bluuebunny/crossref_metadata_2025 huggingface dataset:
A Modified CREATE Intervention Improves Student Cognitive and Affective Outcomes in an Upper-Division Genetics Course
Authors: Lo Stanley M. , Luu Tiffany B. , Tran Justin
Published: May 2020

Many national reports have called for undergraduate biology education to incorporate research and analytical thinking into the curriculum. In response, interventions have been developed and tested. CREATE (
C
onsider,
R
ead,
E
lucidate the hypotheses,
A
nalyze and interpret the data, and
T
hink of the next
E
xperiment) is an instructional strategy designed to engage students in learning core concepts and competencies through careful reading of primary literature in a scaffolded fashion. CREATE has been successfully implemented by many instructors across diverse institutional contexts and has been shown to help students develop in the affective, cognitive, and epistemological domains, consistent with broader meta-analyses demonstrating the effectiveness of active learning. Nonetheless, some studies on CREATE have reported discrepant results, raising important questions on effectiveness in relation to the fidelity and integrity of implementation. Here, we describe an upper-division genetics course that incorporates a modified version of CREATE. Similar to the original CREATE instructional strategy, our intervention’s design was based on existing learning principles. Using existing concept inventories and validated survey instruments, we found that our modified CREATE intervention promotes higher affective and cognitive gains in students in contrast to three comparison groups. We also found that students tended to underpredict their learning and performance in the modified CREATE intervention, while students in some comparison groups had the opposite trend. Together, our results contribute to the expanding literature on how and why different implementations of the same active-learning strategy contribute to student outcomes.
A Single, Narrowly Focused CREATE Primary Literature Module Evokes Gains in Genetics Students’ Self-Efficacy and Understanding of the Research Process
Authors: Krufka Alison , Kenyon Kristy , Hoskins Sally
Published: May 2020

Exposure to primary literature using CREATE tools has been shown to have a positive impact on students’ self-efficacy and beliefs when incorporated into semester-long courses taught by extensively trained faculty. However, it is unknown whether similar benefits can occur with a brief exposure to CREATE in an otherwise traditionally taught course. We hypothesized that students who experienced a short-term CREATE module taught by faculty with minimal training in this pedagogy would make gains in scientific literacy and self-efficacy while also experiencing epistemological maturation. To test this hypothesis, we compared sections of students who experienced the CREATE module with sections of the same course taught without CREATE. Our hypothesis was partially supported by the data in that students in CREATE sections made significant gains in self-efficacy but did not gain transferable data analysis skills. Students in those sections also self-reported significantly enhanced understanding of the research process. Thus, this study suggests that analysis of primary literature using CREATE, even in short modules, can significantly and positively affect students’ self-efficacy and their views of science.
Fiber Force: A Fiber Diet Intervention in an Advanced Course-Based Undergraduate Research Experience (CURE) Course
Authors: Sewall Julia Massimelli , Oliver Andrew , Denaro Kameryn , Chase Alexander B. , Weihe Claudia , Lay Mi , Martiny Jennifer B. H. , Whiteson Katrine
Published: May 2020

Course-based undergraduate research experiences (CUREs) are an effective way to introduce students to contemporary scientific research. Research experiences have been shown to promote critical thinking, improve understanding and proper use of the scientific method, and help students learn practical skills including writing and oral communication. We aimed to improve scientific training by engaging students enrolled in an upper division elective course in a human microbiome CURE. The “Fiber Force” course is aimed at studying the effect of a wholesome high-fiber diet (40 to 50 g/day for two weeks) on the students’ gut microbiomes. Enrolled students participated in a noninvasive diet intervention, designed health surveys, tested hypotheses on the effect of a diet intervention on the gut microbiome, and analyzed their own samples (as anonymized aggregates). The course involved learning laboratory techniques (e.g., DNA extraction, PCR, and 16S sequencing) and the incorporation of computational techniques to analyze microbiome data with QIIME2 and within the R software environment. In addition, the learning objectives focused on effective student performance in writing, data analysis, and oral communication. Enrolled students showed high performance grades on writing, data analysis and oral communication assignments. Pre- and post-course surveys indicate that the students found the experience favorable, increased their interest in science, and heightened awareness of their diet habits. Fiber Force constitutes a validated case of a research experience on microbiology with the capacity to improve research training and promote healthy dietary habits.
Complete Genome Sequence of an
Avian Metapneumovirus
Subtype B Strain from Hungary
Authors: Goraichuk Iryna V. , Kapczynski Darrell R. , Seal Bruce S. , Suarez David L.
Published: May 2020

Avian metapneumoviruses (aMPVs), which have been reported in many countries, cause acute upper respiratory tract disease in chickens and turkeys. Using next-generation sequencing, we report here the complete genome sequence of an aMPV subtype B strain that was isolated from a turkey in Hungary in 1989.
Subtle Variations in Dietary-Fiber Fine Structure Differentially Influence the Composition and Metabolic Function of Gut Microbiota
Authors: Tuncil Yunus E. , Thakkar Riya D. , Arioglu-Tuncil Seda , Hamaker Bruce R. , Lindemann Stephen R.
Published: May 2020

Diet, especially with respect to consumption of dietary fibers, is well recognized as one of the most important factors shaping the colonic microbiota composition. Accordingly, many studies have been conducted to explore dietary fiber types that could predictably manipulate the colonic microbiota for improved health. However, the majority of these studies underappreciate the vastness of fiber structures in terms of their microbial utilization and omit detailed carbohydrate structural analysis. In some cases, this causes conflicting results to arise between studies using (theoretically) the same fibers. In this investigation, by performing
in vitro
fecal fermentation studies using bran arabinoxylans obtained from different classes of wheat, we showed that even subtle changes in the structure of a dietary fiber result in divergent microbial communities and metabolic outputs. This underscores the need for much higher structural resolution in studies investigating interactions of dietary fibers with gut microbiota, both
in vitro
and
in vivo
.
Looking beyond appearances: when liver biopsy is the key for hepatic tuberculosis diagnosis
Authors: Freitas Marta , Magalhães Joana , Marinho Carla , Cotter José
Published: May 2020

Primary hepatic tuberculosis is a rare clinical entity with non-specific clinical and imaging features that can mimic other liver diseases, representing a diagnostic challenge. We report a case of a 35-year-old man with metabolic syndrome, type 2 diabetes and high alcohol consumption presenting asymptomatic with abnormal liver tests, hepatosplenomegaly and diffuse hepatic steatosis in ultrasound imaging initially suspected to be alcoholic steatohepatitis but later diagnosed as hepatic tuberculosis in the histological specimen. Anti-tuberculosis therapy was started. This clinical case highlights the diagnostic difficulty of hepatic tuberculosis and the importance of not overlooking liver biopsy and to consider it in the differential diagnosis in patients with obvious hepatic injury factors but with atypical clinical presentation.
Cross-sectional centiles of blood pressure by age and sex: a four-hospital database retrospective observational analysis
Authors: Wong David , Gerry Stephen , Shamout Farah , Clifton David A , Pimentel Marco A F , Watkinson Peter J
Published: May 2020

Objectives

National guidelines for identifying physiological deterioration and sepsis in hospitals depend on thresholds for blood pressure that do not account for age or sex. In populations outside hospital, differences in blood pressure are known to occur with both variables. Whether these differences remain in the hospitalised population is unknown. This database analysis study aims to generate representative centiles to quantify variations in blood pressure by age and sex in hospitalised patients.

Design

Retrospective cross-sectional observational database analysis.

Setting

Four near-sea-level hospitals between April 2015 and April 2017

Participants

75 342 adult patients who were admitted to the hospitals and had at least one set of documented vital sign observations within 24 hours before discharge were eligible for inclusion. Patients were excluded if they died in hospital, had no vital signs 24 hours prior to discharge, were readmitted within 7 days of discharge, had missing age or sex or had no blood pressure recorded.

Results

Systolic blood pressure (SBP) for hospitalised patients increases with age for both sexes. Median SBP increases from 122 (CI: 121.1 to 122.1) mm Hg to 132 (CI: 130.9 to 132.2) mm Hg in men, and 114 (CI: 113.1 to 114.4) mm Hg to 135 (CI: 134.5 to 136.2) mm Hg in women, between the ages of 20 and 90 years. Diastolic blood pressure peaked around 50 years for men 76 (CI: 75.5 to 75.9) mm Hg and women 69 (CI: 69.0 to 69.4) mm Hg. The blood pressure criterion for sepsis, systolic <100 mm Hg, was met by 2.3% of younger (20–30 years) men and 3.5% of older men (81–90 years). In comparison, the criterion was met by 9.7% of younger women and 2.6% of older women.

Conclusion

We have quantified variations in blood pressure by age and sex in hospitalised patients that have implications for recognition of deterioration. Nearly 10% of younger women met the blood pressure criterion for sepsis at hospital discharge.
Understanding decision making about major surgery: protocol for a qualitative study of shared decision making by high-risk patients and their clinical teams
Authors: Shaw Sara , Hughes Gemma , Stephens Tim , Pearse Rupert , Prowle John , Ashcroft Richard Edmund , Avagliano Ester , Day James , Edsell Mark , Edwards Jennifer , Everest Leslie
Published: May 2020

Introduction

Surgical treatments are being offered to more patients than ever before, and increasingly to high-risk patients (typically multimorbid and over 75). Shared decision making is seen as essential practice. However, little is currently known about what ‘good’ shared decision making involves nor how it applies in the context of surgery for high-risk patients. This new study aims to identify how high-risk patients, their families and clinical teams negotiate decision making for major surgery.

Methods and analysis

Focusing on major joint replacement, colorectal and cardiac surgery, we use qualitative methods to explore how patients, their families and clinicians negotiate decision making (including interactional, communicative and informational aspects and the extent to which these are perceived as shared) and reflect back on the decisions they made. Phase 1 involves video recording 15 decision making encounters about major surgery between patients, their carers/families and clinicians; followed by up to 90 interviews (with the same patient, carer and clinician participants) immediately after a decision has been made and again 3–6 months later. Phase 2 involves focus groups with a wider group of (up to 90) patients and (up to 30) clinicians to test out emerging findings and inform development of shared decision making scenarios (3–5 summary descriptions of how decisions are made).

Ethics and dissemination

The study forms the first part in a 6-year programme of research, Optimising Shared decision-makIng for high-RIsk major Surgery (OSIRIS). Ethical challenges around involving patients at a challenging time in their lives will be overseen by the programme steering committee, which includes strong patient representation and a lay chair. In addition to academic outputs, we will produce a typology of decision making scenarios for major surgery to feed back to patients, professionals and service providers and inform subsequent work in the OSIRIS programme.
Prospective, single-centre, randomised controlled trial to evaluate the efficacy and safety of ischaemia-free liver transplantation (IFLT) in the treatment of end-stage liver disease
Authors: Huang Changjun , Huang Shanzhou , Tang Yunhua , Zhao Qiang , Wang Dongping , Ju Weiqiang , Yang Lu , Zhang Jian , Wu Linwei , Chen Maogen , Zhang Zhiheng , Zhu Zebin , Wang Linhe , Zhu Caihui , Zhang Yixi , Sun Chengjun , Xiong Wei , Shen Yuekun , Chen Xiaoxiang , Ma Yi , Hu Anbin , Zhu Xiaofeng , Rong Jian , Cai Changjie , Guo Zhiyong , He Xiaoshun
Published: May 2020

Introduction

During conventional liver transplantation (CLT), ischaemia-reperfusion injury (IRI) is inevitable and is associated with complications such as early allograft dysfunction (EAD), primary non-function and ischaemic-type biliary lesions. We have established a novel procedure called ischaemia-free liver transplantation (IFLT). The results from a pilot study suggest that IFLT might prevent IRI and yield better transplant outcomes than CLT. The purpose of this study was to further assess the efficacy and safety of IFLT versus CLT in patients with end-stage liver disease.

Methods and analysis

This is an investigator-initiated, open-label, phase III, prospective, single-centre randomised controlled trial on the effects of IFLT in patients with end-stage liver disease. Adult patients (aged 18–75 years) eligible for liver transplantation will be screened for participation in this trial and will be randomised between the IFLT group (n=34) and the CLT group (n=34). In the IFLT group, the donor liver will be procured, preserved and implanted with continuous normothermic machine perfusion (NMP). In the CLT group, the donor liver will be procured after a fast cold flush, preserved in 0°C–4°C solution and implanted under hypothermic and hypoxic conditions. Patients in both groups will be managed according to the standard protocol of our centre. The primary end point is the incidence of EAD after liver transplantation. Intraoperative and postoperative parameters of donor livers and recipients will be observed and recorded, and postoperative liver graft function, complications and recipient and graft survival will be evaluated. After a 12-month follow-up of the last enrolled recipient, the outcomes will be analysed to evaluate the safety and efficacy of IFLT versus CLT in patients with end-stage liver disease.

Ethics and dissemination

The protocol was reviewed and approved by the Ethics Committee of The First Affiliated Hospital of Sun Yat-sen University. The findings will be disseminated to the public through conference presentations and peer-reviewed scientific journals.

Trial registration number

ChiCTR1900021158.
Association between multiple symptoms and quality of life of paediatric patients with cancer in Brazil: a cross-sectional study
Authors: de Andrade Cadamuro Sandra , Onishi Franco Julia , Paiva Carlos Eduardo , Oliveira Marco Antonio de , Sakamoto Ribeiro Paiva Bianca
Published: May 2020

Objectives

To identify the association of multiple symptoms and clinical characteristics on quality of life (QoL) of paediatric patients with cancer.

Design

A descriptive, cross-sectional study.

Setting

South American Children’s Hospital for Cancer Treatment (Barretos, São Paulo, Brazil).

Participants

A total of 157 participants, 116 paediatric patients, diagnosed with cancer, undergoing chemotherapy treatment, between 7 and 18 years of age and 41 proxies for patients between 2 and 6 years of age.

Primary outcome measures

The severity and prevalence ofsymptoms were identified through the use of a culturally adapted multi-symptomscreening tool, and the influence these symptoms, in association with clinicalcharacteristics, had on the QOL of Brazilian pediatric cancer patients wasassessed.

Results

Prevalent symptoms identified by all participants were ‘feeling tired’ (98, 62.4%), ‘feeling more or less hungry (do not feel like eating) than you usually do’ (96, 61.1%), ‘changes in taste (flavour of the food)’ (89, 56.7%), ‘throwing up or feeling like you may throw up’ (77, 49%) and ‘changes in how your body (visually) or face looks’ (72, 45.9%). The multivariate analysis for symptom severity as reported by proxies showed that surgery (OR 0.20, 95% CI 0.04 to 0.98, p=0.047) and time of diagnosis (OR 0.14, 95% CI 0.03 to 0.66, p=0.012) were associated with a decreased OR of high severity symptoms.

An analysis of the clinical characteristics associated with Pediatric Quality of Life Inventory (PedsQL) demonstrated no significant effect on QoL in any of the domains evaluated. The association between Symptom Screening in Pediatrics Tool and PedsQL in the self-report version demonstrated a significant negative influence of all symptoms on the QoL.

Conclusions

The prevalence of symptoms experienced among pediatric patients during treatment was high and significantly influenced all aspects of quality of life,especially in the emotional domain.
Acceptability and use of a patient-held communication tool for people living with dementia: a longitudinal qualitative study
Authors: Leavey Gerard , Corry Dagmar Suzanna , Waterhouse-Bradley Bethany , Curran Emma , Todd Stephen , McIlfatrick Sonja , Coates Vivien , Watson Max , Abbott Aine , McCrory Bernadine , McCormack Brendan
Published: May 2020

Objectives

To assess the acceptability and use of a low-cost patient-held communication tool.

Design

Longitudinal qualitative interviews at three time points over 18 months and document content analysis.

Setting

Primary and community services.

Participants

Twenty-eight dyads: People living with dementia in Northern Ireland and their informal carers.

Interventions

A patient-held healthcare ‘passport’ for people living with dementia.

Primary and secondary outcomes

Acceptability and use of the passport—barriers and facilitators to successful engagement.

Results

There was a qualified appreciation of the healthcare passport and a much more nuanced, individualistic or personalised approach to its desirability and use. How people perceive it and what they actually do with it are strongly determined by individual contexts, dementia stage and other health problems, social and family needs and capacities. We noted concerns about privacy and ambivalence about engaging with health professionals.

Conclusion

Such tools may be of use but there is a need for demanding, thoughtful and nuanced programme delivery for future implementation in dementia care. The incentivisation and commitment of general practitioners is crucial. Altering the asymmetrical relationship between professionals and patients requires more extensive attention.
Dexamethasone intracameral drug-delivery suspension for inflammation associated with vitreoretinal surgery
Authors: Kiernan Daniel F
Published: May 2020

Objective

To evaluate the efficacy of an anterior chamber intracameral dexamethasone (ICD) drug-delivery suspension (Dexycu; EyePoint Pharmaceuticals, Watertown, Massachusetts, USA) providing sustained release of medication following a single application for the treatment of postoperative inflammation in patients undergoing vitreoretinal surgery compared to daily postoperative treatment with topical corticosteroids for up to 1 month.

Methods and analysis

Retrospective case-matched comparison of patients undergoing initial vitreoretinal surgery by a single surgeon. Patients had a preoperative best-corrected visual acuity of 20/20 to light perception and a variety of vitreoretinal pathologies. 27 eyes of 27 patients received ICD at the time of surgery and were compared with 27 eyes of 27 patients who received daily postoperative corticosteroid eye drops over 4 weeks. The primary efficacy outcome was anterior chamber cell (ACC) clearing (0 cells) in the study eye at postoperative day (POD) 7. Ocular adverse events were assessed through POD 90.

Results

ACC clearing at POD 7 was achieved in 67% of eyes in the ICD treatment group and 37% of eyes in the control group treated with topical corticosteroids (p=0.029). No serious ocular adverse events were noted up to POD 90 in either group.

Conclusion

The ICD drug-delivery suspension placed in the anterior chamber after vitreoretinal surgery was more effective than topical corticosteroids in treating inflammation occurring 1 week following vitreoretinal surgery and thus may be an alternative to daily corticosteroid drop installation in this patient population.
Incidence of recreational snowboarding-related spinal injuries over an 11-year period at a ski resort in Niigata, Japan
Authors: Hosaka Noboru , Arai Katsumitsu , Otsuka Hiroshi , Kishimoto Hidefumi
Published: May 2020

Background

There is limited knowledge regarding the incidence of recreational snowboarding-related spinal injuries.

Objective

This study investigated the incidence and characteristics of recent recreational snowboarding-related spinal injuries and discussed possible preventive measures to reduce the risk of spinal injuries.

Methods

This descriptive epidemiological study was conducted to investigate the incidence and characteristics of snowboarding-related spinal injuries at the Myoko ski resort in Niigata Prefecture, Japan, between 2006 and 2017. The incidence of spinal injuries was calculated as the total number of spinal injuries divided by the number of snowboarding visitors, which was estimated based on the ticket sales and estimates regarding the ratio of the number of skiers to the number of snowboarders reported by seven skiing facilities.

Results

In total, 124 (72.5%) males and 47 (27.5%) females suffered spinal injuries. The incidence of spinal injuries was 5.1 (95% CI 4.4 to 5.9) per 100 000 snowboarder visitors. Jumps at terrain parks were the most common factor in 113 (66.1%) spinal injuries, regardless of skill level (29/49 beginners, 78/112 intermediates, 6/10 experts). Overall, 11 (including 9 Frankel A) of 14 (78.6%) cases with residual neurologic deficits were involved with jumps.

Conclusions

In recreational snowboarding, jumping is one of the main causes for serious spinal injuries, regardless of skill level. The incidence of spinal injuries has not decreased over time. Individual efforts and educational interventions thus far have proven insufficient to reduce the incidence of spinal injury. Ski resorts and the ski industry should focus on designing fail-safe jump features to minimise the risk of serious spinal injury.
Enhancing paediatric resuscitation team performance: targeted simulation-based team leader training
Authors: Keilman Ashley , Reid Jennifer , Thomas Anita , Uspal Neil , Stone Kimberly , Beardsley Elaine , Burns Brian , Burns Rebekah
Published: May 2020

Effective team leadership is linked to improved resuscitation outcomes. Previous studies have focused primarily on trainee performance and simulation-based outcomes. We hypothesised that a targeted simulation-based educational intervention for experienced physicians focusing on specific process and communication goals would result in improved performance during actual resuscitations. We conducted an observational pilot study evaluating specific process metrics during clinical resuscitations before and after a 1-hour training intervention for paediatric emergency medicine (PEM) supervising physicians using rapid cycle deliberate practice simulation-based training. Videos of clinical resuscitations from before and after the intervention were retrospectively reviewed to assess time to patient transfer to emergency department stretcher, time to primary assessment and time to team leader summary statement. Between March and July 2018, 21/38 of PEM supervising physicians participated in a training session. After the intervention period, clinical resuscitation teams showed significant improvements in targeted process metrics: transfer of patient within 1 min (79% vs 100%, p=0.03), assessment completed within 3 min (28% vs 75%, p=0.01) and summary statement within 5 min (50% to 85%, p=0.03). Brief, focused simulation-based team leader training can improve the teamwork and communication performance of experienced clinicians during clinical resuscitations.
Paradoxical interaction between cancer and long-term postsepsis disorder: impairment of de novo carcinogenesis versus favoring the growth of established tumors
Authors: Leite Caio Abner , Mota Jose Mauricio , de Lima Kalil Alves , Wanderley Carlos Wagner , Nascimento Leticia Almeida , Ferreira Marcela Davoli , Silva Camila Meirelles Souza , Colon David Fernando , Sakita Juliana Yumi , Kannen Vinicius , Viacava Paula Ramos , Begnami Maria Dirlei , Lima-Junior Roberto Cesar Pereira , Cordeiro de Lima Vladmir Claudio , Alves-Filho Jose Carlos , Cunha Fernando Queiroz , Ribeiro Ronaldo Albuquerque
Published: May 2020

Background

Previous data have reported that the growth of established tumors may be facilitated by postsepsis disorder through changes in the microenvironment and immune dysfunction. However, the influence of postsepsis disorder in initial carcinogenesis remains elusive.

Methods

In the present work, the effect of postsepsis on inflammation-induced early carcinogenesis was evaluated in an experimental model of colitis-associated colorectal cancer (CAC). We also analyzed the frequency and role of intestinal T regulatory cells (Treg) in CAC carcinogenesis.

Results

The colitis grade and the tumor development rate were evaluated postmortem or in vivo through serial colonoscopies. Sepsis-surviving mice (SSM) presented with a lower colonic DNA damage, polyp incidence, reduced tumor load, and milder colitis than their sham-operated counterparts. Ablating Treg led to restoration of the ability to develop colitis and tumor polyps in the SSM, in a similar fashion to that in the sham-operated mice. On the other hand, the growth of subcutaneously inoculated MC38luc colorectal cancer cells or previously established chemical CAC tumors was increased in SSM.

Conclusion

Our results provide evidence that postsepsis disorder has a dual effect in cancer development, inhibiting inflammation-induced early carcinogenesis in a Treg-dependent manner, while increasing the growth of previously established tumors.
Efficacy of immune checkpoint inhibitors for in-transit melanoma
Authors: Nan Tie Emilia , Lai-Kwon Julia , Rtshiladze Michael Alexander , Na Lumine , Bozzi James , Read Tavis , Atkinson Victoria , Au-Yeung George , Long Georgina V , McArthur Grant A , Sandhu Shahneen , Saw Robyn , Walpole Euan , Menzies Alexander , Smithers Mark , Gyorki David E
Published: May 2020

Background

The efficacy of immune checkpoint inhibitors (ICI) in metastatic melanoma is well established. However, there are limited data regarding their efficacy in in-transit melanoma (ITM). This study assessed the efficacy of ICI in patients with ITM.

Methods

A retrospective review of patients with ITM commenced on an ICI between March 2013 and February 2018 at three tertiary centers in Australia. Patients were excluded if they had previous or synchronous distant metastases. Overall response rate (ORR), progression-free survival (PFS) and overall survival (OS) were based on a composite of radiological and clinical assessments.

Results

Fifty-four patients were included: 27 (50%) female; median age 75 (range 26–94); 12 (22%) stage IIIB, 40 (74%) stage IIIC and 2 (4%) stage IIID; 10 (19%) BRAF mutant. Forty (74%) received single-agent anti-PD-1 (pembrolizumab or nivolumab), 8 (15%) single agent anti-CTLA-4 (ipilimumab), 5 (9%) combination anti-PD-1/anti-CTLA-4 (ipilimumab and nivolumab or pembrolizumab) and 1 (2%) combination anti-PD-L1 (atezolizumab) and MEK inhibitor (cobimetinib). The median follow-up was 15 months (2–46).

ORR to ICI was 54%: 14 (26%) complete responses; 15 (28%) partial responses; 9 (17%) stable disease; 16 (30%) progressive disease. Thirteen (46%) responders had only one ITM lesion. ORR was 58% for single-agent anti-PD-1, 38% for single-agent anti-CTLA4 and 40% for anti-PD-1/anti-CTLA-4. The median PFS was 11.7 months (6.6-not reached). 1-year and 2-year PFS were 48% and 39%, respectively,. Fourteen progressed locoregionally and 11 progressed distantly. The median OS was not reached. 1-year and 2-year OS were 85% and 63%, respectively. No clinicopathological features were associated with ORR.

Conclusions and relevance

ICI produce objective responses in ITM and should be considered in patients with unresectable ITM or disease recurrence.
Oncogenic states dictate the prognostic and predictive connotations of intratumoral immune response
Authors: Roelands Jessica , Hendrickx Wouter , Zoppoli Gabriele , Mall Raghvendra , Saad Mohamad , Halliwill Kyle , Curigliano Giuseppe , Rinchai Darawan , Decock Julie , Delogu Lucia G , Turan Tolga , Samayoa Josue , Chouchane Lotfi , Ballestrero Alberto , Wang Ena , Finetti Pascal , Bertucci Francois , Miller Lance D , Galon Jerome , Marincola Francesco M , Kuppen Peter J K , Ceccarelli Michele , Bedognetti Davide
Published: May 2020

Background

An immune active cancer phenotype typified by a T helper 1 (Th-1) immune response has been associated with increased responsiveness to immunotherapy and favorable prognosis in some but not all cancer types. The reason of this differential prognostic connotation remains unknown.

Methods

To explore the contextual prognostic value of cancer immune phenotypes, we applied a multimodal pan-cancer analysis among 31 different histologies (9282 patients), encompassing immune and oncogenic transcriptomic analysis, mutational and neoantigen load and copy number variations.

Results

We demonstrated that the favorable prognostic connotation conferred by the presence of a Th-1 immune response was abolished in tumors displaying specific tumor-cell intrinsic attributes such as high transforming growth factor-beta (TGF-β) signaling and low proliferation capacity. This observation was independent of mutation rate. We validated this observation in the context of immune checkpoint inhibition. WNT-βcatenin, barrier molecules, Notch, hedgehog, mismatch repair, telomerase activity and AMPK signaling were the pathways most coherently associated with an immune silent phenotype together with mutations of driver genes includingIDH1/2, FOXA2, HDAC3, PSIP1, MAP3K1, KRAS, NRAS, EGFR, FGFR3, WNT5AandIRF7.

Conclusions

This is the first systematic study demonstrating that the prognostic and predictive role of a bona fide favorable intratumoral immune response is dependent on the disposition of specific oncogenic pathways. This information could be used to refine stratification algorithms and prioritize hierarchically relevant targets for combination therapies.
Parental manual ventilation in resource-limited settings: an ethical controversy
Authors: Barsky Emily , Sayeed Sadath
Published: May 2020

Lower respiratory tract infections are a leading cause of paediatric morbidity and mortality worldwide. Children in low-income countries are disproportionately affected. This is in large part due to limitations in healthcare resources and medical technologies. Mechanical ventilation can be a life-saving therapy for many children with acute respiratory failure. The scarcity of functioning ventilators in low-income countries results in countless preventable deaths. Some hospitals have attempted to adapt to this scarcity by using hand-bag ventilation, as either a bridge to a mechanical ventilator, or until clinical improvement occurs rendering mechanical ventilation no longer necessary. In instances of hand-bag ventilation, an endotracheal tube is first placed. Family members are then asked to play the role of a ventilator, manually compressing a bag repeatedly to inflate the child’s lungs. This approach is fraught with numerous ethical challenges. A careful examination of the data and a nuanced approach to the ethical considerations are imperative. Ethical arguments in support of and in opposition to allowing parental hand-bag ventilation are explored, including the best interests of the child, the child’s right to an open future, beneficence and parental protection, legitimising substandard care, and finally, contextual concerns. An algorithmic, potentially ethically permissible approach to parental participation in manual ventilation is proposed.
Salt-tolerance identification and quality evaluation of Abelmoschus manihot (L.) Medik
Authors: Wu Zhe , Xue Zhizhong , Lu Xuelin , Jia Yinsuo , Wang Xiuping , Zhang Xiaodong
Published: May 2020

Abelmoschus manihot (L.) Medik. is a medicinal and edible plant. To evaluate its suitability for cultivation on the coastal saline-alkali land in northern China for high quality functional products, salt-tolerance identification and flavonoid contents were evaluated under saline treatments. Results showed that the salt-tolerance threshold of A. manihot ranged from 4.1 to 6.9 g L−1; however, low soil salt content (<3 g L−1) had the best growth and accumulation of total flavonoids. Sixteen kinds of common functional components such as hyperoside, rutoside, and quercetin were found. Of these components, the four (myricetin-3-0-glucoside, rutoside, quercetin-3′-0-glucoside, and gossypetin-8-0-β-d-glucuronic acid) with the highest content were chosen as the quality evaluation indexes. High levels of quality and yield occurred at a soil salt content of 3 g L−1. Our results suggested that soil salt content should not exceed 3 g L−1 in field cultivation for high quality and high yield of A. manihot.
On the tension between growth rate and CMB data
Authors: Quelle Alba , Maroto Antonio L.
Published: May 2020

We analyze the claimed tension between redshift space distorsions measurements of $$f(z)\sigma _8(z)$$f(z)σ8(z) and the predictions of standard $$\varLambda $$ΛCDM (Planck 2015 and 2018) cosmology. We consider a dataset consisting of 17 data points extending up to redshift $$z=1.52$$z=1.52 and corrected for the Alcock-Paczynski effect. Thus, calculating the evolution of the growth factor in a wCDM cosmology, we find that the tension for the best fit parameters w, $$\varOmega _m$$Ωm and $$\sigma _8$$σ8 with respect to the Planck 2018 $$\varLambda $$ΛCDM parameters is below $$2\sigma $$2σ in all the marginalized confidence regions.
Background rejection in atmospheric Cherenkov telescopes using recurrent convolutional neural networks
Authors: Parsons R. D. , Ohm S.
Published: May 2020

In this work, we present a new, high performance algorithm for background rejection in imaging atmospheric Cherenkov telescopes. We build on the already popular machine-learning techniques used in gamma-ray astronomy by the application of the latest techniques in machine learning, namely recurrent and convolutional neural networks, to the background rejection problem. Use of these machine-learning techniques addresses some of the key challenges encountered in the currently implemented algorithms and helps to significantly increase the background rejection performance between 100 GeV and 100 TeV energies. We apply these machine learning techniques to the H.E.S.S. telescope array, first testing their performance on simulated data and then applying the analysis to two well known gamma-ray sources. With real observational data we find significantly improved performance over the current standard methods, with a 20–25% reduction in the background rate when applying the recurrent neural network analysis. Importantly, we also find that the convolutional neural network results are strongly dependent on the sky brightness in the source region which has important implications for the future implementation of this method in Cherenkov telescope analyses.
Particular superintegrability of 3-body (modified) Newtonian gravity
Authors: Turbiner Alexander V. , Vieyra Juan Carlos Lopez
Published: May 2020

It is found explicitly 5 Liouville integrals in addition to total angular momentum which Poisson commute with Hamiltonian of 3-body Newtonian Gravity in [Formula: see text] along the remarkable figure-8-shape trajectory discovered by Moore-Chenciner-Montgomery. It is verified that they become constants of motion along this trajectory. Hence, 3-body choreographic motion on figure-8-shape trajectory in [Formula: see text] Newtonian gravity (Moore, 1993), as well as in [Formula: see text] modified Newtonian gravity by Fujiwara et al., is maximally superintegrable. It is conjectured that any 3-body potential theory that admits Figure-8-shape choreographic motion is superintegrable along the trajectory.
An Automated Approach for Constructing Framework Instantiation Documentation
Authors: de Queiroz Lafetá Raquel Fialho , de Queiroz Lafetá Thiago Fialho , de Almeida Maia Marcelo
Published: May 2020

A substantial effort, in general, is required for understanding APIs of application frameworks. High-quality API documentation may alleviate the effort, but the production of such documentation still poses a major challenge for modern frameworks. To facilitate the production of framework instantiation documentation, we hypothesize that the framework code itself and the code of existing instantiations provide useful information. However, given the size and complexity of existent code, automated approaches are required to assist the documentation production. Our goal is to assess an automated approach for constructing relevant documentation for framework instantiation based on source code analysis of the framework itself and of existing instantiations. The criterion for defining whether documentation is relevant would be to compare the documentation with an traditional framework documentation, considering the time spent and correctness during instantiation activities, information usefulness, complexity of the activity, navigation, satisfaction, information localization and clarity. We propose an automated approach for constructing relevant documentation for framework instantiation based on source code analysis of the framework itself and of existing instantiations. The proposed approach generates documentation in a cookbook style, where the recipes are programming activities using the necessary API elements driven by the framework features. We performed an empirical study, consisting of three experiments with 44 human subjects executing real framework instantiations aimed at comparing the use of the proposed cookbooks to traditional manual framework documentation (baseline). Our empirical assessment shows that the generated cookbooks performed better or, at least, with non-significant difference when compared to the traditional documentation, evidencing the effectiveness of the approach.
The Most Likely Object to be Seen Through a Window
Authors: Carmi Paz , Chanchary Farah , Maheshwari Anil , Smid Michiel
Published: May 2020

We study data structures to answer window queries using stochastic input sequences. The first problem is the most likely maximal point in a query window: Let [Formula: see text] be constants, with [Formula: see text]. Let [Formula: see text] be a set of [Formula: see text] points in [Formula: see text], for some fixed [Formula: see text]. For [Formula: see text], each point in [Formula: see text] is associated with a probability [Formula: see text] of existence. A point [Formula: see text] in [Formula: see text] is on the maximal layer of [Formula: see text] if there is no other point [Formula: see text] in [Formula: see text] such that [Formula: see text]. Consider a random subset of [Formula: see text] obtained by including, for [Formula: see text], each point of [Formula: see text] independently with probability [Formula: see text]. For a query interval [Formula: see text], with [Formula: see text], we report the point in [Formula: see text] that has the highest probability to be on the maximal layer of [Formula: see text] in [Formula: see text] time using [Formula: see text] space. We solve a special problem as follows. A sequence [Formula: see text] of [Formula: see text] points in [Formula: see text] is given ([Formula: see text]), where each point [Formula: see text] has a probability [Formula: see text] of existence associated with it. Given a query interval [Formula: see text] and an integer [Formula: see text] with [Formula: see text], we report the probability of [Formula: see text] to be on the maximal layer of [Formula: see text] in [Formula: see text] time using [Formula: see text] space.

The second problem we consider is the most likely common element problem. Let [Formula: see text] be the universe. Let [Formula: see text] be a sequence of random subsets of [Formula: see text] such that for [Formula: see text] and [Formula: see text], element [Formula: see text] is added to [Formula: see text] with probability [Formula: see text] (independently of other choices). Let [Formula: see text] be a fixed real number with [Formula: see text]. For query indices [Formula: see text], [Formula: see text], [Formula: see text] and [Formula: see text], with [Formula: see text] and [Formula: see text], we decide whether there exists an element [Formula: see text] with [Formula: see text] such that [Formula: see text] in [Formula: see text] time using [Formula: see text] space and report these elements in [Formula: see text] time, where [Formula: see text] is the size of the output.
Line-of-Sight Pursuit in Monotone and Scallop Polygons
Authors: Berry Lindsay , Beveridge Andrew , Butterfield Jane , Isler Volkan , Keller Zachary , Shine Alana , Wang Junyi
Published: May 2020

We study a turn-based game in a simply connected polygonal environment [Formula: see text] between a pursuer [Formula: see text] and an adversarial evader [Formula: see text]. Both players can move in a straight line to any point within unit distance during their turn. The pursuer [Formula: see text] wins by capturing the evader, meaning that their distance satisfies [Formula: see text], while the evader wins by eluding capture forever. Both players have a map of the environment, but they have different sensing capabilities. The evader [Formula: see text] always knows the location of [Formula: see text]. Meanwhile, [Formula: see text] only has line-of-sight visibility: [Formula: see text] observes the evader’s position only when the line segment connecting them lies entirely within the polygon. Therefore [Formula: see text] must search for [Formula: see text] when the evader is hidden from view.

We provide a winning strategy for [Formula: see text] in two families of polygons: monotone polygons and scallop polygons. In both families, a straight line [Formula: see text] can be moved continuously over [Formula: see text] so that (1) [Formula: see text] is a line segment and (2) every point on the boundary [Formula: see text] is swept exactly once. These are both subfamilies of strictly sweepable polygons. The sweeping motion for a monotone polygon is a single translation, and the sweeping motion for a scallop polygon is a single rotation. Our algorithms use rook’s strategy during its pursuit phase, rather than the well-known lion’s strategy. The rook’s strategy is crucial for obtaining a capture time that is linear in the area of [Formula: see text]. For both monotone and scallop polygons, our algorithm has a capture time of [Formula: see text], where [Formula: see text] is the number of polygon vertices.
Polarization in low energy kaon–hyperon interaction
Authors: Nogueira-Santos M. G. L. , Barros C. C.
Published: May 2020

In this paper, we study the low energy kaon–hyperon interaction considering effective chiral Lagrangians that include kaons, [Formula: see text] mesons, hyperons and the corresponding resonances. The scattering amplitudes are calculated and then we determine the angular distributions and polarizations.
EXISTENCE AND STABILITY ANALYSIS OF SOLUTIONS FOR FRACTIONAL LANGEVIN EQUATION WITH NONLOCAL INTEGRAL AND ANTI-PERIODIC-TYPE BOUNDARY CONDITIONS
Authors: DEVI AMITA , KUMAR ANOOP , ABDELJAWAD THABET , KHAN AZIZ
Published: May 2020

In this paper, we deal with the existence and uniqueness (EU) of solutions for nonlinear Langevin fractional differential equations (FDE) having fractional derivative of different orders with nonlocal integral and anti-periodic-type boundary conditions. Also, we investigate the Hyres–Ulam (HU) stability of solutions. The existence result is derived by applying Krasnoselskii’s fixed point theorem and the uniqueness of result is established by applying Banach contraction mapping principle. An example is offered to ensure the validity of our obtained results.
THE REPRODUCING KERNEL ALGORITHM FOR NUMERICAL SOLUTION OF VAN DER POL DAMPING MODEL IN VIEW OF THE ATANGANA–BALEANU FRACTIONAL APPROACH
Authors: MOMANI SHAHER , MAAYAH BANAN , ARQUB OMAR ABU
Published: May 2020

The aim of this paper is to propose the Atangana–Baleanu fractional methodology for fathoming the Van der Pol damping model by using the reproducing kernel algorithm. To this end, we discuss the mathematical structure of this new approach and some other numerical properties of solutions. Furthermore, all needed requirements for characterizing solutions by applying the reproducing kernel algorithm are debated. In this orientation, modern trend and new computational algorithm in terms of analytic and approximate Atangana–Baleanu fractional solutions are proposed. Finally, numerical simulations in fractional emotion is constructed one next to the other with tabulated data and graphical portrayals.
THE FRACTAL STATISTICAL MODEL OF TRANSREGIONAL AND TRANSNATIONAL E-COMMERCE ENTERPRISES SUPPLY CHAIN SEQUENCE
Authors: ZHU QIAN , ZHOU HAN
Published: May 2020

With the rapid development of world trade exchange, transnational and cross regional e-commerce enterprises have become the heat conductor of trade exchanges among people, organizations and related enterprises of all countries, as well as the important content of high-quality economic development of all countries. Multi-national and transregional e-commerce enterprises have the characteristics of simple circulation structure, simplified transaction cost, high efficiency and rapid evolution in economic and trade activities. However, the traditional transnational and transregional e-commerce enterprises have the disadvantages of slow development and low efficiency in the supply chain. At the same time, there are still many uncertain factors in the corresponding decision sequence. In this paper, the risks faced by cross-border e-commerce supply chain will be comprehensively analyzed and studied. At the same time, the decision-making problem of cross-border e-commerce supply chain sequence will be studied innovatively from two aspects of random uncertainty and fuzzy uncertainty, and a double-layer random expectation model will be established to form a fractal statistical model of supply chain sequence. In this paper, two kinds of sequential strategies are discussed in detail, and a double-layer fuzzy equivalent model is established. Finally, the model is solved by optimization software. The experimental results show that the fractal fractional optimization model proposed in this paper has advantages for the supply chain optimization of multi-national and cross regional e-commerce enterprises.