bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of Immunotherapy in Hepatocellular Carcinoma: A Systematic Review and Pooled Analysis of 2,402 Patients
Authors: Ziogas Ioannis A. , Evangeliou Alexandros P. , Giannis Dimitrios , Hayat Muhammad H. , Mylonas Konstantinos S. , Tohme Samer , Geller David A. , Elias Nahel , Goyal Lipika , Tsoulfas Georgios
Published: December 2020

Background

Immune checkpoints inhibitors (ICIs) have emerged as a treatment option for several malignancies. Nivolumab, pembrolizumab, nivolumab plus ipilimumab, and atezolizumab plus bevacizumab have been approved for the management of advanced-stage hepatocellular carcinoma (HCC). We aimed to systematically review the literature and summarize the characteristics and outcomes of patients with HCC treated with ICIs.

Methods

A systematic literature search of PubMed, the Cochrane Library, and ClinicalTrials.gov was performed according to the PRISMA statement (end of search date: November 7, 2020). Quality of evidence assessment was also performed.

Results

Sixty-three articles including 2,402 patients were analyzed, 2,376 of whom received ICIs for unresectable HCC. Response to ICIs could be evaluated in 2,116 patients; the overall objective response rate (ORR) and disease control rate (DCR) were 22.7% and 60.7%, respectively, and the mean overall survival (OS) was 15.8 months. The ORR, DCR, and OS for nivolumab (n = 846) were 19.7%, 51.1%, and 18.7 months, respectively; for pembrolizumab (n = 435) they were 20.7%, 64.6% and 13.3 months, respectively. The combination of atezolizumab/bevacizumab (n = 460) demonstrated an ORR and DCR of 30% and 77%, respectively. The overall rate of treatment discontinuation because of adverse events was 14.9%. Fifteen patients received ICIs in the liver transplant (LT) setting (one pre-LT for bridging, 14 for post-LT recurrence); fatal graft rejection was reported in 40.0% (n = 6/15) and mortality in 80.0% (n = 12/15).

Conclusion

ICIs are safe and effective against unresectable HCC, but caution is warranted regarding their use in the LT setting because of the high graft rejection rate.

Implications for Practice

This systematic review pooled the outcomes from studies reporting on the use of immune checkpoint inhibitors (ICIs) for the management of 2,402 patients with advanced-stage hepatocellular carcinoma (HCC), 2,376 of whom had unresectable HCC. The objective response rate and disease control rate were 22.7% and 60.7%, respectively, and the mean overall survival was 15.8 months. The overall rate of treatment discontinuation because of adverse events was 14.9%. Fifteen patients received ICIs in the liver transplant (LT) setting (one pre-LT for bridging, 14 for post-LT recurrence). Six of these patients experienced graft rejection (40.0%).
Polypropylene/abaca fiber eco‐composites: Influence of bio‐waste additive on flame retardancy and mechanical properties
Authors: Mai Nguyen Tran Thanh , M. N. Prabhakar , Lee Dong Woo , Cabo Maurelio, Jr. , Song Jung‐Il
Published: December 2020

This research focused on the fabrication of flame‐retardant green composites by utilizing inexpensive bio‐waste eggshell powder (ESP) as a flame‐retardant additive to polypropylene (PP)/abaca fibers (AF) composites (AF/ESP‐PP). The optimization of AF reinforcement in composites examines various wt% (5‐20) of fibers in the light of mechanical properties. Fifteen weight percentage of AF reinforcement showing the highest tensile (26 MPa) and flexural (46 MPa) strength compared to the remaining composites. Spectral (Fourier‐transform infrared spectroscopy) and micro (scanning electron microscope) analysis support the improvement of mechanical strength of the composites in connection with the interaction between AF with PP. Besides, different wt% (2, 4, 6, and 8) of ESP were incorporated into the AF/PP composites and examine the thermal and flame‐retardant properties by thermogravimetric analysis, horizontal burn test, and microcalorimetry, respectively. An improvement in thermal stability 9.82 wt% at 700°C, horizontal burn test results and decrement in peak heat release rate to 947 W/g.
Registration of ‘KS Western Star’ hard red winter wheat
Authors: Zhang Guorong , Fritz Allan K. , Haley Scott D. , Li Yonghui , Bai Guihua , Bowden Robert L. , Chen Ming‐Shun , Jin Yue , Chen Xianming , Kolmer James A. , Seabourn Bradford W. , Chen Richard Y. , Marshall David S.
Published: December 2020

‘KS Western Star’ (Reg. no. CV‐1174, PI 693935) hard red winter wheat (Triticum aestivum L.) was developed by the wheat breeding program at the Agricultural Research Center–Hays, Kansas State University, and released by the Kansas Agricultural Experiment Station in 2019. KS Western Star was developed with the objectives to further improve drought tolerance, straw strength, and multiple disease resistance of currently available cultivars for western Kansas. KS Western Star was selected from a single cross ‘Byrd’/KS05HW121‐2 made in 2009. KS Western Star was developed as an F6–derived line using a modified bulk breeding method and was evaluated in yield trials from 2014 to 2019. It has medium maturity, medium height, and high grain volume weight, as well as high flour yield and good bread‐making quality. KS Western Star has good adaption to semi‐arid areas in western Kansas with its drought tolerance, stripe rust and leaf rust resistance, and improved lodging resistance.
Highly selective mono‐functionalization of open‐cage silsesquioxane toward film‐formable homopolymer
Authors: Igarashi Amato , Ueda Yukiho , Katoh Ryoichi , Imoto Hiroaki , Naka Kensuke
Published: December 2020

Open‐cage silsesquioxanes have lower crystallinity without diminishing the thermal stability than traditional closed‐cage silsesquioxanes. Two of the three siloxane groups of commercially available corner‐opened cage silsesquioxanes were selectively substituted, and the remaining one was functionalized for the mono‐methacrylate monomer. The resultant polymer formed a homogeneous and transparent film with high‐thermal stability.
Psychosocial care for cancer survivors: A systematic literature review on the role of general practitioners
Authors: Deckx Laura , Chow Ka Hei , Askew Deborah , van Driel Mieke L. , Mitchell Geoffrey K. , van den Akker Marjan
Published: December 2020

Objective

To explore the general practitioners (GP's) role in providing psychosocial care for cancer survivors through a systematic literature review.

Methods

We searched MEDLINE, EMBASE, PsycINFO, and CINAHL and included the studies that complied with the predefined inclusion and exclusion criteria. At least two independent reviewers performed the quality appraisal and data extraction.

Results

We included 33 (five qualitative, 19 observational, and nine intervention) studies; the majority of these studies focused on care for depression and anxiety (21/33). Cancer survivors were more likely to contact their GP for psychosocial problems compared with noncancer controls. Survivors were more likely to use antidepressants compared with controls, although 71% of survivors preferred depression treatment to be “talking therapy only.” Overall, GPs and patients mostly agreed that GPs are the preferred healthcare provider to manage psychosocial problems. The major exception is a survivor's fear of recurrence—here, the oncologist was the preferred healthcare provider. Only two interventions effectively decreased depression or anxiety; these studies included patients who had a clinical indication for psychosocial care, were specifically designed for decreasing depression/anxiety, and consisted of a multidisciplinary team approach. The other interventions evaluated GP‐led follow‐up for cancer survivors and found that this did not impact the patients' levels of anxiety, depression, or distress neither negatively nor positively.

Conclusions

Cancer survivors often prefer psychosocial care by their GP, and GPs generally consider they are well placed to provide this care. Although evidence on the effectiveness of psychosocial care by GPs is limited, an active multidisciplinary team approach seems key.
Distinct conformational dynamics and allosteric networks in alpha tryptophan synthase during active catalysis
Authors: O'Rourke Kathleen F. , D'Amico Rebecca N. , Sahu Debashish , Boehr David D.
Published: December 2020

Experimental observations of enzymes under active turnover conditions have brought new insight into the role of protein motions and allosteric networks in catalysis. Many of these studies characterize enzymes under dynamic chemical equilibrium conditions, in which the enzyme is actively catalyzing both the forward and reverse reactions during data acquisition. We have previously analyzed conformational dynamics and allosteric networks of the alpha subunit of tryptophan synthase under such conditions using NMR. We have proposed that thisworkingstate represents a four to one ratio of the enzyme bound with the indole‐3‐glycerol phosphate substrate (E:IGP) to the enzyme bound with the products indole and glyceraldehyde‐3‐phosphate (E:indole:G3P). Here, we analyze the inactive D60N variant to deconvolute the contributions of the substrate‐ and products‐bound states to theworkingstate. While the D60N substitution itself induces small structural and dynamic changes, the D60N E:IGP and E:indole:G3P states cannot entirely account for the conformational dynamics and allosteric networks present in theworkingstate. The act of chemical bond breakage and/or formation, or possibly the generation of an intermediate, may alter the structure and dynamics present in theworkingstate. As the enzyme transitions from the substrate‐bound to the products‐bound state, millisecond conformational exchange processes are quenched and new allosteric connections are made between the alpha active site and the surface which interfaces with the beta subunit. The structural ordering of the enzyme and these new allosteric connections may be important in coordinating the channeling of the indole product into the beta subunit.
Revisiting the phosphotyrosine binding pocket of Fyn SH2 domain led to the identification of novel SH2 superbinders.
Authors: Li Shuhao , Zou Yang , Zhao Dongping , Yin Yuqing , Song Jingyi , He Ningning , Liu Huadong , Qian Dongmeng , Li Lei , Huang Haiming
Published: December 2020

Protein engineering through directed evolution is an effective way to obtain proteins with novel functions with the potential applications as tools for diagnosis or therapeutics. Many natural proteins have undergone directed evolution in vitro in the test tubes in the laboratories worldwide, resulting in the numerous protein variants with novel or enhanced functions. we constructed here an SH2 variant library by randomizing 8 variable residues in its phosphotyrosine (pTyr) binding pocket. Selection of this library by a pTyr peptide led to the identification of SH2 variants with enhanced affinities measured by EC50. Fluorescent polarization was then applied to quantify the binding affinities of the newly identified SH2 variants. As a result, three SH2 variants, named V3, V13 and V24, have comparable binding affinities with the previously identified SH2 triple‐mutant superbinder. Biolayer Interferometry assay was employed to disclose the kinetics of the binding of these SH2 superbinders to the phosphotyrosine peptide. The results indicated that all the SH2 superbinders have two‐orders increase of the dissociation rate when binding the pTyr peptide while there was no significant change in their associate rates. Intriguingly, though binding the pTyr peptide with comparable affinity with other SH2 superbinders, the V3 does not bind to the sTyr peptide. However, variant V13 and V24 have cross‐reactivity with both pTyr and sTyr peptides. The newly identified superbinders could be utilized as tools for the identification of pTyr‐containing proteins from tissues under different physiological or pathophysiological conditions and may have the potential in the therapeutics.
Electrophysiological and behavioral responses of red imported fire ants (Hymenoptera: Formicidae) to an essential balm and its components
Authors: Wen Chao , Chen Jian , He Yinghao , Wang Fang , Qian Chenyu , Wen Junbao , Wen Xiujun , Wang Cai
Published: December 2020

BACKGROUND

An over‐the‐counter medicine product of China known as essential balm effectively repelled red imported fire ants, Solenopsis invicta Buren. However, it was not clear which chemical component(s) accounted for the repellency, and whether they would effectively repel S. invicta in the field.

RESULTS

Five components, eucalyptol, camphor, menthol, methyl salicylate, and eugenol, were identified in essential balm using gas chromatography–mass spectrometry (GC–MS). Each component elicited concentration‐dependent electroantennography (EAG) response. Under field conditions, all components showed repellency against foraging ants. Interestingly, foraging ants managed to access the food items placed on a surface smeared with eucalyptol, camphor, menthol, or methyl salicylate by depositing soil particles on the surface and then walking on soil particles. However, they failed to do so when the surface was smeared with eugenol. Repellency of eugenol lasted for > 24 h, which was much longer than that of the other four components of essential balm and is comparable to that of N,N‐diethyl‐m‐toluamide (DEET), the standard for insect repellants.

CONCLUSION

Olfactory response of S. invicta to all five components of the essential balm was confirmed. Each component showed repellency against S. invicta workers in the field. However, only eugenol significantly suppressed both foraging and particle‐covering behavior within 24 h. The repellent effect of eugenol lasted much longer than the other four components. Particle‐covering behavior has been largely ignored in studying fire ant repellants. Our study demonstrated that it is necessary to consider such behaviors in ant repellent bioassays in the future. © 2020 Society of Chemical Industry
Different Types of Photon Entanglement from a Constantly Driven Quantum Emitter Inside a Cavity
Authors: Seidelmann Tim , Cosacchi Michael , Cygorek Moritz , Reiter Doris E. , Vagov Alexei , Axt Vollrath M.
Published: December 2020

Bell states are the most prominent maximally entangled photon states. In a typical four‐level emitter, like a semiconductor quantum dot, the photon states exhibit only one type of Bell state entanglement. By adding an external driving to the emitter system, also other types of Bell state entanglement are reachable without changing the polarization basis. In this work, it is shown under which conditions the different types of entanglement occur and analytical equations are given to explain these findings. Furthermore, special points are identified, where the concurrence, being a measure for the degree of entanglement, drops to zero, while the coherences between the two‐photon states stay strong. Results of this work pave the way to achieve a controlled manipulation of the entanglement type in practical devices.
New bounded real lemma for singular Markovian jump systems: Application toH∞control
Authors: Park Chan‐eun , Kwon Nam Kyu , Park PooGyeon
Published: December 2020

This article proposes a new strictly bounded real lemma (BRL) for continuous‐time singular Markovian jump systems (SMJSs) in terms of strict linear matrix inequalities (LMIs). While the previous studies have been done for SMJSs that do not have a path from disturbances to desired output, the proposed BRL covers SMJSs with disturbance‐contaminated output by introducing additional free matrix variables. Based on the proposed BRL, the sufficient condition for state‐feedback stabilization is successfully obtained in terms of strict LMIs. The result leads to find the minimalperformance by solving the optimization problem subject to the suggested LMIs. Two examples show the less conservatism of proposed method compared with the previous work.
Characterizing Competing Tensions in Black Immigrant Literacies: Beyond Partial Representations of Success
Authors: Smith Patriann , Lee Jaehoon , Chang Rong
Published: December 2020

In this study, we problematize the notion that Black immigrant youth be designated as high achieving or new model minority when comparing their literate success with that of their Black American peers. We draw from ideological and autonomous views regarding literacies while recognizing notions such as languaging informed by personhood, monoglossic norms, heteroglossic perspectives, and raciolinguistic ideologies, which come to bear on the literacies of Black immigrant youth. Using these lenses, we examined Black immigrant literacy from both qualitative and quantitative paradigms. Quantitative findings revealed that native English‐speaking Black immigrant youth had significantly higher scores on reading literacy than native English‐speaking Black American youth on the Programme for International Student Assessment. Among all Black students in 2009, native English speakers outperformed non‐native English speakers. However, superior reading literacy performance among native English speakers was not as obvious in 2015 as was observed in 2009. In 2015, non‐native English speakers outperformed native English speakers among Black immigrants, whereas native English speakers had higher scores than non‐native English speakers on reading literacy among Black Americans. Qualitative findings showed that (a) literate success in one Black immigrant youth’s (D’Arcy) literacy practices was influenced by multilingualism as both an asset and a deficit; (b) dialectal difference was perceived as language interference and as binary (i.e., legitimate vs. nonlegitimate); (c) there was persistent unacceptability of D’Arcy’s language, accent, and certain literacies across home and school; (d) expectations about D’Arcy’s racial literate identity remained steeped in assumptions regarding racialized language and raciolinguistic ideology; and (e) teacher interventions revealed tensions across (racio)linguistic ideologies. Implications for theory, research, policy, and practice are provided.
Composition Dependent Structural and Magnetic Properties of Mn−Zn Ferrite
Authors: Wu Tengyan , Ding Feng , Li Duxin , Zhong Hongbin
Published: December 2020

To reveal the intrinsic mechanism of MnxZn1‐xFe2O4 (x=0.2, 0.4, 0.6, 0.8 and 1) nanoferrite with various content of Mn/Zn are prepared by hydrothermal method. The physical properties are characterized by X‐ray diffraction (XRD), Fourier transformed infrared spectrometer (FTIR), Transmission electronic microscope (TEM), Energy Dispersion Spectrum (EDS) and Vibrating Sample Magnetometer (VSM). The phase structure, lattice parameters, and magnetic properties have been investigated based on the entire cation distribution with enhancement of the Mn2+. The XRD and FTIR analysis indicate that the samples have cubic spinel ferrite structure, the lattice constant at and crystallite size D increase with enhancement of Mn content. The VSM plots demonstrate that the Mn0.6Zn0.4Fe2O4 sample has the largest saturation magnetization value (77 emu/g). These results indicate that a fine tuning of Mn2+ content can adjust the micro‐structure and magnetic properties of MnxZn1‐xFe2O4.
Structural Deformation to β‐Cyclodextrin Due to Strong π‐Stacking in the Self‐Assembly of Inclusion Complex
Authors: Jeevan Athira K. , Krishnan Sumesh B. , Gopidas Karical R.
Published: December 2020

We report severe distortion to the structure of β‐cyclodextrin and partial de‐encapsulation of included guest prompted by strong π‐stacking of appended pyrene moieties in the self‐assembly of inclusion complex into toroidal nanostructures. The inclusion complex formed from bis(β‐cyclodextrin)‐substituted pyrene and bis(adamantane)‐substituted methyl viologen assembled into ring‐like structures. The rings undergo further self‐assembly which involve strong face‐to‐face π‐stacking of pyrene chromophores. Close approach of the pyrenes for π‐stacking demands severe distortion of the cyclodextrin truncated cone structure and partial de‐encapsulation of the guest from the cavity. The understanding that β‐CD can be distorted severely during self‐assembly may be helpful in the design of molecular architectures.
High‐Throughput Metagenomics for Identification of Pathogens in the Clinical Settings
Authors: Li Na , Cai Qingqing , Miao Qing , Song Zeshi , Fang Yuan , Hu Bijie
Published: December 2020

The application of sequencing technology is shifting from research to clinical laboratories owing to rapid technological developments and substantially reduced costs. However, although thousands of microorganisms are known to infect humans, identification of the etiological agents for many diseases remains challenging as only a small proportion of pathogens are identifiable by the current diagnostic methods. These challenges are compounded by the emergence of new pathogens. Hence, metagenomic next‐generation sequencing (mNGS), an agnostic, unbiased, and comprehensive method for detection, and taxonomic characterization of microorganisms, has become an attractive strategy. Although many studies, and cases reports, have confirmed the success of mNGS in improving the diagnosis, treatment, and tracking of infectious diseases, several hurdles must still be overcome. It is, therefore, imperative that practitioners and clinicians understand both the benefits and limitations of mNGS when applying it to clinical practice. Interestingly, the emerging third‐generation sequencing technologies may partially offset the disadvantages of mNGS. In this review, mainly: a) the history of sequencing technology; b) various NGS technologies, common platforms, and workflows for clinical applications; c) the application of NGS in pathogen identification; d) the global expert consensus on NGS‐related methods in clinical applications; and e) challenges associated with diagnostic metagenomics are described.
Socioeconomic Situation and Satisfaction in the Family Life
Authors: Kraus Blahoslav
Published: December 2020

In this chapter, the attention is paid to two fields which are linked with family lifestyle. The first one concerns socioeconomic situations in a family and shows that the economic side of family functioning is actually very essential these days. The importance of family economic situation is affirmed also in the results of our international survey. We asked what was the main family income, experience with unemployment and whether our respondents had possibility to save some money. Furthermore, we were interested in expenditure items and in evaluation of an overall standard of living by respondents. The Germans and then Czechs evaluated it as the best, the worst was found in families in Latvia. The second part monitors life satisfaction as a subjective feeling of well-being and is understood as a part of quality of life. To the question “How do you imagine a satisfied family?”, the most frequent response was—harmonic coexistence without conflicts, well-being, good health of all family members and material security. For the question “What do you lack to your satisfaction?” respondents stated—financial security and lack of free time for the family. However, there were specific differences among individual surveyed countries.
Leisure Time in Family Life
Authors: Junová Iva
Published: December 2020

The chapter in its first part presents changing understanding of leisure time in the past and currently. Major shifts have occurred in the increasing amount of free time and its democratization. The free time or leisure time is understood only just as a supplement or the rest after work; however, it has its intrinsic value, carries potential of freedom, self-realization, fun and relax. The text deals with leisure time functions and its meaning for individuals and complete family. It highlights issues that are connected with spending of leisure time. In the second part of the chapter, there are results of survey, which was mapping of family spending of free time, its amount and fulfilment. In all the surveyed countries, spending of leisure time has proved to be an important perquisite for family life satisfaction. Activities that are the most likely to be undertaken together with family members are watching TV, walks, trips, visits of friends or relatives, visits of cultural actions and social games.
Breaking the Liberal-Market Mold? Family Policy Variation Across U.S. States and Why It Matters
Authors: Engeman Cassandra
Published: December 2020

Drawing from U.S. state legislative documents, this chapter examines the development of subnational leave policies across states and over time. The research identifies 72 leave laws adopted by states between 1942 and 2017 and shows how some states are more active than others. In comparison to other countries, states quickly abandoned female-targeted policies in favor of gender-neutral, individual entitlements, and leave rights in the United States can be uniquely distinguished by whether they provide time-off to address medical or caregiving needs. I argue that American lawmakers have an opportunity to layer wage-replacement benefits on top of preexisting, gender-neutral and individual entitlements to job-protected leave in a step toward gender-egalitarian family policy models found in other countries.
Conceptualizing and Analyzing Family Policy and How It Is Changing
Authors: Daly Mary
Published: December 2020

This chapter focuses on the conceptualization of family policy as well as identifying the main trends and policy reforms. The chapter first sets out an analytic framework. This underlines the complexity of family policy and the necessity to see it as relating to both family structure and family-related behavior. The chapter then proceeds to identify major contemporary trends, focusing on three main areas of family policy: income supports for families with children, early childhood education and care and parenting-related leaves from employment. It shows family policy as dynamic and seeking to balance a series of tensions between resourcing families on the one hand and regulating them on the other. At issue is the balance to be struck between continuity in the structure of families, in their economic and social organization and in regard to the relative resourcing of different generations and life phases.
Conclusion: The Next Decade of Family Policy Research
Authors: Van Lancker Wim , Nieuwenhuis Rense
Published: December 2020

Based on the multilevel perspective on family policy research brought together in this handbook, this chapter highlights five major societal challenges for the future outlook and outcomes of family policies, and reflects on what the handbook teaches us about how to effectively address these challenges, as well as what there is yet to learn. The challenges pertain to the (1) levels of policy implementation, and in particular globalization and decentralization, (2) austerity and marketization, (3) economic inequality, (4) changing family relations, and (5) welfare states adapting to women’s empowered roles. The chapter concludes by examining what lessons were learned, and are yet to learn, regarding the capacity of family policies to cope with shocks of various kinds and to support families during extraordinary times.
One Hundred Years of Social Protection: The Rise of the Social Question in Brazil, India, China, and South Africa, 1920–2020
Authors: Leisering Lutz
Published: December 2020

This chapter concludes the volume on social protection in Brazil, India, China, and South Africa, 1920–2020. The main findings are: (1) Historical evolution—the hundred years from 1920 to 2020 mark the century of the rise of social protection in the four countries. (2) The social construction of the social—all four countries, with the exception of India, have articulated social issues in a generalised way as a social question. (3) Political language—semantics of the social have spread in all four countries. (4) “Multireferentiality”—social protection policies were largely driven and shaped by “non-social” ideas and interests. (5) Transnational diffusion—external ideas have pervaded domestic social protection policies. The chapter closes by thoughts about the future of social protection in middle-income countries.
(Re)formulating the Social Question in Post-apartheid South Africa: Zola Skweyiya, Dignity, Development and the Welfare State
Authors: Seekings Jeremy
Published: December 2020

Democratisation in 1994 meant that, for the first time, the South African state recognised that all South Africans had claims on and responsibilities to society. To address the racialised legacy ofapartheid, the new government sought to expand opportunities for black South Africans—and hence solve the social question—through racially inclusive economic growth and development. The government initially viewed the system of social grants that it inherited as insufficiently developmental and worried about the poor becoming “dependent” on public support. When unemployment and poverty persisted, compounded by HIV/AIDS, reformers—including especially the Minister of Social Development from 1999 to 2009, Zola Skweyiya—reframed the social question in terms of dignity and responsibility and expanded the social grant system.
The Potassium Cycle and Its Relationship to Recommendation Development
Authors: Brouder Sylvie M. , Volenec Jeffrey J. , Murrell T. Scott
Published: December 2020

Nutrient recommendation frameworks are underpinned by scientific understanding of how nutrients cycle within timespans relevant to management decision-making. A trusted potassium (K) recommendation is comprehensive enough in its components to represent important differences in biophysical and socioeconomic contexts but simple and transparent enough for logical, practical use. Here we examine a novel six soil-pool representation of the K cycle and explore the extent to which existing recommendation frameworks represent key plant, soil, input, and loss pools and the flux processes among these pools. Past limitations identified include inconsistent use of terminology, misperceptions of the universal importance and broad application of a single soil testing diagnostic, and insufficient correlation/calibration research to robustly characterize the probability and magnitude of crop response to fertilizer additions across agroecozones. Important opportunities to advance K fertility science range from developing a better understanding of the mode of action of diagnostics through use in multivariate field trials to the use of mechanistic models and systematic reviews to rigorously synthesize disparate field studies and identify knowledge gaps and/or novel targets for diagnostic development. Finally, advancing evidence-based K management requires better use of legacy and newly collected data and harnessing emerging data science tools and e-infrastructure to expand global collaborations and accelerate innovation.
How Closely Is Potassium Mass Balance Related to Soil Test Changes?
Authors: Franzen David W. , Goulding Keith , Mallarino Antonio P. , Bell Michael J.
Published: December 2020

The exchangeable fraction of soil potassium (K) has been viewed as the most important source of plant-available K, with other sources playing smaller roles that do not influence the predictive value of a soil test. Thus, as K mass balance changes, the soil test should change correspondingly to be associated with greater or reduced plant availability. However, soil test changes and the availability of K to plants are influenced by many other factors. This chapter reviews research on soil test K changes and the relation to crop uptake and yield. A mass-balance relationship is rarely achieved from the measurement of exchangeable K because of the potential for buffering of K removal from structural K in feldspars and from interlayer K in primary and secondary layer silicates. Similarly, surplus K additions can be fixed in interlayer positions in secondary layer silicates, or potentially sequestered in sparingly soluble neoformed secondary minerals, neither of which is measured as exchangeable K. In addition, soil moisture, temporal differences in exchangeable K with K uptake by crops, K leaching from residues, clay type, organic matter contribution to the soil CEC, and type of K amendment confound attempts to relate K additions and losses with an exchangeable K soil test. Research is needed to create regionally specific K soil test procedures that can predict crop response for a subset of clays and K-bearing minerals within specific cropping systems.
The Patient Journey
Authors: Beleffi Elena , Mosconi Paola , Sheridan Susan
Published: December 2020

The wide implementation of patient safety improvement efforts continues to face many barriers including insufficient involvement of all stakeholders in healthcare, lack of individual and organizational learning when medical errors occur and scarce investments in patient safety. The promotion of systems-based approaches offers methods and tools to improve the safety of care. A multidisciplinary perspective must include the involvement of patients and citizens as fundamental contributors to the design, implementation, and delivery of health services.

The patient journey is a challenging example of using a systems approach. The inclusion of the patient’s viewpoint and experience about their health journey throughout the time of care and across all the care settings represents a key factor in improving patient safety. Patient engagement ensures that the design of healthcare services are aligned with the values, the preferences, and needs of the patient community and integrates the real-life experience and the skills of the people to enhance patient safety in the patient journey.

The utmost priority to implement patient engagement is the training of patients. Therefore, training for both patients/families/advocates and health professionals is the foundation on which to build active engagement of patients and consequently an effective and efficient patient journey.

The chapter offers examples of successful training courses designed to foster strategic alliances among healthcare professionals and researchers with patients and their organizations. Training of patients constitutes the first step to develop shared knowledge, co-produced projects, and the achievement of active multilevel participation of patients for the implementation of patient safety in the patient journey.
From Theory to Real-World Integration: Implementation Science and Beyond
Authors: Dagliana Giulia , Albolino Sara , Mulissa Zewdie , Davy Jonathan , Todd Andrew
Published: December 2020

The increasing complexity and dynamicity of our society (and world of work) have meant that healthcare systems have and continue to change and consequently the state of healthcare systems continues to assume different characteristics. The causes of mortality are an excellent example of this rapid transformation: non-communicable diseases have become the leading cause of death, according to World Health Organization (WHO) data, but at the same time there are new problems emerging such as infectious diseases, like Ebola or some forms of influenza, which occur unexpectedly or without advanced warning. Many of these new diseases diffuse rapidly through the different parts of the globe due to the increasingly interconnected nature of the world. Another example of the healthcare transformation is the innovation associated with the introduction and development of advanced communication and technology systems (such as minimally invasive surgery and robotics, transplantation, automated antiblastic preparation) at all levels of care. Consequently, the social and technical dimensions of healthcare are becoming more and more complex and provide a significant challenge for all the stakeholders in the system to make sense of and ensure high quality healthcare. These stakeholders include but are not limited to patients and their families, caregivers, clinicians, managers, policymakers, regulators, and politicians. It is an inescapable truth that Humans are always going to be part of the healthcare systems, and it is these human, who by their very nature introduce variability and complexity to the system (we do not necessarily view this as a negative and this chapter will illustrate). A microlevel a central relationship in focus is that between the clinician and the patient, two human beings, making the health system a very peculiar organization compared to similarly high-risk organizations such as aviation or nuclear energy. This double human being system [1] requires significant effort (good design) in managing unpredictability through the development of personal and organization skills, such as the ability to react positively and rapidly to unexpected events and to adopt a resilient strategy for survival and advancement. In contrast to other similar industries, in terms of level of risk and system safety, healthcare settings are still plagued by numerous errors and negative events involving humans (and other elements) at various levels within the system. The emotional involvement is very high due to the exposure to social relationships daily and results in significant challenges to address both technical and non-technical issues simultaneously.
Emergency Department Clinical Risk
Authors: Pini Riccardo , Ralli Maria Luisa , Shanmugam Saravanakumar
Published: December 2020

The emergency department of any institution is an entry point for a significant number of patients to any health care organization. The department caters to various trauma and medical emergencies in both adults and in children round the clock and is adequately staffed with emergency physicians, and nursing to handle such emergencies at all times and days. The department also oversees operations of the prehospital emergency medical services (ambulance) and coordinates their services.

The emergency department (ED) is considered particularly high risk for adverse events (AE): 60% of ED patients experienced Medication Error (Patanwala et al., Ann Emerg Med 55:522–526, 2010). From a systematically review about AE related to ED, appears that the prevalence of AE among hospitalized patients ranging from 2.9% to 16.6%, with 36.9% to 51% of events considered preventable (Stang et al., PLoS One 8:e74214, 2013).

Maintaining quality and developing error-free systems have been the focus of engineering over the last few decades.

Consider the degree of variability of every individual human being compared to machine and also wisdoms from engineering field, for error-free system that guarantees good quality assistance should be defined a program reasonably simple, locally relevant, easily implementable, not be resource intense and have tangible outcomes which can be measured.
Risks in Oncology and Radiation Therapy
Authors: Marcolongo Adriano , Cristofaro Glauco , Mariotto Aldo , Mascarin Maurizio , Puglisi Fabio
Published: December 2020

This chapter aims to promote awareness by providing essential scientific elements about the risks associated with clinical oncology, with a particular focus on chemotherapy and radiotherapy.
Patient Safety in Laboratory Medicine
Authors: Plebani Mario , Aita Ada , Sciacovelli Laura
Published: December 2020

Laboratory medicine in the healthcare system has recently been recognized as a fundamental service in the clinical decision-making process. Therefore, the notion of patient safety in laboratory medicine must be recognized as the assurance that harm to patients will be avoided, safe care outcomes will be enhanced through error prevention, and the total testing process (TTP) will be continuously improved.

Although the goal for patient safety is zero errors, and although laboratory professionals have made numerous efforts to reduce errors in the last few decades, current research into laboratory-related diagnostic errors highlights that: (a) errors occur at every step of the TTP, mainly affecting phases at clinical interfaces; (b) despite the improvement strategies adopted, analytical quality remains a challenge; (c) errors are linked not only to clinical chemistry tests, but also to new, increasingly complex diagnostic testing.

Medical laboratories must therefore implement effective quality assurance tools to identify and prevent errors in order to guarantee the reliability of laboratory information. Accreditation in compliance with the International Standard ISO 15189 represents the first step, establishing processes with excellence requirements and greater expectations of staff competency. Another important step in preventing errors and ensuring patient safety is the development of specific educational and training programs addressed to all professionals involved in the process, in which both technical and administrative skills are integrated. A wide variety of information is provided by a robust quality management system and consensus-approved Quality Indicators (QI) that identify undesirable events, evaluate the risk to the patient, and call for corrective and preventive actions. However, the effectiveness of the system depends on the careful analysis of data collected and on staff awareness of the importance of laboratory medicine to the healthcare process. The main task of the new generation of laboratory professionals should be to gain experience in “clinical laboratory stewardship.” In order to safeguard patients, laboratory professionals must assist clinicians in selecting the right test for the right patient at the right time and facilitate the interpretation of laboratory information.
Community and Primary Care
Authors: Alti Elisabetta , Mereu Alessandro
Published: December 2020

WHO defined primary care “as socially appropriate, universally accessible, scientifically sound first level care provided by a suitably trained workforce supported by integrated referral systems and in a way that gives priority to those most needed, maximizes community and individual self-reliance and participation and involves collaboration with other sectors, including health promotion, illness prevention, care of the sick, advocacy and community development” [1].
Analysis
Authors: Müller Francis
Published: December 2020

Drawing on sociological Grounded Theory and ethnographic semantics, this chapter argues that analysis is a genuinely creative practice. Analysis entails not simply classifying the data found or produced in the field in accordance with everyday, common-sense knowledge but rather looking for aesthetic and semantic clues in it. It is also not a fixed program, but rather a hermeneutic and explorative search for new connections and patterns of meaning. This is demonstrated through examples of various data materials, such as transcripts of interviews, observation protocols, photographs, video, and material culture.
Epilogue
Authors: Müller Francis
Published: December 2020

Design ethnography consists in iterative processes in which research, interventions, and design flow into one another, whereby design itself develops epistemological qualities. Design ethnography means moving rapidly between the various approaches and constantly adopting new perspectives. Methods should not be dogmatically adhered to, but can and should be adapted and transcended. Design ethnography is therefore a “dirty” practice that tends toward anarchy. It can become “clean” and intersubjectively accessible only by means of inner distancing, conscious reflection, and not least, language.
Tool Support for Co-Simulation-Based Analysis
Authors: Albers Karsten , Bolte Benjamin , Meyer Max-Arno , Terfloth Axel , Wißdorf Anna
Published: December 2020

The development of collaborative embedded systems (CESs) requires the validation of their runtime behavior during design time. In this context, simulation-based analysis methods play a key role in the development of such systems. Simulations of CESs tend to become complex. One cause is that CESs work in collaborative system groups (CSGs) within a dynamic context., which is why CESs must be simulated as participants of a CSG. Another cause stems from the fact that CES simulations cover various cyber-physical domains. The models incorporated are often managed by different tools that are specialized for specific simulation disciplines and must be jointly executed in a cosimulation. Besides the methodological aspects, the interoperability of models and tools within such a co-simulation is a major challenge. This chapter focusses on the tool integration aspect of enabling co-simulations. It motivates the need for co-simulation for CES development and describes a general tool architecture. The chapter presents the advantages and limitations of adopting existing standards such as FMI and DCP, as well as best practices for integrating simulation tools and models for CESs and CSGs.
Online Experiment-Driven Learning and Adaptation
Authors: Gerostathopoulos Ilias , auf der Straße Alexander
Published: December 2020

This chapter presents an approach for the online optimization of collaborative embedded systems (CESs) and collaborative system groups (CSGs). Such systems have to adapt and optimize their behavior at runtime to increase their utilities and respond to runtime situations. We propose to model such systems as black boxes of their essential input parameters and outputs, and search efficiently in the space of input parameters for values that optimize (maximize or minimize) the system’s outputs. Our optimization approach consists of three phases and combines online (Bayesian) optimization with statistical guarantees stemming from the use of statistical methods such as factorial ANOVA, binomial testing, and t-tests in different phases. We have applied our approach in a smart cars testbed with the goal of optimizing the routing of cars by tuning the configuration of their parametric router at runtime.
Handling Uncertainty in Collaborative Embedded Systems Engineering
Authors: Bandyszak Torsten , Jöckel Lisa , Kläs Michael , Törsleff Sebastian , Weyer Thorsten , Wirtz Boris
Published: December 2020

As collaborative embedded systems operate autonomously in highly dynamic contexts, they must be able to handle uncertainties that can occur during operation. On the one hand, they must be able to handle uncertainties due to the imprecision of sensors and the behavior of data-driven components for perceiving and interpreting the context to enable decisions to be made during operation. On the other hand, uncertainties can emerge from the collaboration in a collaborative group, related to the exchange of information (e.g., context knowledge) between collaborative systems. This chapter presents methods for modeling uncertainty early in development and analyzing uncertainty during both design and operation. These methods allow for the identification of epistemic uncertainties that can occur when various, potentially heterogeneous systems are required to collaborate. The methods also enable graphical and formal modeling of uncertainties and their impact on system behavior (e.g., in the course of dynamic traffic scenarios). Furthermore, this chapter investigates the quality of outputs issued by data-driven models used to equip collaborative embedded systems with uncertainty-resilient machine learning capability.
Introduction
Authors: van Dijk Frans
Published: December 2020

The central question that this book will try to answer is whether there is a lack of alignment and—in the extreme—a disconnect between the judiciary and society in countries of Europe (EU and UK). This central question is developed into six sub questions. The sub questions focus on perceptions of judicial independence by various actors, their respect for independence and the trust of the general public in the judiciary.