Development of Coastal Marine Services for Tackling Coastal Risks in the Atlantic Area: the value of regional cooperation

The MyCOAST project (http://mycoast-project.org/) is an INTERREG Atlantic Area project designed to demonstrate that marine services for tackling coastal risks can be jointly developed. The main innovation and originality of the project stems from the implementation of transferable tools able to improve the risk management systems operated in the Atlantic Area. A successful outcome was achieved by identifying mature existing tools and selecting those that could be further developed by partners during the project duration. Demonstration of the tools in pilot actions showed that they are effective in supporting end users and relocatable among different regions in the Atlantic Area.Le projet MyCOAST (http://mycoast-project.org/) est un projet INTERREG de l'Espace Atlantique destiné à démontrer que les services maritimes pour faire face aux risques côtiers peuvent être développés conjointement. La principale innovation et originalité du projet réside dans la mise en œuvre d'outils transférables capables d'améliorer les systèmes de gestion des risques exploités dans l'Espace Atlantique. L'identification d'outils matures existants et la sélection de ceux qui pourraient être développés par les partenaires pendant la durée du projet ont permis d'atteindre un résultat positif. La démonstration des outils dans des actions pilotes a montré qu'ils sont efficaces pour soutenir les utilisateurs finaux et qu'ils peuvent être transférés dans différentes régions de l'Espace Atlantique.En prens

Mixed Binary-Continuous Copula Regression Models with Application to Adverse Birth Outcomes

Bivariate copula regression allows for the flexible combination of two arbitrary, continuous marginal distributions with regression effects being placed on potentially all parameters of the resulting bivariate joint response distribution. Motivated by a study examining the risk factors of adverse birth outcomes, we consider mixed binary-continuous responses that extend this framework to the situation where one response variable is discrete (more precisely binary) while the other response remains continuous. Utilizing the latent continuous representation of binary regression models, we implement a penalized likelihood based approach for the resulting class of copula regression models and employ it in the context of modelling jointly gestational age and the presence/absence of low birth weight. The analysis strongly benefits from the flexible specification of regression effects including nonlinear effects of continuous covariates and spatial effects. Our results imply that racial and spatial inequalities in the risk factors for infant mortality are even greater than previously suggested

Abiraterone acetate plus prednisolone with or without enzalutamide for patients with metastatic prostate cancer starting androgen deprivation therapy: final results from two randomised phase 3 trials of the STAMPEDE platform protocol

Background: Abiraterone acetate plus prednisolone (herein referred to as abiraterone) or enzalutamide added at the start of androgen deprivation therapy improves outcomes for patients with metastatic prostate cancer. Here, we aimed to evaluate long-term outcomes and test whether combining enzalutamide with abiraterone and androgen deprivation therapy improves survival. Methods: We analysed two open-label, randomised, controlled, phase 3 trials of the STAMPEDE platform protocol, with no overlapping controls, conducted at 117 sites in the UK and Switzerland. Eligible patients (no age restriction) had metastatic, histologically-confirmed prostate adenocarcinoma; a WHO performance status of 0–2; and adequate haematological, renal, and liver function. Patients were randomly assigned (1:1) using a computerised algorithm and a minimisation technique to either standard of care (androgen deprivation therapy; docetaxel 75 mg/m2 intravenously for six cycles with prednisolone 10 mg orally once per day allowed from Dec 17, 2015) or standard of care plus abiraterone acetate 1000 mg and prednisolone 5 mg (in the abiraterone trial) orally or abiraterone acetate and prednisolone plus enzalutamide 160 mg orally once a day (in the abiraterone and enzalutamide trial). Patients were stratified by centre, age, WHO performance status, type of androgen deprivation therapy, use of aspirin or non-steroidal anti-inflammatory drugs, pelvic nodal status, planned radiotherapy, and planned docetaxel use. The primary outcome was overall survival assessed in the intention-to-treat population. Safety was assessed in all patients who started treatment. A fixed-effects meta-analysis of individual patient data was used to compare differences in survival between the two trials. STAMPEDE is registered with ClinicalTrials.gov (NCT00268476) and ISRCTN (ISRCTN78818544). Findings: Between Nov 15, 2011, and Jan 17, 2014, 1003 patients were randomly assigned to standard of care (n=502) or standard of care plus abiraterone (n=501) in the abiraterone trial. Between July 29, 2014, and March 31, 2016, 916 patients were randomly assigned to standard of care (n=454) or standard of care plus abiraterone and enzalutamide (n=462) in the abiraterone and enzalutamide trial. Median follow-up was 96 months (IQR 86–107) in the abiraterone trial and 72 months (61–74) in the abiraterone and enzalutamide trial. In the abiraterone trial, median overall survival was 76·6 months (95% CI 67·8–86·9) in the abiraterone group versus 45·7 months (41·6–52·0) in the standard of care group (hazard ratio [HR] 0·62 [95% CI 0·53–0·73]; p<0·0001). In the abiraterone and enzalutamide trial, median overall survival was 73·1 months (61·9–81·3) in the abiraterone and enzalutamide group versus 51·8 months (45·3–59·0) in the standard of care group (HR 0·65 [0·55–0·77]; p<0·0001). We found no difference in the treatment effect between these two trials (interaction HR 1·05 [0·83–1·32]; pinteraction=0·71) or between-trial heterogeneity (I2 p=0·70). In the first 5 years of treatment, grade 3–5 toxic effects were higher when abiraterone was added to standard of care (271 [54%] of 498 vs 192 [38%] of 502 with standard of care) and the highest toxic effects were seen when abiraterone and enzalutamide were added to standard of care (302 [68%] of 445 vs 204 [45%] of 454 with standard of care). Cardiac causes were the most common cause of death due to adverse events (five [1%] with standard of care plus abiraterone and enzalutamide [two attributed to treatment] and one (<1%) with standard of care in the abiraterone trial). Interpretation: Enzalutamide and abiraterone should not be combined for patients with prostate cancer starting long-term androgen deprivation therapy. Clinically important improvements in survival from addition of abiraterone to androgen deprivation therapy are maintained for longer than 7 years. Funding: Cancer Research UK, UK Medical Research Council, Swiss Group for Clinical Cancer Research, Janssen, and Astellas

Public Libraries and the Internet

This video was part of the program “Public Libraries and the Internet, a 30 minute program that aired on public access cable television station Rhode Island Interconnect A. The program featured a round-table discussion between three librarians, with a separate section on Internet search engines and directories by Andrée Rathemacher, which appeared from minute 22:10 through 28:03. The program was first aired on the following dates: Sunday, July 19, 1998 - 12:30 p.m. Monday, July 20, 1998 - 2:00 p.m. Wednesday, July 22, 1998 - 10:30 a.m. Wednesday, July 22, 1998 - 8:30 p.m. It was later re-broadcast the following week and on subsequent dates. The program was produced by Joe McGovern of the Rhode Island Office of Library and Information Services in association with the Public Relations Committee of the Rhode Island Library Association. The video file can be downloaded from DigitalCommons above or viewed online here: https://docs.google.com/open?id=0BwFsXR9Ae67tMEVKUVp4OWtDRXM

Report of an international survey of molecular genetic testing laboratories

Objective: To collect data on the practices of molecular genetic testing (MGT) laboratories for the development of national and international policies for quality assurance (QA). Methods: A web-based survey of MGT laboratory directors (n = 827; response rate 63%) in 18 countries on 3 continents. QA and reporting indices were developed and calculated for each responding laboratory. Results: Laboratory setting varied among and within countries, as did qualifications of the directors. Respondents in every country indicated that their laboratory receives specimens from outside their national borders (64%, n = 529). Pair-wise comparisons of the QA index revealed a significant association with the director having formal training in molecular genetics (p < 0.005), affiliation with a genetics unit (p = 0.003), accreditation of the laboratory (p < 0.005) and participation in proficiency testing (p < 0.005). Research labs had a lower mean report score compared to all other settings (p < 0.05) as did laboratories accessioning <150 samples per year. Conclusion: MGT is provided under widely varying conditions and regulatory frameworks. The data provided here may be a useful guide for policy action at both governmental and professional levels