Pennsylvania Folklife Vol. 43, No. 3

• The Old Order Amish • Amish Quilts: Creativity Supported by Rules and Traditions • Conflict: A Mainspring of Amish Society • Occupational Opportunities for Old Order Amish Women • The Amish Taboo on Photography: Its Historical and Social Significance • Our Changing Amish Church District • Images of the Amish on Stage and Film • Amish Gardens: A Symbol of Identity • The Myth of the Ideal Folk Society Versus the Reality of Amish Lifehttps://digitalcommons.ursinus.edu/pafolklifemag/1140/thumbnail.jp

Intrinsically Red Sources Observed by Spitzer in the Galactic Midplane

We present a highly reliable flux-limited census of 18,949 point sources in the Galactic midplane that have intrinsically red mid-infrared colors. These sources were selected from the Spitzer Space Telescope Galactic Legacy Infrared Midplane Survey Extraordinaire (GLIMPSE) I and II surveys of 274 deg2 of the Galactic midplane, and consist mostly of high- and intermediate-mass young stellar objects (YSOs) and asymptotic giant branch (AGB) stars. The selection criteria were carefully chosen to minimize the effects of position-dependent sensitivity, saturation, and confusion. The distribution of sources on the sky and their location in the Infrared Array Camera and the Multiband Image Photometer for Spitzer 24 μm color-magnitude and color-color space are presented. Using this large sample, we find that YSOs and AGB stars can be mostly separated by simple color-magnitude selection criteria into approximately 50%-70% of YSOs and 30%-50% of AGB stars. Planetary nebulae and background galaxies together represent at most 2%-3% of all the red sources. 1004 red sources in the GLIMPSE II region, mostly AGB stars with high mass-loss rates, show significant (≥0.3 mag) variability at 4.5 and/or 8.0 μm. With over 11,000 likely YSOs and over 7000 likely AGB stars, this is to date the largest uniform census of AGB stars and high- and intermediate-mass YSOs in the Milky Way Galaxy

A Family-Care Rubric: Developing Family Care and Communication Skills Using Simulation

Background: A gap in the literature identified a lack of evidence-based tools that frame feedback and evaluate nursing actions. The Van Gelderen Family Care Rubric (VGFCR) was developed to enhance learning experiences and skill development of family care and communication skills in simulation. Methods: A quantitative instrument development and psychometric testing followed a four-phase design. The rubric was tested at four international sites with registered nurses, nursing-midwifery students, and nurse researchers using simulation scenarios. Results: Eleven of twelve constructs exhibited significance at p = .05. Overall, VGFCR was determined reliable with Fleiss’ Kappa significance at p = .05 at the 95% confidence interval and Cronbach’s alpha = 0.842 among researchers and participants combined. Conclusions: The VGFCR was tested internationally and shown to be a reliable and valid tool in assisting educators in development of student and nursing staff’s family care and communication skills

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial

Background Previous evidence indicates that adjuvant, short-course androgen deprivation therapy (ADT) improves metastasis-free survival when given with primary radiotherapy for intermediate-risk and high-risk localised prostate cancer. However, the value of ADT with postoperative radiotherapy after radical prostatectomy is unclear. Methods RADICALS-HD was an international randomised controlled trial to test the efficacy of ADT used in combination with postoperative radiotherapy for prostate cancer. Key eligibility criteria were indication for radiotherapy after radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to radiotherapy alone (no ADT) or radiotherapy with 6 months of ADT (short-course ADT), using monthly subcutaneous gonadotropin-releasing hormone analogue injections, daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as distant metastasis arising from prostate cancer or death from any cause. Standard survival analysis methods were used, accounting for randomisation stratification factors. The trial had 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 80% to 86% (hazard ratio [HR] 0·67). Analyses followed the intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov, NCT00541047. Findings Between Nov 22, 2007, and June 29, 2015, 1480 patients (median age 66 years [IQR 61–69]) were randomly assigned to receive no ADT (n=737) or short-course ADT (n=743) in addition to postoperative radiotherapy at 121 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 9·0 years (IQR 7·1–10·1), metastasis-free survival events were reported for 268 participants (142 in the no ADT group and 126 in the short-course ADT group; HR 0·886 [95% CI 0·688–1·140], p=0·35). 10-year metastasis-free survival was 79·2% (95% CI 75·4–82·5) in the no ADT group and 80·4% (76·6–83·6) in the short-course ADT group. Toxicity of grade 3 or higher was reported for 121 (17%) of 737 participants in the no ADT group and 100 (14%) of 743 in the short-course ADT group (p=0·15), with no treatment-related deaths. Interpretation Metastatic disease is uncommon following postoperative bed radiotherapy after radical prostatectomy. Adding 6 months of ADT to this radiotherapy did not improve metastasis-free survival compared with no ADT. These findings do not support the use of short-course ADT with postoperative radiotherapy in this patient population

Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial

Background Previous evidence supports androgen deprivation therapy (ADT) with primary radiotherapy as initial treatment for intermediate-risk and high-risk localised prostate cancer. However, the use and optimal duration of ADT with postoperative radiotherapy after radical prostatectomy remains uncertain. Methods RADICALS-HD was a randomised controlled trial of ADT duration within the RADICALS protocol. Here, we report on the comparison of short-course versus long-course ADT. Key eligibility criteria were indication for radiotherapy after previous radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to add 6 months of ADT (short-course ADT) or 24 months of ADT (long-course ADT) to radiotherapy, using subcutaneous gonadotrophin-releasing hormone analogue (monthly in the short-course ADT group and 3-monthly in the long-course ADT group), daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as metastasis arising from prostate cancer or death from any cause. The comparison had more than 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 75% to 81% (hazard ratio [HR] 0·72). Standard time-to-event analyses were used. Analyses followed intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov , NCT00541047 . Findings Between Jan 30, 2008, and July 7, 2015, 1523 patients (median age 65 years, IQR 60–69) were randomly assigned to receive short-course ADT (n=761) or long-course ADT (n=762) in addition to postoperative radiotherapy at 138 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 8·9 years (7·0–10·0), 313 metastasis-free survival events were reported overall (174 in the short-course ADT group and 139 in the long-course ADT group; HR 0·773 [95% CI 0·612–0·975]; p=0·029). 10-year metastasis-free survival was 71·9% (95% CI 67·6–75·7) in the short-course ADT group and 78·1% (74·2–81·5) in the long-course ADT group. Toxicity of grade 3 or higher was reported for 105 (14%) of 753 participants in the short-course ADT group and 142 (19%) of 757 participants in the long-course ADT group (p=0·025), with no treatment-related deaths. Interpretation Compared with adding 6 months of ADT, adding 24 months of ADT improved metastasis-free survival in people receiving postoperative radiotherapy. For individuals who can accept the additional duration of adverse effects, long-course ADT should be offered with postoperative radiotherapy. Funding Cancer Research UK, UK Research and Innovation (formerly Medical Research Council), and Canadian Cancer Society

The predictive validity of the UMAT : a multi-institutional study

Background and Aims: This multi-centre study aimed to determine the predictive validity of the Undergraduate Medicine and Health Sciences Admission Test (UMAT) and other selection tools (ATAR/GPA, Interview) on medical student academic performance, to inform best practice in undergraduate medical student selection. Methods: Eleven of twelve universities across Australia and New Zealand participated. The dataset consists of N=10471 medical students commencing from 2006-2012. Admissions scores (UMAT, ATAR/GPA and Interview score), sex and age were used to predict academic performance during medical school. Two transition points were identified as outcome variables using knowledge- and clinical-based assessment results as well as total year scores. These were the transition from campus-based to hospital-based training (T1), and between the penultimate to pre-internship year (T2). An overall course total was also included (T3). Results: Hierarchical Multiple Regressions were used to analyse the predictive validity of the selection tools. ATAR/GPA was the strongest predictor of higher performance at the transition years (T1 &T2) and overall during the course (T3). UMAT Section 1 (Problem Solving and Logical Reasoning) was a significant predictor of increased performance at all three points. UMAT Section 2 (Understanding People) was a significant predictor at T1 and T2. UMAT Section 3 (Non-Verbal Reasoning) was a significant negative predictor at T2 and T3. Interview score was a predictor of higher performance in the hospital-based years, and of overall course performance. Conclusions / Recommendations: The presentation reports the preliminary analysis of this comprehensive dataset. Additional analyses using advanced statistical modelling techniques are underway to further determine the predictive validity of selection tools on medical student academic performance

Common Leukemia- and Lymphoma-Associated Genetic Aberrations in Healthy Individuals

Leukemia- and lymphoma-associated (LLA) chromosomal rearrangements are critical in the process of tumorigenesis. These genetic alterations are also important biological markers in the diagnosis, prognosis, and treatment of hematopoietic malignant diseases. To detect the presence or absence of these genetic alterations in healthy individuals, sensitive nested RT-PCR analyses were performed on a large number of peripheral blood samples for selected markers including MLL partial tandem duplications (PTDs), BCR-ABL p190, BCR-ABL p210, MLL-AF4, AML1-ETO, PML-RARA, and CBFB-MYH11. Using nested RT-PCR, the presence of all of these selected markers was detected in healthy individuals at various prevalence rates. No correlation was observed between incidence and age except for BCR-ABL p210 fusion, the incidence of which rises with increasing age. In addition, nested RT-PCR was performed on a large cohort of umbilical cord blood samples for MLL PTD, BCR-ABL p190 and BCR-ABL p210. The results demonstrated the presence of these aberrations in cord blood from healthy neonates. To our knowledge, the presence of PML-RARA and CBFB-MYH11 in healthy individuals has not been previously described. The present study provides further evidence for the presence of LLA genetic alterations in healthy individuals and suggests that these mutations are not themselves sufficient for malignant transformation