Minimum Number Of Subjects Research Articles

Survival rate of children acute lymphoblastic leukemia at the end of therapy protocol with minimal residual disease (MRD) in Prof I G.N.G. Ngoerah General Hospital Denpasar

Link of Video Abstract: https://youtu.be/5DFCQHg86rU Background: Acute lymphoblastic leukemia (ALL) is the most common malignancy in children. Although the survival rate of pediatric patients with ALL is currently improving, cases of relapse still occur. Minimal residual disease (MRD) status is a prognostic factor that plays an important role in recurrence of ALL patients who have been through induction therapy. Aim: To determine the survival rate in pediatric patients with ALL based on negative MRD examination is better than positive MRD at the end of therapy. Method: A retrospective cohort study with inclusion criteria including pediatric patients aged 1 to 18 years who were diagnosed with ALL in the period of 2017-2019 at Sanglah General Hospital, Denpasar. Subject’s recruitment was initiated when the minimum number of subjects was fulfilled. Result: From 32 research subjects, the mean age was 5.1 years, the majority obtained MRD+ results, the dominant sex was male, the average leukocyte was 28.33 thousand, most of the subjects had no mediastinal masses, and generally experienced remissions. MRD levels were found to be significantly lower in remitting patients than patients who did not achieve remission (p value <0.05). The Kaplan-Meier estimates for event-free survival on MRD status (negative versus positive) were 84.6% and 42.1% (P = 0.030). Conclusion: There was a significant relation between MRD levels and the survival rate to achieve remission and MRD levels are significantly lower in remitting patients than patients who do not achieve remission.

Factors that influence the impact of Chronic Non-Cancer Pain on daily life: A partial least squares modelling approach

BackgroundChronic Non-Cancer Pain is pain of more than three months' duration and is not associated with an oncological condition. There is ample literature that recognises that Chronic Non-Cancer Pain impacts numerous areas of the life of the person who suffers from it. This impact is difficult to determine and quantify because Chronic Pain is a subjective experience. ObjectiveThe objective of this study was to test a recursive model of hypothesised factors that comprise the concept of Chronic Non-Cancer Pain Impact on daily life using Partial Least Squares-Structural Equation Modelling. DesignA cross-sectional study was carried out. The sample size was calculated using G*Power V.3.1.9.4 with five parameters (two-tailed, large effect size (f2 = 0.35), power of 0.95, statistical significance of 95% (α = 0.05) and 36 predictors). The minimum number of subjects was considered to be 137. MethodsA recursive model was built based on data from a sample of 395 people over 18 years of age with Chronic Non-Cancer Pain. Data collection was conducted between January and March 2020 at Pain Units and Primary Healthcare Centres belonging to the Spanish Public Health System in the province of Seville (Spain). Analyses were based on Partial Least Squares-Structural Equation Modelling. The internal consistency, convergent validity and discriminant validity of the internal measurement model were assessed. For the external measurement model, global model adjustment and structural validity were assessed. The predictive capacity of the final model was also evaluated. All analyses were performed using SmartPLS version 3.3.2 in consistent mode. ResultsFindings showed an adequate validity of the proposed model, which comprised nine factors: pain catastrophising, hopelessness due to pain, support network, proactivity, treatment compliance, self-care, mobility, resilience, and sleep. The internal validity of the model (Cronbach's alpha and rho_A > 0.70; Average Variance Extracted>0.50; standardised outer loadings>0.60; Heterotrait-Monotrait-Ratio < 0.85), goodness of fit (Standardised Root Mean Square Residuals<0.08; Geodesic and Euclidean distance p-value<0.05) and predictive power with out-of-sample values (Stone-Geisser test>0.5) were adequate. The hypothesised structure of the instrument has also been confirmed (path coefficients>0.3; R2 > 0.1; f2 > 0.2). ConclusionsThe results have shown an adequate internal consistency, convergent validity and discriminant validity of the model. Likewise, the model has shown an adequate goodness of fit, and the validity of its structure and the hypothesis have been confirmed. However, more research is needed in this regard as the possible interaction between the different factors evaluated in the model with the confounding or moderating variables that may exist.

AAUS guidelines 2021 revision sexually transmitted infection (STIs) diagnostic strategy for STI

AAUS guidelines 2021 revision sexually transmitted infection (STIs) diagnostic strategy for STI

Forensic age assessment using Kvaal’s method with digital orthopantomographs (OPG) and comparison with the actual age of the subjects

Background: Forensic Dentistry is one of the branch of Forensic Medicine which deals with the complete handling of dental evidence, estimation and examination and the evidence obtained would be used in the court for justice. Kvaal and Solheim given a method used on adults for calculation of age with the help of morphological and radiological methods, but extraction was still required. Hence to improve this procedure Kvaal et al made a method which is totally based on radiological analysis. Aims and Objective: The present study was designed to compare the forensic age assessment using Kvaal’s method and digital orthopantomographs with the actual age of the subjects. Materials and Methods: Present observational study was conducted in subjects with all the required complement of teeth on either right or left side, completely erupted clinical crown, without any morphological abnormalities for age estimation by Kvaal’s method with digital orthopantomograph as and compared with actual age of subjects. Results: In the present study out of 100 subjects, maximum number of subjects i.e. 61 were in the age group of 20 – 29 and minimum number of subjects i.e. 7 were in the age group of 50 –59. 43 were females and 57 were males. The regression equation was derived for all six studied teeth and coefficient of determination R2 was found for all the individual six teeth. Coefficient of determination was highest for lower first premolar (0.517) followed by upper central incisor (0.178), lower canine (0.134), lower lateral incisors, upper second premolar and upper lateral incisors. M &amp; W-L were found significant predictors for lower first premolar, lower canine and upper central incisors. Similarly, coefficient of determination (R2) was significant higher for lower three teeth (0.478) than upper three teeth (0.069) with M &amp; W-L were significant predictor. Regression equation derived for all six teeth together shows significant coefficient of determination R2(0.430) with M, W-L both are significant predictors. No statistically significant difference between the actual age and estimated age for all individual six teeth was noted. Mean difference lowest for lower first premolar (0.001) followed by lower canine (0.007). Conclusion: We noted that age assessment using Kvaal’s method with digital orthopantomographas and actual age of the subjects were comparable &amp; no significant difference was noted. Kvaal’s method with digital orthopantomographas is a better option for age estimation without teeth removal.

English

BACKGROUND Parkinson’s disease is a chronic neurodegenerative disorder with a prevalence rate of 108 - 257 per 100,000 people, occurring in later half of life and affecting both genders equally. The progressive nature of the disease is associated with growing disability and has a considerable impact on quality of life. Quality of life (QOL) is an important goal in every rehabilitation process and its impact on disease process, stage and prognosis is closely associated, which often gets neglected. Thus, it was necessary to conduct this study to establish actual impact of Parkinson’s disease on quality of life, emphasizing on disease duration. METHODS A questionnaire based observational study was carried out among patients with Parkinson’s disease in Maharashtra. The survey was conducted in Parkinson’s Association Group by handing over the hard copies of questionnaires to 120 patients and their respective care takers. Questionnaire used was ‘The Parkinson’s Disease Questionnaire (PDQ39)’. It had 39 items grouped into 8 domains. Statistical analysis of the collected data was carried out using InStat software and Microsoft excel. RESULTS In motor symptom-based questions, the impact on quality of life was more significant i.e., 54 % (P &lt; 0.0001) compared to non-motor symptoms which was 46 % (P &lt; 0.0001). Maximum number of subjects were from age group 71 to 80 while minimum number of subjects were from 91 to 100 yrs. CONCLUSIONS There was significant impact of motor as well as non-motor symptoms on patient’s quality of life; but motor symptoms like tremors and slowness of movement had greater impact compared to non-motor symptoms which included speech difficulty and social stigma. There was no co-relation between specific age group and incidence of disease. KEY WORDS Parkinson’s Disease, PDQ - 39 Questionnaire, Quality of Life (QOL), Motor and NonMotor Symptoms, Activities of Daily Living

Keterkaitan antara Susu sebagai Pelengkap Sarapan terhadap Prestasi Belajar Siswa Sekolah Dasar

&lt;p&gt;&lt;em&gt;The study aims to determine the association of milk as complimentary breakfast towards learning achievement of elementary school students, using a retrospective case-control research design. Subjects were determined purposively with the inclusion criteria having normal BMI and not lactose intolerance. The minimum number of subjects was based on calculations were 38 children. Subjects as many as 22 elementary school children were exposed to a complete breakfast habit with milk and 17 elementary school children became a control group for breakfast habits without milk. Completing the 2x24 hour food recall questionnaire and 7-day food record and subject interviews were conducted for 1 week. Learning achievement is measured using the final score of the semester 1 by K13 curriculum. There was a significant relationship in the exposed group and the control group on learning achievement especially Bahasa scores (p = 0,001) as many as 90,91% in the exposed group and 88,24%, in the control group, also, the tendency for a better IPA (Science) scores in the exposed group was 81,82% compared to the control group at 64,71%. Thus, the habit of breakfast supplemented with milk is closely related to the learning achievement of elementary school children.&lt;/em&gt;&lt;/p&gt;

Immunotherapy with Y90-radioembolization for metastatic colorectal cancer (iRE-C).

TPS276 Background: Immune checkpoint inhibitors have revolutionized the treatment of a number of cancers. In colorectal cancers, their efficacy is limited to mismatch repair deficient or microsatellite stability-high (dMMR/MSI-High) tumors only. These constitute only 4-5% of all metastatic colorectal cancers (mCRC). Novel approaches are needed to make immunotherapy a viable option for mismatch repair proficient or microsatellite stable (pMMR/MSS) tumors. Increasing exposure of neo-antigens to the immune system could be one potential strategy to enhance the response of immunotherapy. Yttrium 90-radioembolization (Y90-RE) in combination with immunotherapy may work synergistically to enhance efficacy of each other. Additionally, radiation can potentially make the tumor microenvironment conducive to effector T-cell recruitment and function. Therefore, we hypothesize and propose the clinical trial of combining immunotherapy with Y90-RE as a feasible and safe strategy that will improve outcomes in patients with mCRC with liver-predominant metastases. Methods: This clinical trial will be conducted as a single-center, open-label, Phase I/II trial to evaluate initially the feasibility and safety of Y90-RE in combination with a fixed dose of immunotherapy (durvalumab) in subjects with liver-predominant, mCRC (Table). It will be offered in the refractory setting. The trial will be performed in 18 subjects with mCRC with liver metastasis and the safety of immunotherapy (durvalumab) with Y90-RE will be investigated in an accelerated titration design. This would allow a maximum tolerated dose with the minimum number of subjects. Correlative studies pertaining to serial circulating tumor DNA (ctDNA - liquid biopsies) testing as well as immune-panel based profiling will be performed alongside pre- and post-biopsies to study changes in the tumor microenvironment. Clinical trial information: NCT04108481. [Table: see text]

Social Media Use in Patients with Gynecologic Pain

Study Objective To determine if patients with gynecologic pain are more likely than patients without gynecologic pain to use social media to learn about or manage their condition. Design Comparative prospective patient survey. Setting Six hospital systems across country, university-based and community-based. Patients or Participants 497 patients who presented to an FMIGS-affiliated clinic and consented to participate in the survey. Interventions Subjects self-determined if their gynecologic visit was related to pain. Those with pain were in the Study group. Those without pain were in the Control group. Subjects independently completed a survey regarding their internet and social media use in relation to their gynecologic care. The minimum number of subjects needed to detect a 10% difference in the primary outcome was 471 subjects. Fisher's exact test was used to test for significance at a power of 80% and an alpha of .05. Measurements and Main Results 497 subjects enrolled in the study. 459 of 497 (92.4%) of enrolled subjects completed the study survey, 321 (69.6%) with pain (Study group) and 138 (30.1%) without pain (Control group). The median age of participants was 39 years (IQR 29-55) in the Pain group and 42 years (IQR 31-54) in the Control group. 119/321 (37.1%) subjects in the Pain group and 27/138 (19.6%) of subjects in the Control group reported using social media to learn about or manage their gynecologic condition; this difference was statistically significant (p Conclusion Patients with gynecologic pain were more likely than those without pain to use social media to learn about or manage their condition.

Treatments for giant cell arteritis: Meta-analysis and assessment of estimates reliability using the fragility index.

To better communicate the results of randomized controlled trials (RCTs) of giant cell arteritis (GCA), we propose the use of the fragility index (FI), which is an intuitive measure defined as the minimum number of subjects whose status would have to change (e.g., from having the outcome to not) to render a statistically significant result nonsignificant, or vice-versa. We conducted a systematic review and random-effects meta-analysis of RCTs of glucocorticoid (GC) sparing strategies for relapse-free maintenance in GCA, and used the FI to simplify the presentation of results. Ten RCTs (nine phase II and one phase III enrolling 645 subjects) were included. Tocilizumab, IV GC and methotrexate significantly improved the likelihood of being relapse free with relative risks and 95% confidence intervals of 3.54 (2.28, 5.51), 5.11 (1.39, 18.81) and 1.54 (1.02, 2.30); respectively. The median FI was 4.5 (range, 1-28), and was generally higher for negative RCTs (n = 6; median FI 4.5) than for positive RCTs (n = 4; median FI 3.5). The range of FI per treatment was (1-8) for methotrexate, (2-6) for anti-TNF agents, 4 for abatacept, 3 for IV GC pulses and (4-28) for tocilizumab. Tocilizumab, IV GC and methotrexate improve the likelihood of being relapse-free in subjects with GCA. Assessment of GC sparing strategies in GCA has long depended on imprecise trials that would change significance if outcomes were reversed for a handful of subjects. FI may be used in rheumatology to simplify communication of statistical significance and overcome limitations of p-value.

Letter regarding article by Wang et al., “Internal fixation of distal tibiofibular syndesmotic injuries: a systematic review with meta-analysis”

To the Editor, We read with great interest the article by Wang et al. [1] titled “Internal fixation of distal tibiofibular syndesmotic injuries: a systematic review with meta-analysis” published on-line in July 2013 in International Orthopaedics. In this meta-analysis, Wang et al. analysed the optimal method for syndesmotic fixation. Four comparisons with traditional metallic screw were identified in terms of bioabsorbable screws, tricortical fixation method, suture-button device and nonfixation in low syndesmotic injuries. The authors concluded that patients with low syndesmotic injuries should be well assessed before fixation determination and that the indication for screw placement in such conditions needs to be further defined. Nevertheless, we have several queries to communicate with the authors. The authors have not focused specifically or in any detail on the issue of the completeness of the search strategy report for databases. They just described the retrieval strategy by using the keywords “syndesmosis” or “tibiofibular”. We suggest that the authors provide details of the retrieval strategy. The authors defined one exclusion criterion as “study subjects to be less than 20”. We are wondering the reason for this exclusion criterion. Among the included studies, the minimum number of subjects was 24 by Coetzee et al. [2] and Pakarinen et al. [3]. Therefore, we suggest that exclusion criteria should be redefined by the authors. We suggest that the authors evaluate the methodological quality of the included studies, which could avoid potential bias in the meta-analysis. Each included study should be independently assessed by two reviewers. Meanwhile, the authors also should clarify how to assess the quality of all included studies and detailed scores for each trial. The authors used a fixed-effects model to pool data in all forest plots (Tables 2–5). However, different effects models may result in different results. Therefore, we would like to know the reason that the authors chose the fixed effects model for all analyses. In our opinion, the authors should pay attention to the I2, which is on behalf of heterogeneity. When I2 was under 50 %, low heterogeneity was assumed, and the fixed-effects model could be used to pool data. Conversely, when I2 exceeded 50 %, heterogeneity was thought to exist and the effects model should be random. Moreover, further high-quality randomised controlled trials (RCTs) based on larger sample sizes are still needed. We believe that our remarks will contribute to more accurate elaboration of the results presented by Wang et al.

Population pharmacokinetic modelling of S-warfarin to evaluate the design of drug–drug interaction studies for CYP2C9

This study is to assess pharmacokinetic (PK) sampling time schedules and trial size requirements of drug-drug interaction (DDI) studies for CYP2C9, based on S-warfarin population PK models. S-warfarin plasma concentrations from eight DDI studies were utilized to develop S-warfarin population PK models. Optimal PK sampling times were obtained that minimized mean squared error of geometric mean of the area under the concentration-time curve (AUC(0-∞)). The powers and type I error rates of testing the equivalences of the geometric means of AUC(0-∞) only and AUC(0-∞) and maximum concentration (C (max)), jointly, were assessed via simulation for two-by-two cross-over designs. The results were compared to those from three bioequivalence sample size calculation methods. Two-compartment population PK models with first order absorption were established for non-Asian and Asian subjects. The optimal PK sampling times of size 17 per individual per period were found to be 0.0, 0.5, 1.0, 2.0, 4.0, 6.0, 10.0, 12.0, 16.0, 24.0, 36.0, 48.0, 60.0, 72.0, 96.0, 120.0, 144.0 h post a single oral dose of 25 mg warfarin. For non-Asian subjects, the minimum numbers of subjects required per trial with the optimal PK sampling schedule to achieve 80% power and 5% type I error rate, ranged from 6 to 19 for the equivalence of AUC(0-∞) and C (max) jointly. It has been demonstrated that appropriately selected PK sampling time points can greatly increase the corresponding power of the study without increasing the number of subjects, especially when the true ratio is near the default bioequivalence boundary (0.8-1.25).

A comparison of three measures of upper limb function in Friedreich ataxia

Friedreich Ataxia (FRDA) is the commonest inherited ataxia. Clinical trials of pharmaceuticals are increasingly being conducted in this condition. This requires the most accurate outcome measures to enable trials to be conducted with a minimum number of subjects in the shortest time frame and to minimize the risk of false negative results. Upper limb function is a major area of morbidity in FRDA. We therefore have compared the performance of three tests of upper limb function in FRDA: the Nine Hole Peg Test (9HPT), Box and Blocks Test (BBT) and Jebsen Taylor Hand Function Test (JTHFT). This study was undertaken to ascertain the best test for inclusion in a Friedreich Ataxia Functional Composite (FAFC) test for use in clinical studies and therapeutic trials. The three tests were administered to the dominant and non-dominant upper limbs of 38 individuals with genetically proven FRDA on two occasions, 12 months apart. The results of testing were correlated with the following disease parameters; age at disease onset, disease duration and score for the Friedreich Ataxia Rating Scale (FARS). The responsiveness to change of each test was assessed by measuring the effect size and calculations of the number of subjects required for similarly powered therapeutic trials. Results for all tests correlated significantly with disease duration and FARS score. The only test scores that changed significantly over 12 months were those for the non-dominant 9HPT and BBT. Scores for these two tests also had the largest effect sizes and required the fewest subjects for similarly powered therapeutic trials. We conclude, therefore, that the non-dominant 9HPT and BBT are the best tests for inclusion in a FAFC. Since the 9HPT has already been suggested for inclusion in a FAFC, we recommend that this test is used but that it is the non-dominant limb that is tested.

A better stopping rule for conventional statistical tests

The goal of some research studies is to demonstrate the existence of an effect. Statistical testing, withp less than .05, is one criterion for establishing the existence of this effect. In this situation, the fixedsample stopping rule, in which the number of subjects is determined in advance, is impractical and inefficient. This article presents a sequential stopping rule that is practical and about 30% more efficient: Once a minimum number of subjects is tested, stop withp less than .01 or greater than .36; otherwise, keep testing. This procedure keeps alpha at .05 and can be adjusted to fit researchers’ needs and inclinations.

Statistical methods for testing the visual quality of displays

Although the business benefits of usability testing are widely accepted, it is still rare to find visual displays tested against user performance standards. Part of the reason for this is the assumption that, to be valid, user performance testing requires a large number of subjects and hence takes too long. In this paper we review a range of statistical procedures that allow decisions to be made on the acceptability of a display using the minimum number of subjects, and show that valid decisions can be obtained with as few as 15 subjects.

The Use of the Lanthony New Color Test in Determining the Effects of Aging on Color Vision

The primary purpose of this study was to collect data on the loss of color vision as a function of age. The Lanthony New Color Test (NCT), which measures acquired losses of color vision in the dimensions of hue, saturation, and brightness, was used to compile data on 68 subjects. The minimum number of subjects were 10 per decade from age 30 to 90 years. An age gradient of selective loss of discrimination of saturation beginning at age 50 was demonstrated, with rapid change noted after age 60. Similar findings were seen for hue but were not evident for brightness. By age 70, a neutral zone emerged at blue/purple, Munsell chroma level 2. The instrument was shown to be reliable and valid in comparison to the Farnsworth Dichotomous Panel D.15. It is seen that this information will provide a basis for planning safer, more functional environments for elderly people.

Individual bioequivalence: What matters to the patient

Current procedures for assessing the bioequivalence of two formulations are based on the concept of average bioequivalence. That is, they assess whether the average responses between individuals on the two formulations are similar. We show first that average bioequivalence is not sufficient to assure that an individual patient could be expected to respond similarly to the two formulations. To have such reasonable assurance requires a different notion of bioequivalence; individual (or within-subject) bioequivalence. Second, we propose a simple statistical procedure for assessing individual bioequivalence. This decision rule, TIER (test of individual equivalence ratios) requires the specification of the minimum proportion of subjects in the applicable population for which the two formulations being tested must be bioequivalent (a regulatory decision). The TIER rule is summarized in terms of the minimum number of subjects with bioavailability ratios falling within the specified equivalence interval necessary to be able to claim bioequivalence for given sample size and type I error. We recommend that the corresponding lower bounds (one-sided confidence intervals) for the proportion of bioequivalent subjects be calculated.

Ethical and behavioural issues in rodent experimentation

Several scientific associations and editorial boards have recently formed Ethical and Animal Care Committees, producing guidelines on the use of captive animals in research and selecting for publication only those articles that do not violate the spirit of the guidelines. These committees provide powerful self-regulation bodies for research involving animals, based on ethical and methodological principles. When painful stimulation is unavoidable, for example, in assessing pain threshold or analgesic efficacy, it should be minimized within the requirements of the experiment, and the animal should have the opportunity to stop or to avoid the painful event (e.g., hot-plate and tail-flick tests). Studies on predator/prey interactions or fighting among conspecifics should consider the use of data on natural aggressive encounters first. Where staged encounters are unavoidable, the use of model predators should be considered, together with the following: (a) monitoring of the animal's behavioural state; (b) experiments made as short as possible; (c) a minimum number of subjects. This can be achieved using: (i) statistical tests enabling several factors to be assessed at one time; (ii) strictly controlled experimental conditions reducing external variability; (iii) genetically homogeneous animal samples (inbred strains). Experiments are strongly affected when variables on physiological parameters, such as social housing conditions (isolation, overcrowding), are insufficiently considered. Animals under stress have to dedicate most of their time to coping with the event, thus providing unreliable baselines. Changes in hormonal and immunological reactivity owing to stressful conditions substantially alter experimental results.

University and Educational Intelligence

A BROAD and liberal scheme has been published by the Cambridge Syndicate on the affiliation of local Colleges to the University as suggested in various Memorials. They have taken a large amount of evidence and have had interviews with deputations from Nottingham and Sheffield. They have also held conferences with a Committee of the Hebdomadal Council of the University of Oxford, with whom they find themselves in general agreement. The Syndicate recommend that application be made to the University of Cambridge Commissioners for the powers required to enable the University to affiliate local Colleges, and that the following conditions of affiliation be established by grace of the Senate. Any educational institution within the British dominions, in which the majority of the students are over seventeen years of age, may be admitted on condition that it be incorporated by Royal Charter, or established on a permanent and efficient footing; that the University shall be represented on its Governing Body, and undertake the general conduct of its Examinations; and that the connection between the University and an affiliated College shall be established and shall be terminable by a grace of the Senate, or by a resolution of the Governing Body of the College. Persons who have completed an approved course of three years at an affiliated College, passing satisfactorily the Examinations connected with that course, will be entitled to receive a University Certificate, and if they obtain honours in the final Examination connected with that course, shall be excused the previous Examination; and provided they obtain a degree by one of the Tripos Examinations will be permitted to take their degree after only six terms' residence at Cambridge. In each College thereare to be three examinations yearly, the Annual College Examination, the First and the Second Examinations, the Annual College Examination is to be held in subjects taught with the sanction of the University, in the College, and be open to those students noly who have satisfactorily attended the teaching in these subjects. To pass the First Examination every candidate will be required to satisfy the Examiners in (1) Arithmetic; (2) Euclid, Books I., II., and III.; and Algebra, to Quadratic Equations inclusive; (3) One of the following languages: Latin Greek, French, Italian, German. Candidates will be at liberty to take up more than one language, and one or more additional subjects, including Heat, Experimental Mechanics, Chemistry Botany, and Mathematics. 4. The Second Examination shall include four groups: (1) Ancient and Modern Language, two to be taken. (2) Mathematics, one higher subject, pure or applied, being required. (3) Natural Science. Candidates pass in Elementary Chemistry and Physics, and also in one of the following:—Higher Chemistry, Higher Physics, Animal and Vegetable Physiology, Comparative Anatomy with selected portions of Zoology, Vegetable Anatomy and Physiology with Classificatory Botany, Geology and Physiography, Mineralogy. Candidates to pass in (1) English Constitutional History and (2) Political Economy or Logic, and subjects connected with History, Literature, and Philosophy. A pass in one group will give a pass in this second examination, and honours may be obtained on the minimum number of subjects. The Syndicate think it desirable to avoid if possible increasing seriously the severe strain caused by the outside work of the University. The sections and groups of the senior and higher local examinations are in general correspondence with the scheme, and the lectures at the centres are under the superintendence of the Syndicate for conducting local examinations and lectures. Thus there is machinery in existence which may, with some modifications, be conveniently and properly used. It is thought desirable that the Universities of Oxford and Cambridge should, as far as practicable, act in concert in conducting this great scheme of affiliation. It is recommended that the scheme be so administered as to be self-supporting.