Assessing the Methodological Quality of Systematic Reviews : The Development of AMSTAR

Boers, M. [Promotor]Bouter, L.M. [Promotor]Grimshaw, J. [Copromotor

A Grammatical Approach for Customization of Laminated Composite Materials

The wide range of properties covered by the manufacturable fiber—matrix combinations of composite materials, along with their directional property characteristics, provides designers with material selection flexibility during designing composite material products. Meeting multiple property goals, however, complicates the design process as both the composite material selection and the component shape formation becomes intricate with the multiple loading conditions, which may require matrix calculations of high order to determine theoretical value of composite material properties. This article presents a grammatical approach that is derived by extending shape grammars to simultaneously consider the shape of a component and select appropriate composite materials to meet multiple property goals, derived from a set of design loads. In this approach the grammar is divided into four interconnected steps, which are used to design the shape of the component depending on its function and user requirements, calculate the property requirements from the loading constraints based on the designed shape, and select composite materials according to the property requirements. Selection of composite materials involves determining the fiber and matrix, their volume fraction, number of plies, and ply orientations in different location of the load-bearing component. A hollow shape hip replacement joint is designed using composite material to illustrate the approach. Finite element analysis is performed to verify the design.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

A scoping review establishes need for consensus guidance on reporting health equity in observational studies.

To evaluate the support from the available guidance on reporting of health equity in research for our candidate items and to identify additional items for the Strengthening Reporting of Observational studies in Epidemiology-Equity extension. We conducted a scoping review by searching Embase, MEDLINE, CINAHL, Cochrane Methodology Register, LILACS, and Caribbean Center on Health Sciences Information up to January 2022. We also searched reference lists and gray literature for additional resources. We included guidance and assessments (hereafter termed "resources") related to conduct and/or reporting for any type of health research with or about people experiencing health inequity. We included 34 resources, which supported one or more candidate items or contributed to new items about health equity reporting in observational research. Each candidate item was supported by a median of six (range: 1-15) resources. In addition, 12 resources suggested 13 new items, such as "report the background of investigators". Existing resources for reporting health equity in observational studies aligned with our interim checklist of candidate items. We also identified additional items that will be considered in the development of a consensus-based and evidence-based guideline for reporting health equity in observational studies

Anti-CD30 CAR-T Cell Therapy in Relapsed and Refractory Hodgkin Lymphoma

PURPOSE Chimeric antigen receptor (CAR) T-cell therapy of B-cell malignancies has proved to be effective. We show how the same approach of CAR T cells specific for CD30 (CD30.CAR-Ts) can be used to treat Hodgkin lymphoma (HL). METHODS We conducted 2 parallel phase I/II studies (ClinicalTrials.gov identifiers: NCT02690545 and NCT02917083) at 2 independent centers involving patients with relapsed or refractory HL and administered CD30.CAR-Ts after lymphodepletion with either bendamustine alone, bendamustine and fludarabine, or cyclophosphamide and fludarabine. The primary end point was safety. RESULTS Forty-one patients received CD30.CAR-Ts. Treated patients had a median of 7 prior lines of therapy (range, 2-23), including brentuximab vedotin, checkpoint inhibitors, and autologous or allogeneic stem cell transplantation. The most common toxicities were grade 3 or higher hematologic adverse events. Cytokine release syndrome was observed in 10 patients, all of which were grade 1. No neurologic toxicity was observed. The overall response rate in the 32 patients with active disease who received fludarabine-based lymphodepletion was 72%, including 19 patients (59%) with complete response. With a median follow-up of 533 days, the 1-year progression-free survival and overall survival for all evaluable patients were 36% (95% CI, 21% to 51%) and 94% (95% CI, 79% to 99%), respectively. CAR-T cell expansion in vivo was cell dose dependent. CONCLUSION Heavily pretreated patients with relapsed or refractory HL who received fludarabine-based lymphodepletion followed by CD30.CAR-Ts had a high rate of durable responses with an excellent safety profile, highlighting the feasibility of extending CAR-T cell therapies beyond canonical B-cell malignancies

Portion Size: What We Know and What We Need to Know

There is increasing evidence that the portion sizes of many foods have increased and in a laboratory at least this increases the amount eaten. The conclusions are, however, limited by the complexity of the phenomenon. There is a need to consider meals freely chosen over a prolonged period when a range of foods of different energy densities are available. A range of factors will influence the size of the portion size chosen: amongst others packaging, labeling, advertising, and the unit size rather than portion size of the food item. The way portion size interacts with the multitude of factors that determine food intake needs to be established. In particular, the role of portion size on energy intake should be examined as many confounding variables exist and we must be clear that it is portion size that is the major problem. If the approach is to make a practical contribution, then methods of changing portion sizes will need to be developed. This may prove to be a problem in a free market, as it is to be expected that customers will resist the introduction of smaller portion sizes, given that value for money is an important motivator

Composition of woody species in a dynamic forest-woodland-savannah mosaic in Uganda: implications for conservation and management

Forest¿woodland¿savannah mosaics are a common feature in the East African landscape. For the conservation of the woody species that occur in such landscapes, the species patterns and the factors that maintain it need to be understood. We studied the woody species distribution in a forest¿woodland¿savannah mosaic in Budongo Forest Reserve, Uganda. The existing vegetation gradients were analyzed using data from a total of 591 plots of 400 or 500 m2 each. Remotely sensed data was used to explore current vegetation cover and the gradients there in for the whole area. A clear species gradient exists in the study area ranging from forest, where there is least disturbance, to wooded grassland, where frequent fire disturbance occurs. Most species are not limited to a specific part of the gradient although many show a maximum abundance at some point along the gradient. Fire and accessibility to the protected area were closely related to variation in species composition along the ordination axis with species like Cynometra alexandri and Uvariopsis congensis occurring at one end of the gradient and Combretum guenzi and Lonchocarpus laxiflorus at the other. The vegetation cover classes identified in the area differed in diversity, density and, especially, basal area. All vegetation cover classes, except open woodland, had indicator species. Diospyros abyssinica, Uvariopsis congensis, Holoptelea grandis and all Celtis species were the indicator species for the forest class, Terminalia velutina and Albizia grandbracteata for closed woodland, Grewia mollis and Combretum mole for very open woodland and Lonchocarpus laxiflorus, Grewia bicolor and Combretum guenzi for the wooded grassland class. Eleven of the species occurred in all cover classes and most of the species that occurred in more than one vegetation cover class showed peak abundance in a specific cover class. Species composition in the study area changes gradually from forest to savannah. Along the gradient, the cover classes are distinguishable in terms of species composition and vegetation structure. These classes are, however, interrelated in species composition. For conservation of the full range of the species within this East African landscape, the mosaic has to be managed as an integrated whole. Burning should be varied over the area with the forest not being burnt at all and the wooded grassland burnt regularly. The different vegetation types that occur between these two extremes should be maintained using a varied fire regim

Plasma lipid profiles discriminate bacterial from viral infection in febrile children

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection ar