703 research outputs found

    Update to the Vitamin C, Thiamine and Steroids in Sepsis (VICTAS) protocol: statistical analysis plan for a prospective, multicenter, double-blind, adaptive sample size, randomized, placebo-controlled, clinical trial.

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    BACKGROUND: Observational research suggests that combined therapy with Vitamin C, thiamine and hydrocortisone may reduce mortality in patients with septic shock. METHODS AND DESIGN: The Vitamin C, Thiamine and Steroids in Sepsis (VICTAS) trial is a multicenter, double-blind, adaptive sample size, randomized, placebo-controlled trial designed to test the efficacy of combination therapy with vitamin C (1.5 g), thiamine (100 mg), and hydrocortisone (50 mg) given every 6 h for up to 16 doses in patients with respiratory or circulatory dysfunction (or both) resulting from sepsis. The primary outcome is ventilator- and vasopressor-free days with mortality as the key secondary outcome. Recruitment began in August 2018 and is ongoing; 501 participants have been enrolled to date, with a planned maximum sample size of 2000. The Data and Safety Monitoring Board reviewed interim results at N = 200, 300, 400 and 500, and has recommended continuing recruitment. The next interim analysis will occur when N = 1000. This update presents the statistical analysis plan. Specifically, we provide definitions for key treatment and outcome variables, and for intent-to-treat, per-protocol, and safety analysis datasets. We describe the planned descriptive analyses, the main analysis of the primary end point, our approach to secondary and exploratory analyses, and handling of missing data. Our goal is to provide enough detail that our approach could be replicated by an independent study group, thereby enhancing the transparency of the study. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03509350. Registered on 26 April 2018

    Bring a plate: facilitating experimentation in the Welcome Dinner Project

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    Drawing on in-depth empirical research, we explore a project called The Welcome Dinner (WDP). The WDP aims to bring together ‘newly arrived’ people and ‘established Australians’ to meet and ‘share stories’ over a potluck meal in ‘the comfort of their own home’. The purpose is to create meaningful connections, new friendships and social solidarities. In this paper, we focus on the micro-contexts of the dinners and the minute activities and techniques that facilitators use in hosting. Our aim is not to analyse the effects of the project but rather the design and meaning of the activities. As a form of ‘designed everyday multiculturalism’, focused on welcoming new arrivals to Australia, it takes effort, skill and labour to manage the contact between different cultural groups over organised meals. Thus, facilitators take over the hosting of the lunches and dinners to run activities, which are imagined to lubricate social dynamics and relations, and produce convivial commensal affects and behaviours. Drawing on theories of training activities as embodied and cognitive experimentations, which enable new knowledge practices and social relations, we analyse field notes and interviews about the facilitation, structure and activities at the WDP home dinners

    Ernst Freund as Precursor of the Rational Study of Corporate Law

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    Gindis, David, Ernst Freund as Precursor of the Rational Study of Corporate Law (October 27, 2017). Journal of Institutional Economics, Forthcoming. Available at SSRN: https://ssrn.com/abstract=2905547, doi: https://dx.doi.org/10.2139/ssrn.2905547The rise of large business corporations in the late 19th century compelled many American observers to admit that the nature of the corporation had yet to be understood. Published in this context, Ernst Freund's little-known The Legal Nature of Corporations (1897) was an original attempt to come to terms with a new legal and economic reality. But it can also be described, to paraphrase Oliver Wendell Holmes, as the earliest example of the rational study of corporate law. The paper shows that Freund had the intuitions of an institutional economist, and engaged in what today would be called comparative institutional analysis. Remarkably, his argument that the corporate form secures property against insider defection and against outsiders anticipated recent work on entity shielding and capital lock-in, and can be read as an early contribution to what today would be called the theory of the firm.Peer reviewe

    Contributions of hard and soft blocks in the self-healing of metal-ligand-containing block copolymers

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    The main aim of this work is to study the respective contribution of the hard and soft blocks of a metal-ligand containing block copolymer to the self-healing behavior. To this aim, different block copolymers containing terpyridine were synthesized using reversible addition-fragmentation chain transfer (RAFT) polymerization. These block copolymers consisted of polystyrene as the hard block, n-butyl acrylate (BA) as soft block and terpyridine units as the ligand moiety placed at different locations in the soft block. These block copolymers were complexed with manganese(II) chloride to introduce transient crosslinks and, thus, self-healing behavior. Homopolymers with the hard and soft block only were also synthesized and tested. A quasi-irreversible crosslinking, i.e. by using nickel(II) nitrate, was performed in order to study the dynamics of the permanently (strongly) crosslinked network. Rheological master curves were generated enabling the determination of the terminal flow in these networks and the reversibility of the supramolecular interactions. Additionally, the macroscopic scratch healing behavior and the molecular mobility of the polymer chains in these supramolecular networks were investigated. A kinetic study of the scratch healing was performed to determine the similarities in temperature dependence for rheological relaxations and macroscopic scratch healing. In our previous work, we have explored the effect of strength of the reversible metal-ligand interaction and the effect of changing the ratio of hard to soft block. This work goes further in separating the individual contributions of the hard and soft blocks as well as the reversible interactions and to reveal their relative importance in the complex phenomenon of scratch healing

    A functional calcium-transporting ATPase encoded by chlorella viruses

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    Calcium-transporting ATPases (Ca2+ pumps) are major players in maintaining calcium homeostasis in the cell and have been detected in all cellular organisms. Here, we report the identification of two putative Ca2+ pumps, M535L and C785L, encoded by chlorella viruses MT325 and AR158, respectively, and the functional characterization of M535L. Phylogenetic and sequence analyses place the viral proteins in group IIB of P-type ATPases even though they lack a typical feature of this class, a calmodulin-binding domain. A Ca2+ pump gene is present in 45 of 47 viruses tested and is transcribed during virus infection. Complementation analysis of the triple yeast mutant K616 confirmed that M535L transports calcium ions and, unusually for group IIB pumps, also manganese ions. In vitro assays show basal ATPase activity. This activity is inhibited by vanadate, but, unlike that of other Ca2+ pumps, is not significantly stimulated by either calcium or manganese. The enzyme forms a 32P-phosphorylated intermediate, which is inhibited by vanadate and not stimulated by the transported substrate Ca2+, thus confirming the peculiar properties of this viral pump. To our knowledge this is the first report of a functional P-type Ca2+-transporting ATPase encoded by a virus

    Neutrophils in cancer: neutral no more

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    Neutrophils are indispensable antagonists of microbial infection and facilitators of wound healing. In the cancer setting, a newfound appreciation for neutrophils has come into view. The traditionally held belief that neutrophils are inert bystanders is being challenged by the recent literature. Emerging evidence indicates that tumours manipulate neutrophils, sometimes early in their differentiation process, to create diverse phenotypic and functional polarization states able to alter tumour behaviour. In this Review, we discuss the involvement of neutrophils in cancer initiation and progression, and their potential as clinical biomarkers and therapeutic targets
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