% nos casos e 23,7% nos controlos. Após ajustamento, a EV em 2015/2016 foi de 56,1% (IC95%: 3,5%; 80,0%) e 65,8% (IC95%:12,5%; 86,7%), respetivamente na população geral e no grupo-alvo para a vacinação antigripal. Estes resultados sugerem que a vacina antigripal nesta época conferiu uma proteção moderada. As estimativas da EV estão em linha com resultados publicados por outros países europeus.

Children's health and indoor air quality in primary schools and homes in Portugal-Study design

The main aim of the research project "On the Contribution of Schools to Children's Overall Indoor Air Exposure" is to study associations between adverse health effects, namely, allergy, asthma, and respiratory symptoms, and indoor air pollutants to which children are exposed to in primary schools and homes. Specifically, this investigation reports on the design of the study and methods used for data collection within the research project and discusses factors that need to be considered when designing such a study. Further, preliminary findings concerning descriptors of selected characteristics in schools and homes, the study population, and clinical examination are presented. The research project was designed in two phases. In the first phase, 20 public primary schools were selected and a detailed inspection and indoor air quality (IAQ) measurements including volatile organic compounds (VOC), aldehydes, particulate matter (PM2.5, PM10), carbon dioxide (CO2), carbon monoxide (CO), bacteria, fungi, temperature, and relative humidity were conducted. A questionnaire survey of 1600 children of ages 8-9 years was undertaken and a lung function test, exhaled nitric oxide (eNO), and tear film stability testing were performed. The questionnaire focused on children's health and on the environment in their school and homes. One thousand and ninety-nine questionnaires were returned. In the second phase, a subsample of 68 children was enrolled for further studies, including a walk-through inspection and checklist and an extensive set of IAQ measurements in their homes. The acquired data are relevant to assess children's environmental exposures and health status.

BACS en el Centro Histórico de Cuenca: diseño de modelos arquitectónicos para intervenciones de vivienda multifamiliar en predios vacíos del área de primer orden del Centro Histórico de Cuenca, aplicando la normativa BACS ensamble

El Centro Histórico de Cuenca tiene como actividades predominantes el comercio, la administración, gestión de servicios, entre otros. Sin embargo, el uso de vivienda se ha ido perdiendo a través de los años. Este abandono perjudica a toda la ciudad, puesto que las personas buscan establecer sus nuevos domicilios en zonas periféricas, ocasionando disgregación y dispersión espacial de actividades, alterando el correcto crecimiento de la ciudad. Así mismo, uno de los mayores problemas que enfrenta el Centro Histórico es el no poder desarrollarse como un organismo vivo, teniendo un uso combinado de vivienda y comercio, que permite que la zona esté activa todo el tiempo. La habitabilidad es fundamental para el mantenimiento y buena salud de los Centros Históricos. Cuenca no es la excepción y es necesario devolverle a esta zona de la ciudad una función residencial más intensa. Por estas razones y a manera de estudio, se ha decidido hacer un proyecto de diseño de modelos arquitectónicos de vivienda multifamiliar en predios vacíos del área de Primer Orden del Centro Histórico de Cuenca, no solo respetando la normativa municipal, sino también aplicando la normativa BACS ensamble!, desarrollada por el Departamento de Investigación Espacio y Población a través del grupo LlactaLab Ciudades Sustentables de la Universidad de Cuenca, que defiende la posibilidad de generar barrios compactos sustentables, en zonas consolidadas de la ciudad, que ayuden a construir un modelo de ciudad diferente a la actual, donde el ser humano sea el centro de reflexión.

The Effect of using online homework exercises on student achievement in a Quantitative methods course

Abstract: Quantitative Methods (QM) is a compulsory course in the Social Science program in CEGEP. Many QM instructors assign a number of homework exercises to give students the opportunity to practice the statistical methods, which enhances their learning. However, traditional written exercises have two significant disadvantages. The first is that the feedback process is often very slow. The second disadvantage is that written exercises can generate a large amount of correcting for the instructor. WeBWorK is an open-source system that allows instructors to write exercises which students answer online. Although originally designed to write exercises for math and science students, WeBWorK programming allows for the creation of a variety of questions which can be used in the Quantitative Methods course. Because many statistical exercises generate objective and quantitative answers, the system is able to instantly assess students’ responses and tell them whether they are right or wrong. This immediate feedback has been shown to be theoretically conducive to positive learning outcomes. In addition, the system can be set up to allow students to re-try the problem if they got it wrong. This has benefits both in terms of student motivation and reinforcing learning. Through the use of a quasi-experiment, this research project measured and analysed the effects of using WeBWorK exercises in the Quantitative Methods course at Vanier College. Three specific research questions were addressed. First, we looked at whether students who did the WeBWorK exercises got better grades than students who did written exercises. Second, we looked at whether students who completed more of the WeBWorK exercises got better grades than students who completed fewer of the WeBWorK exercises. Finally, we used a self-report survey to find out what students’ perceptions and opinions were of the WeBWorK and the written exercises. For the first research question, a crossover design was used in order to compare whether the group that did WeBWorK problems during one unit would score significantly higher on that unit test than the other group that did the written problems. We found no significant difference in grades between students who did the WeBWorK exercises and students who did the written exercises. The second research question looked at whether students who completed more of the WeBWorK exercises would get significantly higher grades than students who completed fewer of the WeBWorK exercises. The straight-line relationship between number of WeBWorK exercises completed and grades was positive in both groups. However, the correlation coefficients for these two variables showed no real pattern. Our third research question was investigated by using a survey to elicit students’ perceptions and opinions regarding the WeBWorK and written exercises. Students reported no difference in the amount of effort put into completing each type of exercise. Students were also asked to rate each type of exercise along six dimensions and a composite score was calculated. Overall, students gave a significantly higher score to the written exercises, and reported that they found the written exercises were better for understanding the basic statistical concepts and for learning the basic statistical methods. However, when presented with the choice of having only written or only WeBWorK exercises, slightly more students preferred or strongly preferred having only WeBWorK exercises. The results of this research suggest that the advantages of using WeBWorK to teach Quantitative Methods are variable. The WeBWorK system offers immediate feedback, which often seems to motivate students to try again if they do not have the correct answer. However, this does not necessarily translate into better performance on the written tests and on the final exam. What has been learned is that the WeBWorK system can be used by interested instructors to enhance student learning in the Quantitative Methods course. Further research may examine more specifically how this system can be used more effectively.

Recommended reporting standards for test accuracy studies of infectious diseases of finfish, amphibians, molluscs and crustaceans: the STRADAS-aquatic checklist

Complete and transparent reporting of key elements of diagnostic accuracy studies for infectious diseases in cultured and wild aquatic animals benefits end-users of these tests, enabling the rational design of surveillance programs, the assessment of test results from clinical cases and comparisons of diagnostic test performance. Based on deficiencies in the Standards for Reporting of Diagnostic Accuracy (STARD) guidelines identified in a prior finfish study (Gardner et al. 2014), we adapted the Standards for Reporting of Animal Diagnostic Accuracy Studies—paratuberculosis (STRADAS-paraTB) checklist of 25 reporting items to increase their relevance to finfish, amphibians, molluscs, and crustaceans and provided examples and explanations for each item. The checklist, known as STRADAS-aquatic, was developed and refined by an expert group of 14 transdisciplinary scientists with experience in test evaluation studies using field and experimental samples, in operation of reference laboratories for aquatic animal pathogens, and in development of international aquatic animal health policy. The main changes to the STRADAS-paraTB checklist were to nomenclature related to the species, the addition of guidelines for experimental challenge studies, and the designation of some items as relevant only to experimental studies and ante-mortem tests. We believe that adoption of these guidelines will improve reporting of primary studies of test accuracy for aquatic animal diseases and facilitate assessment of their fitness-for-purpose. Given the importance of diagnostic tests to underpin the Sanitary and Phytosanitary agreement of the World Trade Organization, the principles outlined in this paper should be applied to other World Organisation for Animal Health (OIE)-relevant species.

School Development in Urbanizing Areas

Good schools are essential for building thriving urban areas. They are important for preparing the future human resource and directly contribute to social and economic development of a place. They not only act as magnets for prospective residents, but also are necessary for retaining current population. As public infrastructure, schools mirror their neighborhood. “Their location, design and physical condition are important determinants of neighborhood quality, regional growth and change, and quality of life.”2 They impact housing development and utility requirements among many things. Hence, planning for schools along with other infrastructure in an area is essential. Schools are very challenging to plan, especially in urbanizing areas with changing demographic dynamics, where the development market and housing development can shift drastically a number of times. In such places projecting the future school enrollments is very difficult and in case of large population influx, school development can be unable to catch up with population growth which results in overcrowding. Typical is the case of Arlington County VA. In the past two decades the County has changed dramatically from a collection of bedroom communities in Washington DC Metro Region to a thriving urban area. Its metro accessible urban corridors are among most desired locations for development in the region. However, converting single family neighborhoods into high density areas has put a lot of pressure on its school facilities and has resulted in overcrowded schools. Its public school enrollment has grown by 19% from 2009 to 2014.3 While the percentage of population under 5 years age has increased in last 10 years, those in the 5-19 age group have decreased4. Hence, there is more pressure on the elementary school facilities than others in the County. Design-wise, elementary schools, due to their size, can be imagined as a community component. There are a number of strategies that can be used to develop elementary school in urbanizing areas as a part of the neighborhood. Experimenting with space planning and building on partnership and mixed-use opportunities can help produce better designs for new schools in future. This thesis is an attempt to develop elementary school models for urbanizing areas of Arlington County. The school models will be designed keeping in mind the shifting nature of population and resulting student enrollments in these areas. They will also aim to be efficient and sustainable, and lead to the next generation design for elementary school education. The overall purpose of the project is to address barriers to elementary school development in urbanizing areas through creative design and planning strategies. To test above mentioned ideas, the Joint-Use School typology of housing +school design has been identified for elementary school development in urbanizing areas in this thesis project. The development is based on the Arlington Public School’s Program guidelines (catering to 600 students). The site selected for this project is Clarendon West (part of Red Top Cab Properties) in Clarendon, Arlington County VA.

TORP: The Open Robot Project A Framework for Module-Based Robots

The development of robots has shown itself as a very complex interdisciplinary research field. The predominant procedure for these developments in the last decades is based on the assumption that each robot is a fully personalized project, with the direct embedding of hardware and software technologies in robot parts with no level of abstraction. Although this methodology has brought countless benefits to the robotics research, on the other hand, it has imposed major drawbacks: (i) the difficulty to reuse hardware and software parts in new robots or new versions; (ii) the difficulty to compare performance of different robots parts; and (iii) the difficulty to adapt development needs-in hardware and software levels-to local groups expertise. Large advances might be reached, for example, if physical parts of a robot could be reused in a different robot constructed with other technologies by other researcher or group. This paper proposes a framework for robots, TORP (The Open Robot Project), that aims to put forward a standardization in all dimensions (electrical, mechanical and computational) of a robot shared development model. This architecture is based on the dissociation between the robot and its parts, and between the robot parts and their technologies. In this paper, the first specification for a TORP family and the first humanoid robot constructed following the TORP specification set are presented, as well as the advances proposed for their improvement.

CERVIXCHECK: A SPIRITUALLY-BASED SMS TEXT MESSAGING PILOT INTERVENTION TO INCREASE CERVICAL CANCER AWARENESS AND PAP TEST SCREENING INTENTION AMONG AFRICAN AMERICAN WOMEN

African American women account for a disproportionate burden of cervical cancer incidence and mortality rate when compared to non-Hispanic White women. Cervical cancer is one of the most preventable types of cancer, and women can be screened for it with a routine Pap test. Given that religion occupies an essential place in African American lives, framing health messages with important spiritual themes and delivering them through a popular communication delivery channel may allow for a more culturally-relevant and accessible technology-based approach to promoting cervical cancer educational content to African American women. Using community-engaged research as a framework, the purpose of this multiple methods study was to develop, pilot test, and evaluate the feasibility, acceptability, and initial efficacy of a spiritually-based SMS text messaging intervention to increase cervical cancer awareness and Pap test screening intention among African American women. The study recruited church-attending African American women ages 21-65 and was conducted in three phases. Phases 1 and 2 consisted of a series of focus group discussions (n=15), cognitive response interviews (n=8), and initial usability testing that were conducted to inform the intervention development and modifications. Phase 3 utilized a non-experimental one-group pretest-posttest design to pilot test the 16-day text messaging intervention (n=52). Of the individuals enrolled, forty-six completed the posttest (retention rate=88%). Findings provided evidence for the early feasibility, high acceptability, and some initial efficacy of the CervixCheck intervention. There were significant pre-post increases observed for knowledge about cervical cancer and the Pap test (p = .001) and subjective norms (p = .006). Additionally, results post-intervention revealed that 83% of participants reported being either “satisfied” or “very satisfied” with the program and 85% found the text messages either “useful” or “very useful”. 85% of the participants also indicated that they would “likely” or “very likely” share the information they learned from the intervention with the women around them, with 39% indicating that they had already shared some of the information they received with others they knew. A spiritually-based SMS text messaging intervention could be a culturally appropriate and cost-effective method of promoting cervical cancer early detection information to African American women.

Design of a project for a film festival

[ES] Shoot&Soul Festival es un festival de cine y música para Bilbao. El proyecto pretende convertir la ciudad en un punto de encuentro multicultural con el uso del inglés como lengua principal; a la vez que promover la cultura y costumbres locales como la gastronomía, el folclore, etc.

Investigation into the Influence of Build Parameters on Failure of 3D Printed Parts

Additive manufacturing, including fused deposition modeling (FDM), is transforming the built world and engineering education. Deep understanding of parts created through FDM technology has lagged behind its adoption in home, work, and academic environments. Properties of parts created from bulk materials through traditional manufacturing are understood well enough to accurately predict their behavior through analytical models. Unfortunately, Additive Manufacturing (AM) process parameters create anisotropy on a scale that fundamentally affects the part properties. Understanding AM process parameters (implemented by program algorithms called slicers) is necessary to predict part behavior. Investigating algorithms controlling print parameters (slicers) revealed stark differences between the generation of part layers. In this work, tensile testing experiments, including a full factorial design, determined that three key factors, width, thickness, infill density, and their interactions, significantly affect the tensile properties of 3D printed test samples.

Design de equipamento médico

Dissertação de Mestrado para obtenção do grau de Mestre em Design de Produto, apresentada na Universidade de Lisboa - Faculdade de Arquitectura.