Commercial Funding Research Articles

Authors of trials from high-ranking anesthesiology journals were not willing to share raw data

ObjectivesTo analyze data sharing practices among authors of randomized controlled trials (RCTs) published in seven high-ranking anesthesiology journals from 2014 to 2016. Study Design and SettingWe analyzed data sharing statements in 619 included RCTs and contacted their corresponding authors, asking them to share de-identified raw data from trial. ResultsOf the 86 (14%) authors who responded to our query for data sharing, only 24 (4%) provided the requested data. Only one of those 24 had a data sharing statement in the published manuscript. Only 24 (4%) of manuscripts contained statements suggesting a willingness to share trial data; only one of those authors actually shared data. There was no difference in proportion of data sharing between studies with commercial and nonprofit funding. Among the 62 authors who refused to provide data, reasons were seldom provided. When reasons were provided, common themes included issues regarding data ownership and participant privacy. Only one of the seven analyzed journals encouraged authors toward data sharing. ConclusionWillingness to share data among anesthesiology RCTs is very low. To achieve widespread availability of de-identified trial data, journals should request their publication, as opposed to only encouraging authors to do so.

Discussion

Discussion

Global burden of obesity

Global burden of obesity Introduction The burden of nutritional disorders is increasing despite advances in scientific research and health promotion. Nutritional disorders include excess body mass conditions especially obesity (body mass index [BMI] > 30 kg/m2) and being overweight (BMI > 25 and < 30 kg/m2). These conditions are now considered as precursors to several diseases including diabetes, heart disease, musculoskeletal disorders as well as psychiatric illnesses. We studied the global burden of obesity to assess temporal trends and regional variations of this highly prevalent nutritional disorder. Methods We used the Global Burden of Disease database from the Institute of Health Metrics (www.healthdata.org) at the University of Washington, Seattle. This database collates data from a very large number of studies and census figures to generate regional estimates for health statistics. We analyzed the data from 1990 to 2015 using global averages for years lived with disability (YLD). The primary risk factor analyzed was ‘High body-mass index’. The effect of high BMI on all causes of health reduction (including diabetes) were studied for temporal (1990 to 2015) and regional/national patterns. Results The global of burden of diseases due to high BMI is rising continuously, from 213 YLDs per 100,000 in 1990 to 388 YLDs in 2015. A high burden of YLDs was seen in developed regions including North America and Australasia. Northern Europe and Middle East were also disproportionately affected. Areas with low rates of YLDs from obesity included sub-Saharan Africa, south Asia and south east Asia. Marked increases in the rates per 100,000 populations were seen over 1990 to 2015 in countries such as Fiji, USA, Egypt and Ukraine. The burden of suffering is higher among women than men. Conclusion The global burden of suffering due to illnesses caused by high body mass index is continuing to rise. Existing public health measures appear to be ineffective and more efficacious nutritional education and health promotion strategies are urgently needed. Conflicts of interest disclosure: no external or commercial funding source, and no holding of significant equity in a company relevant to the study.

Cannabinoids for the treatment of dementia

Background Dementia is a common chronic condition, mainly affecting older adults, characterised by a progressive decline in cognitive and functional abilities. Medical treatments for dementia are limited. Cannabinoids are being investigated for the treatment of dementia. Objectives To determine the efficacy and safety of cannabinoids for the treatment of dementia. Search methods We searched ALOIS - the Cochrane Dementia and Cognitive Improvement Group's Specialised Register - on 8 July 2021, using the terms cannabis or cannabinoid or endocannabinoid or cannabidiol or THC or CBD or dronabinol or delta-9-tetrahydrocannabinol or marijuana or marihuana or hashish. The register contains records from all major healthcare databases (the Cochrane Library, MEDLINE, Embase, PsycINFO, CINAHL, LILACS), as well as from many clinical trials registries and grey literature sources. Selection criteria We included all randomised controlled trials (RCTs) of cannabinoids for the treatment of dementia. We included participants of any age and of either sex with diagnosed dementia of any subtype, or with unspecified dementia of any severity, from any setting. We considered studies of cannabinoids administered by any route, at any dose, for any duration, compared with placebo, no treatment, or any active control intervention. Data collection and analysis Two review authors independently screened and selected studies for inclusion, extracted data, and assessed the risk of bias in included studies. When necessary, other review authors were involved in reaching consensus decisions. We conducted meta-analyses using a generic inverse variance fixed-effect model to derive estimates of effect size. We used GRADE methods to assess our confidence in the effect estimates. Main results We included four studies (126 participants) in this review. Most participants had Alzheimer's disease; a few had vascular dementia or mixed dementia. Three studies had low risk of bias across all domains; one study had unclear risk of bias for the majority of domains. The included studies tested natural delta-9-tetrahydrocannabinol (THC) (Namisol) and two types of synthetic THC analogue (dronabinol and nabilone). Three trials had a cross-over design. Interventions were applied over 3 to 14 weeks; one study reported adverse events over 70 weeks of follow-up. One trial was undertaken in the USA, one in Canada, and two in The Netherlands. Two studies reported non-commercial funding, and two studies were conducted with the support of both commercial and non-commercial funding. Primary outcomes in this review were changes in global and specific cognitive function, overall behavioural and psychological symptoms of dementia (BPSD), and adverse events. We found very low-certainty evidence suggesting there may be little or no clinically important effect of a synthetic THC analogue on cognition assessed with the standardised Mini-Mental State Examination (sMMSE) (mean difference (MD) 1.1 points, 95% confidence interval (CI) 0.1 to 2.1; 1 cross-over trial, 28 participants). We found low-certainty evidence suggesting there may be little or no clinically important effect of cannabinoids on overall behavioural and psychological symptoms of dementia assessed with the Neuropsychiatric Inventory (or its modified nursing home version) (MD -1.97, 95% CI -3.87 to -0.07; 1 parallel group and 2 cross-over studies, 110 participants). All included studies reported data on adverse events. However, the total number of adverse events, the total numbers of mild and moderate adverse events, and the total number of serious adverse events (SAEs) were not reported in a way that permitted meta-analysis. There were no clear differences between groups in numbers of adverse events, with the exception of sedation (including lethargy), which was more frequent among participants taking nabilone (N = 17) than placebo (N = 6) (odds ratio (OR) 2.83, 95% CI 1.07 to 7.48; 1 cross-over study, 38 participants). We judged the certainty of evidence for adverse event outcomes to be low or very low due to serious concerns regarding imprecision and indirectness. Authors' conclusions Based on data from four small, short, and heterogeneous placebo-controlled trials, we cannot be certain whether cannabinoids have any beneficial or harmful effects on dementia. If there are benefits of cannabinoids for people with dementia, the effects may be too small to be clinically meaningful. Adequately powered, methodologically robust trials with longer follow-up are needed to properly assess the effects of cannabinoids in dementia.

Non-communicable diseases: mapping research funding organisations, funding mechanisms and research practices in Italy and Germany

BackgroundEvidence shows that territorial borders continue to have an impact on research collaboration in Europe. Knowledge of national research structural contexts is therefore crucial to the promotion of Europe-wide policies for research funding. Nevertheless, studies assessing and comparing research systems remain scarce. This paper aims to further the knowledge on national research landscapes in Europe, focusing on non-communicable disease (NCD) research in Italy and Germany.MethodsTo capture the architecture of country-specific research funding systems, a three-fold strategy was adopted. First, a literature review was conducted to determine a list of key public, voluntary/private non-profit and commercial research funding organisations (RFOs). Second, an electronic survey was administered qualifying RFOs. Finally, survey results were integrated with semi-structured interviews with key opinion leaders in NCD research. Three major dimensions of interest were investigated – funding mechanisms, funding patterns and expectations regarding outputs.ResultsThe number of RFOs in Italy is four times larger than that in Germany and the Italian research system has more project funding instruments than the German system. Regarding the funding patterns towards NCD areas, in both countries, respiratory disease research resulted as the lowest funded, whereas cancer research was the target of most funding streams. The most reported expected outputs of funded research activity were scholarly publication of articles and reports.ConclusionsThis cross-country comparison on the Italian and German research funding structures revealed substantial differences between the two systems. The current system is prone to duplicated research efforts, popular funding for some diseases and intransparency of research results. Future research will require addressing the need for better coordination of research funding efforts, even more so if European research efforts are to play a greater role.

The Effect of Synergies and Competition on Organizational Choices in Non-Profits

Whether non-profit organizations should use business tools traditionally associated with the for-profit sector has been a widely debated issue. The push to encourage non-profits to adopt commercial tools has been particularly strong in microfinance, given the co-existence of non-profit institutions with firms that are more commercially oriented, such as for-profit banks and specialized microfinance banks. One such commercial tool is the use of commercial funding, including deposits, which is arguably increasingly useful given declining donations. I find that non-profits frequently do not benefit from the adoption of deposit-taking, and in fact many suffer declines in their financial performance after such adoption. However, those non-profits that make larger loans, thereby more closely mirroring the loan-making behavior of for-profit organizations, improve their financial performance after the adoption of deposit-taking. This result suggests that complementarities between commercial financing and borrower targeting are important, and such synergies are relevant when considering non-profit adoption of for-profit business tools. The extent of financial benefit is moderated by the amount of for-profit competition in the country, suggesting competitive concerns constrain whether these complementarities are worth pursuing.

Vitamin C supplementation for the primary prevention of cardiovascular disease.

Vitamin C is an essential micronutrient and powerful antioxidant. Observational studies have shown an inverse relationship between vitamin C intake and major cardiovascular events and cardiovascular disease (CVD) risk factors. Results from clinical trials are less consistent. To determine the effectiveness of vitamin C supplementation as a single supplement for the primary prevention of CVD. We searched the following electronic databases on 11 May 2016: the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library; MEDLINE (Ovid); Embase Classic and Embase (Ovid); Web of Science Core Collection (Thomson Reuters); Database of Abstracts of Reviews of Effects (DARE); Health Technology Assessment Database and Health Economics Evaluations Database in the Cochrane Library. We searched trial registers on 13 April 2016 and reference lists of reviews for further studies. We applied no language restrictions. Randomised controlled trials of vitamin C supplementation as a single nutrient supplement lasting at least three months and involving healthy adults or adults at moderate and high risk of CVD were included. The comparison group was no intervention or placebo. The outcomes of interest were CVD clinical events and CVD risk factors. Two review authors independently selected trials for inclusion, abstracted the data and assessed the risk of bias. We included eight trials with 15,445 participants randomised. The largest trial with 14,641 participants provided data on our primary outcomes. Seven trials reported on CVD risk factors. Three of the eight trials were regarded at high risk of bias for either reporting or attrition bias, most of the 'Risk of bias' domains for the remaining trials were judged as unclear, with the exception of the largest trial where most domains were judged to be at low risk of bias.The composite endpoint, major CVD events was not different between the vitamin C and placebo group (hazard ratio (HR) 0.99, 95% confidence interval (CI) 0.89 to 1.10; 1 study; 14,641 participants; low-quality evidence) in the Physicians Health Study II over eight years of follow-up. Similar results were obtained for all-cause mortality HR 1.07, 95% CI 0.97 to 1.18; 1 study; 14,641 participants; very low-quality evidence, total myocardial infarction (MI) (fatal and non-fatal) HR 1.04 (95% CI 0.87 to 1.24); 1 study; 14,641 participants; low-quality evidence, total stroke (fatal and non-fatal) HR 0.89 (95% CI 0.74 to 1.07); 1 study; 14,641 participants; low-quality evidence, CVD mortality HR 1.02 (95% 0.85 to 1.22); 1 study; 14,641 participants; very low-quality evidence, self-reported coronary artery bypass grafting (CABG)/percutaneous transluminal coronary angioplasty (PTCA) HR 0.96 (95% CI 0.86 to 1.07); 1 study; 14,641 participants; low-quality evidence, self-reported angina HR 0.93 (95% CI 0.84 to 1.03); 1 study; 14,641 participants; low-quality evidence.The evidence for the majority of primary outcomes was downgraded (low quality) because of indirectness and imprecision. For all-cause mortality and CVD mortality, the evidence was very low because more factors affected the directness of the evidence and because of inconsistency.Four studies did not state sources of funding, two studies declared non-commercial funding and two studies declared both commercial and non-commercial funding. Currently, there is no evidence to suggest that vitamin C supplementation reduces the risk of CVD in healthy participants and those at increased risk of CVD, but current evidence is limited to one trial of middle-aged and older male physicians from the USA. There is limited low- and very low-quality evidence currently on the effect of vitamin C supplementation and risk of CVD risk factors.

Employing Dynamic Logic in Cybersecurity

Dr. Leonid Perlovsky, distinguished physicist and cognitive scientist, pondered this question, which could have a significant impact on his research direction in the years to come. Over the past few decades, he had developed and refined algorithms for distinguishing objects in images, an approach that had found its way into various classified U.S. Department of Defense (DoD) applications. Now he was looking for new potential opportunities to see his research applied, allowing it to evolve further. One of the most interesting aspects of Perlovsky’s approach was that it was very similar to that taken by the human brain in processing sensory information. It began with a very vague model of what might or might not be present in the data being examined. Through successive iterations, analogous to the layers of processing used in human sensory systems, the patterns in the data corresponding to objects would grow more and more distinct until, finally, they became recognizable. Unlike most statistical techniques, this approach—termed “dynamic logic” by Perlovsky—did not require that a model be specified in advance. As such, it was well suited for contexts that required discovery. One application of dynamic logic that particularly impressed him involved the detection of malware in network packet data. Using an externally provided database of this traffic, his algorithm had successfully identified the presence of malware with almost eerie precision, and with substantially less processing than competing techniques. This suggested that dynamic logic could well become a powerful tool in the arsenal of IT professionals seeking to protect their systems from hackers. What other possible cybersecurity-related opportunities might be well suited to this tool? Identifying potential opportunities represented only part of the challenge of putting dynamic logic to work. After letting the project lay dormant for several years, he had recently been approached by an energetic Brazilian master’s student who had identified ways that DL (dynamic logic) could be used. The student had also established a DL open source project on his own initiative. If that project were to move forward, Perlovsky would need to provide some encouragement and guidance. But he had his own set of questions. Was the open source path the right way to proceed? What potential application should be given highest priority? Should government or commercial funding be pursued? And the big question… Perlovsky readily acknowledged that he was no cybersecurity expert. Given that he was already actively pursuing grants from the DoD and National Institute of Health (NIH), would it really make sense to split his attention further, and look towards tackling an entirely new class of problems?

Employing Dynamic Logic in Cybersecurity

A physicist who studies the human brain has adapted dynamic logic, a machine learning algorithm he developed, to run on a test database of network traffic. The algorithm has proven surprisingly adept at identifying malware traffic. Now he ponders how the project might move forward, given that cybersecurity is entirely outside of his domain of expertise (and interest). Dr. Leonid Perlovsky, distinguished physicist and cognitive scientist, pondered this question, which could have a significant impact on his research direction in the years to come. Over the past few decades, he had developed and refined algorithms for distinguishing objects in images, an approach that had found its way into various classified U.S. Department of Defense (DoD) applications. Now he was looking for new potential opportunities to see his research applied, allowing it to evolve further. One of the most interesting aspects of Perlovsky’s approach was that it was very similar to that taken by the human brain in processing sensory information. It began with a very vague model of what might or might not be present in the data being examined. Through successive iterations, analogous to the layers of processing used in human sensory systems, the patterns in the data corresponding to objects would grow more and more distinct until, finally, they became recognizable. Unlike most statistical techniques, this approach—termed “dynamic logic” by Perlovsky—did not require that a model be specified in advance. As such, it was well suited for contexts that required discovery. One application of dynamic logic that particularly impressed him involved the detection of malware in network packet data. Using an externally provided database of this traffic, his algorithm had successfully identified the presence of malware with almost eerie precision, and with substantially less processing than competing techniques. This suggested that dynamic logic could well become a powerful tool in the arsenal of IT professionals seeking to protect their systems from hackers. What other possible cybersecurity-related opportunities might be well suited to this tool? Identifying potential opportunities represented only part of the challenge of putting dynamic logic to work. After letting the project lay dormant for several years, he had recently been approached by an energetic Brazilian master’s student who had identified ways that DL (dynamic logic) could be used. The student had also established a DL open source project on his own initiative. If that project were to move forward, Perlovsky would need to provide some encouragement and guidance. But he had his own set of questions. Was the open source path the right way to proceed? What potential application should be given highest priority? Should government or commercial funding be pursued? And the big question… Perlovsky readily acknowledged that he was no cybersecurity expert. Given that he was already actively pursuing grants from the DoD and National Institute of Health (NIH), would it really make sense to split his attention further, and look towards tackling an entirely new class of problems?

Guldslør. Performative strategier som kritik og affirmation i senkapitalismen

Is immersive performance art with its blurred identities, parallel worlds and transformational potential the perfect genre for hidden capitalist interests, bad working conditions and commercial branding? Following the motive of the veil, and the gesture of unveiling as form of critique, the article examines the relation between labour of performance art, commercial funding and subjectivation in late capitalism. Departing from the claim that the cultural worker – flexible, creative, innovative and self managing – is the role model of today’s neoliberal work ethos, the article analyses strategies of unveiling of the production conditions and work ethos of performance art today.

Financing and financial sustainability of microfinance institutions (MFIs): a conceptual view

Recent evidence shows that MFI financing continues to evolve with an increased inclination towards commercial financing. Taking stock on MFI financing and refocusing on the relationship between financing options and financial sustainability (FS) is unavoidable. The authors consummated a literature review based on complementing the little evidence on the subject with both theoretical and implied evidence from related studies in unpacking the relationship. Though donations are losing grip as a popular MFI financing option, review of literature recommends smart subsidies to spur FS and counter inefficiency, mis-targetting, dependency and distortions. As much as debt addresses agency problems and endorses FS, it has to be kept within limits to curb liquidation and mission drift. Deposit attraction augments FS and outreach, though MFIs must prepare to foot licensing costs, otherwise, mission drift ensues. Equity, though scarce in microfinance, is cheap and additive to FS. The authors suggest that MFIs should consider commercial funding, whilst keeping a check on the downside of each commercial financing option to augment FS and multiply outreach

TU‐H‐202‐01: Introduction to CT Ventilation Imaging: Principles, Validation and Clinical Translation

CT ventilation imaging is an exciting functional imaging modality that combines four‐dimensional computed tomography (4DCT) and deformable image registration (DIR) to provide exquisite ventilation maps of the lung. CT ventilation imaging can be used for: Functional avoidance in thoracic radiation therapy, Imaging longitudinal changes in regional lung function for treatment assessment and adaptation, Image‐assisted diagnosis of non‐oncologic respiratory diseases.CT ventilation imaging uses CT, a predominantly anatomic imaging modality, and through imaging processing creates functional images. CT ventilation imaging provides functional images that are higher resolution, faster and cheaper to perform than the clinical standard, SPECT. Indeed the number of CT ventilation abstracts presented at the AAPM meeting has been doubling every two years. With the world's‐first clinical trial of CT ventilation functional image‐guided radiation therapy now underway, the first dedicated scientific symposium will educate and stimulate AAPM members from both radiology and radiation oncology.This symposium will compare the foundations of CT ventilation imaging with competing MRI, PET and SPECT ventilation imaging methods, and details the first clinical trial of CT ventilation imaging for functional avoidance in lung cancer radiation therapy. The spatial‐temporal nature of pulmonary ventilation, response maps to radiation and the design of predictive models will be presented. Validation efforts and challenges will also be discussed, from clinical outcome correlations in single time point and longitudinal studies, to cross‐modality image comparisons in the first multi‐institutional CT ventilation imaging challenge.The panel will discuss the future role of CT ventilation imaging, and what level of physiologic validation is needed for applications in radiation oncology and beyond. Learning Objectives: Learn the principles of CT ventilation imaging and how ventilation images are acquired with MRI, PET and SPECT Understand the methods used to benchmark CT ventilation and the correlations between CT ventilation imaging and clinical outcomes Recognize the clinical applications of CT ventilation imaging in radiation oncology and beyondAustralian NHMRC Fellowship. Australian NSW Cancer Institute Fellowship.; Y. Vinogradskiy, The authors acknowledge NIH R01CA200817 grant and Stat of Colorado grant.; T. Yamamoto, This study was supported in part by the American Cancer Society and the Dean of the University of California Davis School of Medicine (ACS IRG‐95‐125‐13). Philips Radiation Oncology Systems loaned us a research version of the Pinnacle3 treatment planning system.; J. Bayouth, Funding support from NCIR01 CA166703; J. Kipritidis, This work has been supported by a Cancer Institute NSW Early Career Fellowship and an NHMRC Australia Fellowship.No commercial funding was received for this work.

TU‐H‐202‐03: Spatial Distributions of Radiation Induced Pulmonary Changes Can Be Modeled and Utilized for Image‐Guided Planning and Therapy to Improve Pulmonary Function Preservation and Hence the Therapeutic Ratio for Lung Cancer

CT ventilation imaging is an exciting functional imaging modality that combines four‐dimensional computed tomography (4DCT) and deformable image registration (DIR) to provide exquisite ventilation maps of the lung. CT ventilation imaging can be used for: Functional avoidance in thoracic radiation therapy, Imaging longitudinal changes in regional lung function for treatment assessment and adaptation, Image‐assisted diagnosis of non‐oncologic respiratory diseases.CT ventilation imaging uses CT, a predominantly anatomic imaging modality, and through imaging processing creates functional images. CT ventilation imaging provides functional images that are higher resolution, faster and cheaper to perform than the clinical standard, SPECT. Indeed the number of CT ventilation abstracts presented at the AAPM meeting has been doubling every two years. With the world's‐first clinical trial of CT ventilation functional image‐guided radiation therapy now underway, the first dedicated scientific symposium will educate and stimulate AAPM members from both radiology and radiation oncology.This symposium will compare the foundations of CT ventilation imaging with competing MRI, PET and SPECT ventilation imaging methods, and details the first clinical trial of CT ventilation imaging for functional avoidance in lung cancer radiation therapy. The spatial‐temporal nature of pulmonary ventilation, response maps to radiation and the design of predictive models will be presented. Validation efforts and challenges will also be discussed, from clinical outcome correlations in single time point and longitudinal studies, to cross‐modality image comparisons in the first multi‐institutional CT ventilation imaging challenge.The panel will discuss the future role of CT ventilation imaging, and what level of physiologic validation is needed for applications in radiation oncology and beyond. Learning Objectives: Learn the principles of CT ventilation imaging and how ventilation images are acquired with MRI, PET and SPECT Understand the methods used to benchmark CT ventilation and the correlations between CT ventilation imaging and clinical outcomes Recognize the clinical applications of CT ventilation imaging in radiation oncology and beyondAustralian NHMRC Fellowship. Australian NSW Cancer Institute Fellowship.; Y. Vinogradskiy, The authors acknowledge NIH R01CA200817 grant and Stat of Colorado grant.; T. Yamamoto, This study was supported in part by the American Cancer Society and the Dean of the University of California Davis School of Medicine (ACS IRG‐95‐125‐13). Philips Radiation Oncology Systems loaned us a research version of the Pinnacle3 treatment planning system.; J. Bayouth, Funding support from NCIR01 CA166703; J. Kipritidis, This work has been supported by a Cancer Institute NSW Early Career Fellowship and an NHMRC Australia Fellowship.No commercial funding was received for this work.

TU‐H‐202‐02: Applications, Validation, Clinical Endpoints and Opportunities for CT Ventilation

CT ventilation imaging is an exciting functional imaging modality that combines four‐dimensional computed tomography (4DCT) and deformable image registration (DIR) to provide exquisite ventilation maps of the lung. CT ventilation imaging can be used for: Functional avoidance in thoracic radiation therapy, Imaging longitudinal changes in regional lung function for treatment assessment and adaptation, Image‐assisted diagnosis of non‐oncologic respiratory diseases.CT ventilation imaging uses CT, a predominantly anatomic imaging modality, and through imaging processing creates functional images. CT ventilation imaging provides functional images that are higher resolution, faster and cheaper to perform than the clinical standard, SPECT. Indeed the number of CT ventilation abstracts presented at the AAPM meeting has been doubling every two years. With the world's‐first clinical trial of CT ventilation functional image‐guided radiation therapy now underway, the first dedicated scientific symposium will educate and stimulate AAPM members from both radiology and radiation oncology.This symposium will compare the foundations of CT ventilation imaging with competing MRI, PET and SPECT ventilation imaging methods, and details the first clinical trial of CT ventilation imaging for functional avoidance in lung cancer radiation therapy. The spatial‐temporal nature of pulmonary ventilation, response maps to radiation and the design of predictive models will be presented. Validation efforts and challenges will also be discussed, from clinical outcome correlations in single time point and longitudinal studies, to cross‐modality image comparisons in the first multi‐institutional CT ventilation imaging challenge.The panel will discuss the future role of CT ventilation imaging, and what level of physiologic validation is needed for applications in radiation oncology and beyond. Learning Objectives: Learn the principles of CT ventilation imaging and how ventilation images are acquired with MRI, PET and SPECT Understand the methods used to benchmark CT ventilation and the correlations between CT ventilation imaging and clinical outcomes Recognize the clinical applications of CT ventilation imaging in radiation oncology and beyondAustralian NHMRC Fellowship. Australian NSW Cancer Institute Fellowship.; Y. Vinogradskiy, The authors acknowledge NIH R01CA200817 grant and Stat of Colorado grant.; T. Yamamoto, This study was supported in part by the American Cancer Society and the Dean of the University of California Davis School of Medicine (ACS IRG‐95‐125‐13). Philips Radiation Oncology Systems loaned us a research version of the Pinnacle3 treatment planning system.; J. Bayouth, Funding support from NCIR01 CA166703; J. Kipritidis, This work has been supported by a Cancer Institute NSW Early Career Fellowship and an NHMRC Australia Fellowship.No commercial funding was received for this work.

TU‐H‐202‐04: The VAMPIRE Challenge: Preliminary Results From a Multi‐Institutional Study of CT Ventilation Image Accuracy

CT ventilation imaging is an exciting functional imaging modality that combines four‐dimensional computed tomography (4DCT) and deformable image registration (DIR) to provide exquisite ventilation maps of the lung. CT ventilation imaging can be used for: Functional avoidance in thoracic radiation therapy, Imaging longitudinal changes in regional lung function for treatment assessment and adaptation, Image‐assisted diagnosis of non‐oncologic respiratory diseases.CT ventilation imaging uses CT, a predominantly anatomic imaging modality, and through imaging processing creates functional images. CT ventilation imaging provides functional images that are higher resolution, faster and cheaper to perform than the clinical standard, SPECT. Indeed the number of CT ventilation abstracts presented at the AAPM meeting has been doubling every two years. With the world's‐first clinical trial of CT ventilation functional image‐guided radiation therapy now underway, the first dedicated scientific symposium will educate and stimulate AAPM members from both radiology and radiation oncology.This symposium will compare the foundations of CT ventilation imaging with competing MRI, PET and SPECT ventilation imaging methods, and details the first clinical trial of CT ventilation imaging for functional avoidance in lung cancer radiation therapy. The spatial‐temporal nature of pulmonary ventilation, response maps to radiation and the design of predictive models will be presented. Validation efforts and challenges will also be discussed, from clinical outcome correlations in single time point and longitudinal studies, to cross‐modality image comparisons in the first multi‐institutional CT ventilation imaging challenge.The panel will discuss the future role of CT ventilation imaging, and what level of physiologic validation is needed for applications in radiation oncology and beyond. Learning Objectives: Learn the principles of CT ventilation imaging and how ventilation images are acquired with MRI, PET and SPECT Understand the methods used to benchmark CT ventilation and the correlations between CT ventilation imaging and clinical outcomes Recognize the clinical applications of CT ventilation imaging in radiation oncology and beyondAustralian NHMRC Fellowship. Australian NSW Cancer Institute Fellowship.; Y. Vinogradskiy, The authors acknowledge NIH R01CA200817 grant and Stat of Colorado grant.; T. Yamamoto, This study was supported in part by the American Cancer Society and the Dean of the University of California Davis School of Medicine (ACS IRG‐95‐125‐13). Philips Radiation Oncology Systems loaned us a research version of the Pinnacle3 treatment planning system.; J. Bayouth, Funding support from NCIR01 CA166703; J. Kipritidis, This work has been supported by a Cancer Institute NSW Early Career Fellowship and an NHMRC Australia Fellowship.No commercial funding was received for this work.

TU‐H‐202‐00: CT Ventilation Imaging: The New Clinical Reality of Functional Avoidance and Response Assessment in Lung Cancer Radiation Therapy

CT ventilation imaging is an exciting functional imaging modality that combines four‐dimensional computed tomography (4DCT) and deformable image registration (DIR) to provide exquisite ventilation maps of the lung. CT ventilation imaging can be used for: Functional avoidance in thoracic radiation therapy, Imaging longitudinal changes in regional lung function for treatment assessment and adaptation, Image‐assisted diagnosis of non‐oncologic respiratory diseases.CT ventilation imaging uses CT, a predominantly anatomic imaging modality, and through imaging processing creates functional images. CT ventilation imaging provides functional images that are higher resolution, faster and cheaper to perform than the clinical standard, SPECT. Indeed the number of CT ventilation abstracts presented at the AAPM meeting has been doubling every two years. With the world's‐first clinical trial of CT ventilation functional image‐guided radiation therapy now underway, the first dedicated scientific symposium will educate and stimulate AAPM members from both radiology and radiation oncology.This symposium will compare the foundations of CT ventilation imaging with competing MRI, PET and SPECT ventilation imaging methods, and details the first clinical trial of CT ventilation imaging for functional avoidance in lung cancer radiation therapy. The spatial‐temporal nature of pulmonary ventilation, response maps to radiation and the design of predictive models will be presented. Validation efforts and challenges will also be discussed, from clinical outcome correlations in single time point and longitudinal studies, to cross‐modality image comparisons in the first multi‐institutional CT ventilation imaging challenge.The panel will discuss the future role of CT ventilation imaging, and what level of physiologic validation is needed for applications in radiation oncology and beyond. Learning Objectives: Learn the principles of CT ventilation imaging and how ventilation images are acquired with MRI, PET and SPECT Understand the methods used to benchmark CT ventilation and the correlations between CT ventilation imaging and clinical outcomes Recognize the clinical applications of CT ventilation imaging in radiation oncology and beyondAustralian NHMRC Fellowship. Australian NSW Cancer Institute Fellowship.; Y. Vinogradskiy, The authors acknowledge NIH R01CA200817 grant and Stat of Colorado grant.; T. Yamamoto, This study was supported in part by the American Cancer Society and the Dean of the University of California Davis School of Medicine (ACS IRG‐95‐125‐13). Philips Radiation Oncology Systems loaned us a research version of the Pinnacle3 treatment planning system.; J. Bayouth, Funding support from NCIR01 CA166703; J. Kipritidis, This work has been supported by a Cancer Institute NSW Early Career Fellowship and an NHMRC Australia Fellowship.No commercial funding was received for this work.

Access to Philanthropic and Commercial Income Among Nonprofit Community Service Organisations

Governments depend on nonprofit, voluntary sector organisations to deliver social and community services, and public funding is the sector’s most important income source. However, in many countries, public funding for social services is becoming more limited, conditional and precarious, and governments are encouraging nonprofits to diversify their funding base, and shift their reliance to income from market activity and private donations. This article is concerned with access to philanthropic and commercial funding among nonprofits, and the factors affecting it. It firstly discusses an emerging policy agenda to promote private funding among nonprofit community service providers. Then, multivariate analysis of survey data from 521 Australian nonprofits shows which organisations access income from client fees, business activities, community fundraising, and philanthropic foundations. By exploring inequalities in the distribution of these main sources of private funding, the article helps identify the types of organisations that face challenges in establishing and sustaining streams of private income, and which are likely to require ongoing public support.

The ICMJE Recommendations and pharmaceutical marketing--strengths, weaknesses and the unsolved problem of attribution in publication ethics.

BackgroundThe International Committee of Medical Journal Editors (ICMJE) Recommendations set ethical and editorial standards for article publication in most leading medical journals. Here, I examine the strengths and weaknesses of the Recommendations in the prevention of commercial bias in industry-financed journal literature, on three levels – scholarly discourse, article content, and article attribution.DiscussionWith respect to overall discourse, the most important measures in the ICMJE Recommendations are for enforcing clinical trial registration and controlling duplicate publication. With respect to article content, the ICMJE promotes stringent author accountability and adherence to established reporting standards. However, the ICMJE accepts the use of commercial editorial teams to produce manuscripts, which is a potential source of bias, and accepts private company ownership and analysis of clinical trial data. New ICMJE guidance on data sharing will address but not eliminate problems of commercial data access. With respect to attribution, the Recommendations oppose guest authorship and encourage clear documentation of author contributions. However, they exclude writers from coauthorship; provide no specific advice on the attribution of commercial literature, for instance with respect to company authorship, author sequence or prominent commercial labeling; and endorse the use of fine print and euphemism. The ICMJE requires detailed author interest disclosures, but overlooks the interests of non-authors and companies, and does not recommend that interests most salient to the publication are highlighted. Together, these weaknesses facilitate “advocacy”-based marketing, in which literature planned, financed and produced by companies is fronted by academics, enabling commercial messages to be presented to customers by their respected clinical peers rather than companies themselves.ConclusionsThe ICMJE Recommendations set important research and reporting standards, without which commercial bias would likely be a significantly greater problem than it is today. However, they also support practices of commercial data control, content development and attribution that run counter to science’s values of openness, objectivity and truthfulness. These weaknesses could be addressed with appropriate modifications to the Recommendations. The ICMJE should also disclose its own commercial interests and funding – not least because publishing organizations that finance it and pay the salaries of some member editors derive substantial revenues from industry.

The Federal Reserve's Financial Crisis Response D: Commercial Paper Market Facilities

During the summer 2007 the U.S. residential mortgage market began to decline sharply negatively impacting the asset-backed commercial paper (ABCP) market, which often relied on mortgages as underlying support. Money Market Mutual Funds (MMMFs), significant investors in commercial paper (CP), quickly retreated from the market causing a substantial decline in outstanding ABCP. In September 2008, pressures on the markets severely escalated again, when the Reserve Primary Fund MMMF “broke the buck” and prompted run-like redemption requests by many MMMF investors. These disruptions resulted in higher rates and shorter maturities, practically freezing the market for term CP. Concerned about the impacts on the financial system and possible spillover to the greater economy, the Federal Reserve (the Fed) invoked its emergency powers to implement (i) the Asset-Backed Commercial Paper Money Market Fund Mutual Liquidity Facility (AMLF) and the (i) the Commercial Paper Funding Facility (CPFF), which collectively provided more than $1 trillion dollars to MMMFs and CP issuers and helped shore up the ABCP market, preserve the MMMFs, and eventually stimulate the CP market. This case discusses the two facilities and also demonstrates the interconnectedness between financial markets, the possibility of contagion that this creates, and how this proved challenging for the Fed in fighting the crisis.

Commercial Paper Funding Facility

On September 16, 2008, just a day after Lehman Brothers filed for bankruptcy protection, the Reserve Primary Fund money market mutual fund (MMMF) “broke the bank,” announcing a net asset value of less than $1 per share because of a large exposure to Lehman Brothers commercial paper (CP). As a result, the CP markets came under considerable pressure as other MMMFs began to experience run-like redemption requests and became reluctant to hold CP. The difficulties in the CP market lead to a severe shortening of maturities and increased rates that threatened to freeze these lending channels, which were widely used by financial and nonfinancial companies of all sizes to fund operating expenses and loans to small businesses and consumers. On October 7, 2008, the Federal Reserve (the Fed) intervened announcing the Commercial Paper Funding Facility (CPFF), which would backstop the CP market. Through the CPFF the Federal Reserve Bank of New York funded the indirect purchase of CP from issuers. The CPFF was highly utilized and at its early stages purchased the overwhelming majority of new term CP being issued. At its highest level it held $350 billion of CP, 20 percent of all outstanding CP. As markets improved, utilization of the CPFF waned and it expired on February 1, 2010, having helped to stabilize the CP markets.