bluuebunny/crossref_metadata_2025 huggingface dataset:
Patients’ perspective of attending nursing consultations—A pilot and feasibility study
Authors: Graarup Jytte , Højskov Ida Elisabeth
Published: June 2020

Aim

The aims were to explore: (a) how patients with advanced heart and lung failure accept the overall framework of the nursing consultations and (b) the patients’ acceptability and applicability of the nursing consultations.

Design

Qualitative study.

Methods

Interviews were conducted in an holistic frame and analysed using Graneheim and Lundman's qualitative content thematic analysis. Patients were interviewed between April and May 2018 regarding their general view of the nursing consultation and their experience of the framework inspired by R. R. Parse.

Results

The overall theme was A confidential moment with the nurse to deal with and become more aware of what is important, based on following subthemes: “An option that makes sense,” “Scheduled time with the nurse is important” and “To find a new normality in everyday life.” The framework addressed a space of freedom requested by the informants, for whom attending nursing consultations was useful and meaningful, enabling them to reflect on everyday challenges.
A combined hybrid mixed element method for incompressible miscible displacement problem with local discontinuous Galerkin procedure
Authors: Zhang Jiansong , Han Huiran , Guo Hui , Shen Xiaomang
Published: June 2020

In this article, we propose a combined hybrid discontinuous mixed finite element method for miscible displacement problem with local discontinuous Galerkin method. Here, to obtain more accurate approximation and deal with the discontinuous case, we use the hybrid mixed element method to approximate the pressure and velocity, and use the local discontinuous Galerkin finite element method for the concentration. Compared with other combined methods, this method can improve the efficiency of computation, deal with the discontinuous problem well and keep local mass balance. We study the convergence of this method and give the corresponding optimal error estimates inL∞(L2)for velocity and concentration and the super convergence inL∞(H1)for pressure. Finally, we also present some numerical examples to confirm our theoretical analysis.
Anti‐tumour effects of PIM kinase inhibition on progression and chemoresistance of hepatocellular carcinoma
Authors: Leung Ming‐Sum , Chan Kristy Kwan‐Shuen , Dai Wen‐Juan , Wong Cheuk‐Yan , Au Kwan‐Yung , Wong Pik‐Ying , Wong Carmen Chak‐Lui , Lee Terence Kin‐Wah , Ng Irene Oi‐Lin , Kao Weiyuan John , Lo Regina Cheuk‐Lam
Published: June 2020

Hepatocellular carcinoma (HCC) is a biologically aggressive cancer. Targeted therapy is in need to tackle challenges in the treatment perspective. A growing body of evidence suggests a promising role of pharmacological inhibition of PIM (proviral integration site for Moloney murine leukaemia virus) kinase in some human haematological and solid cancers. Yet to date, the potential application of PIM inhibitors in HCC is still largely unexplored. In the present study we investigated the pre‐clinical efficacy of PIM inhibition as a therapeutic approach in HCC. Effects of PIM inhibitors on cell proliferation, migration, invasion, chemosensitivity, and self‐renewal were examined in vitro. The effects of PIM inhibitors on tumour growth and chemoresistance in vivo were studied using xenograft mouse models. Potential downstream molecular mechanisms were elucidated by RNA sequencing (RNA‐seq) of tumour tissues harvested from animal models. Our findings demonstrate that PIM inhibitors SGI‐1776 and PIM447 reduced HCC proliferation, metastatic potential, and self‐renewal in vitro. Results from in vivo experiments supported the role of PIM inhibition in suppressing of tumour growth and increasing chemosensitivity of HCC toward cisplatin and doxorubicin, the two commonly used chemotherapeutic agents in trans‐arterial chemoembolisation (TACE) for HCC. RNA‐seq analysis revealed downregulation of the MAPK/ERK pathway upon PIM inhibition in HCC cells. In addition, LOXL2 and ICAM1 were identified as potential downstream effectors. Taken together, PIM inhibitors demonstrated remarkable anti‐tumourigenic effects in HCC in vitro and in vivo. PIM kinase inhibition is a potential approach to be exploited in formulating adjuvant therapy for HCC patients of different disease stages. © 2020 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
A new PARAFAC‐based algorithm for HPLC–MS data treatment: herbal extracts identification
Authors: Turova Polina , Rodin Igor , Shpigun Oleg , Stavrianidi Andrey
Published: June 2020

Introduction

Role of highly informative high‐performance liquid chromatography mass spectrometry (HPLC–MS) methods in quality control is increasing. Complex herbal products and formulations can simultaneously contain extracts from different plants. Therefore, due to the leads to lack of commercial standards it is important to develop novel approaches for comprehensive treatment of big datasets.

Objective

The aim of this study is to create a straightforward and information‐saving algorithm for the identification of plants extracts in commercial products.

Material and methods

In total, 34 samples, including Glycyrrhiza glabra and Panax ginseng dried roots; and Abrus precatorius dried leaves, their double and triple mixtures and flavoured oolong tea samples were analysed by HPLC–MS and combined in a three‐dimensional dataset (retention time–mass‐to‐charge ratio (m/z)–samples). This dataset was subjected to smoothing and denoising techniques and further decomposed using parallel factor analysis (PARAFAC).

Results

Samples were divided into eight clusters; loading matrices were interpreted and the presence of the most characteristic triterpene glycoside groups was demonstrated and supported by the characteristic chromatogram approach. The occurrence of Abrus precatorius and G. glabra additives in flavoured tea was confirmed.

Conclusion

Developed HPLC–MS‐PARAFAC method is potentially reliable and an efficient tool for handling untreated experimental data and its future development may lead to more comprehensive evaluation of chemical composition and quality control of food additives and other complex mixtures.
Adherence and barriers to general and respiratory exercises in cystic fibrosis
Authors: Santuzzi Cíntia Helena , Liberato Fernanda Mayrink Gonçalves , Morau Samilly Ariany Corrêa , de Oliveira Néville Ferreira Fachini , Nascimento Lucas Rodrigues
Published: June 2020

Objectives

To investigate the adherence and the self‐reported barriers to general and respiratory exercises reported by individuals with cystic fibrosis (CF).

Study Design

An exploratory, experimental study.

Methods

Community‐dwelling individuals aged 16 years and over, diagnosed with CF, who were accompanied in referral centers were included. Information regarding adherence to exercises was obtained by a questionnaire and reported as a ratio between prescribed exercises and self‐reported adherence. The weekly frequency was used to verify adherence to exercise initiation, and the amount of session duration concluded was used to verify adherence to exercise duration. Values above 0.70 were considered as high adherence. Eight demographic and clinical factors were examined to explore their relationships with adherence, and the barriers to exercises were also collected by questionnaire.

Results

Thirty‐four participants met the inclusion criteria. Overall, adherence to exercise initiation was 0.40 (standard deviation [SD] = 0.3) for general exercises and 0.63 (SD = 0.4) for respiratory exercises. Adherence to exercise duration was 0.76 (SD = 0.4) for general exercises and 0.73 (SD = 0.4) for respiratory exercises. Forced vital capacity (r = 0.39; P = .02) was associated with adherence to the duration of general exercises, and body mass index (r = −0.33; P = .05) was associated with adherence to the duration of respiratory exercises. The main reported barriers were lack of interest, motivation and time, tiredness, noncommitment, and do not recognize the benefits of exercises.

Conclusions

Individuals with CF minded completing the sessions of prescribed exercises once they have initiated it, but most of the days they did not practice general or respiratory exercises.
Skull metastases revealing a hepatocellular carcinoma: Case report and literature review
Authors: Essadi Ismail , Lalya Issam , Kaakoua Mohamed , Arsalane Adil , Elomrani Abdelhamid , Khouchani Mouna , Belbaraka Rhizlane
Published: June 2020

Introduction

Hepatocellular carcinoma (HCC) revealed by skull metastasis is very rare situation. This would mean that the patient was probably misdiagnosed allowing the disease to progress to an advanced stage, for which no curative treatment can be envisaged.

Case Presentation

We report the case of a 70‐years‐old Moroccan male, treated by interferon since 2014 for viral hepatitis C. He reported a gradual installation of scalp masses, which have grown in size and become painful. Surgical biopsy with histopathologic and immunohistochemical studies established the diagnosis of metastasis of HCC. This case was managed by palliative radiotherapy and is currently under treatment by Sorafenib.

Conclusion

Cranial metastasis as first symptom of HCC, represents an exceptional situation, which must not delay the diagnosis allowing a fast and effective management to have access to an optimal therapeutic outcome.
A mechanistic view of enzyme evolution
Authors: Yang Gloria , Miton Charlotte M. , Tokuriki Nobuhiko
Published: June 2020

New enzyme functions often evolve through the recruitment and optimization of latent promiscuous activities. How do mutations alter the molecular architecture of enzymes to enhance their activities? Can we infer general mechanisms that are common to most enzymes, or does each enzyme require a unique optimization process? The ability to predict the location and type of mutations necessary to enhance an enzyme's activity is critical to protein engineering and rational design. In this review, via the detailed examination of recent studies that have shed new light on the molecular changes underlying the optimization of enzyme function, we provide a mechanistic perspective of enzyme evolution. We first present a global survey of the prevalence of activity‐enhancing mutations and their distribution within protein structures. We then delve into the molecular solutions that mediate functional optimization, specifically highlighting several common mechanisms that have been observed across multiple examples. As distinct protein sequences encounter different evolutionary bottlenecks, different mechanisms are likely to emerge along evolutionary trajectories toward improved function. Identifying the specific mechanism(s) that need to be improved upon, and tailoring our engineering efforts to each sequence, may considerably improve our chances to succeed in generating highly efficient catalysts in the future.
Carbon Nanohybrids for Advanced Electronic Applications
Authors: Deshmukh Megha A. , Park Sang-Joon , Kang Byeong-Cheol , Ha Tae-Jun
Published: June 2020

Recently, carbon nanohybrids based on carbon nanomaterials including fullerene, carbon nanotube (CNT), carbon nanofiber (CNF), and graphene have attracted considerable attention in the field of science and technology due to their unique electrical, mechanical, chemical, spectroscopic properties, and high porosities. These nanohybrids not only increase electrical conductivity, but also enhance surface areas, thereby overcoming the limitations of individual carbon nanomaterial for material science and electronic engineering. Herein, the electronic and materials properties of carbon nanohybrids consisting of CNT/graphene, CNT/fullerene, CNT/CNF, and graphene/fullerene for advanced electronic applications are discussed.
The generalized Ekman model for the tropical cyclone boundary layer revisited: The myth of inertial stability as a restoring force
Authors: Smith Roger K. , Montgomery Michael T.
Published: June 2020

We revisit the linear boundary‐layer approximation that expresses a generalized Ekman balance and use it to clarify a range of interpretations in the previous literature on the tropical cyclone boundary layer. Some of these interpretations relate to the reasons for inflow in the boundary layer and others relate to the presumed effects of inertial stability on boundary‐layer dynamics. Inertial stability has been invoked, for example, to explain aspects of boundary‐layer behaviour, including the frontogenetic nature of the boundary layer and its relationship to vortex spin‐up. Our analysis exposes the fallacy of invoking inertial stability as a resistance to radial inflow in the boundary layer. The analysis shows also that the nonlinear acceleration terms become comparable to the linear Coriolis acceleration terms in relatively narrow vortices that are inertially stable above the boundary layer. Estimates of the nonlinear accelerations using the linear solutions are expected to underestimate the actual contribution in a nonlinear boundary‐layer model, cautioning against neglecting the nonlinear terms in diagnostic or prognostic models.
A hybrid homogeneously weighted moving average control chart for process monitoring
Authors: Adeoti Olatunde Adebayo , Koleoso Sunday Olawale
Published: June 2020

Several modifications and enhancements to control charts in increasing the performance of small and moderate process shifts have been introduced in the quality control charting techniques. In this paper, a new hybrid control chart for monitoring process location is proposed by combining two homogeneously weighted moving average (HWMA) control charts. The hybrid homogeneously weighted moving average (HHWMA) statistic is derived using two smoothing constants λ1 and λ2. The average run length (ARL) and the standard deviation of the run length (SDRL) values of the HHWMA control chart are obtained and compared with some existing control charts for monitoring small and moderate shifts in the process location. The results of study show that the HHWMA control chart outperforms the existing control charts in many situations. The application of the HHWMA chart is demonstrated using a simulated data.
Simple click chemistry‐based derivatization to quantify endogenous formaldehyde in milk using ultra‐high‐performance liquid chromatography/tandem mass spectrometry in selected reaction monitoring mode
Authors: Shetty Sweekruthi A. , Rangiah Kannan
Published: June 2020

Rationale

Formaldehyde (FA) exposure via environmental pollution or through the food chain poses a serious threat to human health, especially in developing countries like India. Although the addition of FA to food is proscribed, it is often illegally added to foods such as milk to increase the shelf‐life. There are challenges in differentiating the endogenous FA content in milk from externally added FA.

Method

We have developed a simple method using ultra‐high‐performance liquid chromatography/tandem mass spectrometry in selected reaction monitoring mode (UHPLC/MS/SRM) for the absolute quantification of endogenous FA in milk. The steps include fat removal, protein precipitation using acid, and spiking with labelled FA (FA*), followed by simple click chemistry‐based derivatization using Girard P reagent (GP) and final analysis.

Results

A standard curve with FA* was constructed and used for the calculation of endogenous FA in milk. The optimal conditions for the derivatization reaction using 500 μL of milk were: GP, 50 μg; temperature, 37°C; time, 60 min; and 0.1% HCl. The validation parameters such as accuracy (95.84 to 99.73%), precision (2.84 to 8.02%) and spiked recovery (>95%) are within the FDA guidelines. This method is highly sensitive [limit of detection (LOD) of 1 ng/mL] with a dynamic range of 3.12 to 200 ng/mL. The endogenous FA level in pasteurized cow milk is 70 ng/mL (n = 60). The FA content in raw milk samples from cow, goat and buffalo (each n = 10) varied from 134 to 255 ng/mL.

Conclusions

This method is precise and sufficiently sensitive to quantify endogenous FA in milk samples using a minimal sample volume. As it involves simple sample preparation steps, it can be used routinely to quantify endogenous FA.
“Estoy Explorando Science”: Emergent bilingual students problematizing electrical phenomena through translanguaging
Authors: Suárez Enrique
Published: June 2020

As science education continues to embrace science‐as‐practice, equitable science learning environments must value and leverage emergent bilingual students' ways of communicating. This study investigates the translanguaging practices of a group of elementary‐aged emergent bilingual students while they problematized electrical phenomena. Building on asset‐oriented theories for supporting student learning, I utilize translanguaging as a theoretical and pedagogical lens for understanding how emergent bilingual students leverage their full semiotic repertoires for productive disciplinary engagement. The study took place in an out‐of‐school program focused on creating opportunities for students to problematize electrical phenomena, specifically electrical resistance. I present a close analysis of students constructing models of electric flow through a circuit and how electrical resistance regulates that flow. The findings also include evidence that students engaged in different kinds of translanguaging practices when problematizing electrical phenomena and co‐constructing knowledge with each other and the instructor. Specifically, students drew from and used multiple linguistic and nonlinguistic semiotic resources for communicating their models. Finally, the findings suggest that the instructor's pedagogical moves and own translanguaging practices implicitly signaled to students when and how to participate in translanguaging practices themselves. The findings emphasize the importance of desettling what counts as productive forms of communication in science for elementary‐aged emergent bilingual students by eschewing pedagogical models that police discursive boundaries. Therefore, equitable science learning environments must create opportunities for emergent bilingual students to leverage their full semiotic repertoires for meaning‐making, by inviting and valuing multiple languages and gestures.
Foreign direct investment and manufacturing pollution emissions: A perspective from heterogeneous environmental regulation
Authors: Sun Haibo , Liu Zhonglu , Chen Yingchao
Published: June 2020

Sustainable development has become the consensus of mankind. Reducing manufacturing pollution emissions is critical to manufacturing sustainability. This article explores the influence of heterogeneous environmental regulation and foreign direct investment (FDI) on manufacturing pollution emissions, based on the micro data of Chinese manufacturing enterprises. The results show that FDI significantly increases manufacturing pollution emissions, and both expenditure‐style environmental regulation and investment‐style environmental regulation have an inverted U‐shaped relationship with manufacturing pollution emissions. Moreover, the expenditure‐style environmental regulation can only restrain the manufacturing pollution emissions caused by FDI in the current period, while the investment‐style environmental regulation is not only effective in the current period, but also plays a role in the lag period. Further research finds that both expenditure‐style environmental regulation and investment‐style environmental regulation have significant industrial and regional heterogeneity in reducing manufacturing pollution emissions caused by FDI. Our findings provide a reference for the rational introduction of foreign capital and manufacturing industry sustainable development.
Assessment of the critical factors in ımplementing ISO 14001:2015 environmental management systems for developing countries: A case study for Sri Lanka
Authors: Weerasinghe I. H. S. K. , Jayasooriya V. M.
Published: June 2020

ISO 14001:2015 is an international standard that specifies the requirements of environmental management systems (EMS). This study assessed the influence of top management commitment, applications of compliance and other requirements, operational control, monitoring and measurements, resource management and improvements as critical factors on successful implementation and the operation of the ISO 14001:2015, by considering organizations in Sri Lanka as a case study. A data collection was conducted via questionnaires and structured interviews from stakeholders who are directly responsible for the EMS such as environmental managers, quality mangers and general managers of the organizations, who are certified with ISO 14001:2015, and comparisons were undertaken. The statistical analysis of the critical factors has shown a significant positive effect on both large‐scale organizations and export‐oriented organizations on EMS implementation. Furthermore, the results indicate that the EMS adoption has created significant positive impacts on efficient energy and resource consumption within organizations.
APE: A Command-Line Tool and API for Automated Workflow Composition
Authors: Kasalica Vedran , Lamprecht Anna-Lena
Published: June 2020

Automated workflow composition is bound to take the work with scientific workflows to the next level. On top of today’s comprehensive eScience infrastructure, it enables the automated generation of possible workflows for a given specification. However, functionality for automated workflow composition tends to be integrated with one of the many available workflow management systems, and is thus difficult or impossible to apply in other environments. Therefore we have developed APE (the Automated Pipeline Explorer) as a command-line tool and API for automated composition of scientific workflows. APE is easily configured to a new application domain by providing it with a domain ontology and semantically annotated tools. It can then be used to synthesize purpose-specific workflows based on a specification of the available workflow inputs, desired outputs and possibly additional constraints. The workflows can further be transformed into executable implementations and/or exported into standard workflow formats. In this paper we describe APE v1.0 and discuss lessons learned from applications in bioinformatics and geosciences.
TsT, $$ \mathrm{T}\overline{\mathrm{T}} $$ and black strings
Authors: Apolo Luis , Detournay Stéphane , Song Wei
Published: June 2020

Abstract

We study the relationship between TsT transformations, marginal deformations of string theory on AdS3 backgrounds, and irrelevant deformations of 2d CFTs. We show that TsT transformations of NS-NS backgrounds correspond to instantaneous deformations of the worldsheet action by the antisymmetric product of two Noether currents, holographically mirroring the definition of the

$$ T\overline{T},J\overline{T},T\overline{J} $$

T

T
¯

,
J

T
¯

,
T

J
¯

, and

$$ J\overline{J} $$

J

J
¯

deformations of 2d CFTs. Applying a TsT transformation to string theory on BTZ ×S
3 × M
4 we obtain a general class of rotating black string solutions, including the Horne-Horowitz and the Giveon-Itzhaki-Kutasov ones as special cases, which we show are holographically dual to thermal states in single-trace

$$ T\overline{T} $$

T

T
¯

-deformed CFTs. We also find a smooth solution interpolating between global AdS3 in the IR and a linear dilaton background in the UV that is interpreted as the NS-NS ground state in the dual

$$ T\overline{T} $$

T

T
¯

-deformed CFT. This background suggests the existence of an upper bound on the deformation parameter above which the solution becomes complex. We find that the worldsheet spectrum, the thermodynamics of the black strings (in particular their Bekenstein-Hawking entropy), and the critical value of the deformation parameter match the corresponding quantities obtained from single-trace

$$ T\overline{T} $$

T

T
¯

deformations.
Reducible KAM Tori for the Degasperis–Procesi Equation
Authors: Feola Roberto , Giuliani Filippo , Procesi Michela
Published: June 2020

We develop KAM theory close to an elliptic fixed point for quasi-linear Hamiltonian perturbations of the dispersive Degasperis–Procesi equation on the circle. The overall strategy in KAM theory for quasi-linear PDEs is based on Nash–Moser nonlinear iteration, pseudo differential calculus and normal form techniques. In the present case the complicatedsymplectic structure, theweak dispersiveeffects of the linear flow and the presence ofstrong resonant interactionsrequire a novel set of ideas. The main points are to exploit the integrability of the unperturbed equation, to look for specialwave packetsolutions and to perform a very careful algebraic analysis of the resonances. Our approach is quite general and can be applied also to other 1d integrable PDEs. We are confident for instance that the same strategy should work for the Camassa–Holm equation.
Differential diagnosis of sinonasal extranodal NK/T cell lymphoma and diffuse large B cell lymphoma on MRI
Authors: Chen Yun , Wang Xinyan , Li Long , Li Wei , Xian Junfang
Published: June 2020

Purpose

To evaluate whether imaging features on conventional magnetic resonance imaging (MRI) can differentiate sinonasal extranodal natural killer/T cell lymphomas (ENKTL) from diffuse large B cell lymphoma (DLBCL).

Methods

Consecutively, pathology-proven 59 patients with ENKTL and 27 patients with DLBCL in the sinonasal region were included in this study. Imaging features included tumor side, location, margin, pre-contrast T1 and T2 signal intensity and homogeneity, post-contrast enhancement degree and homogeneity, septal enhancement pattern, internal necrosis, mass effect, and adjacent involvements. These imaging features for each ENKTL or DLBCL on total 86 MRI scans were indicated independently by two experienced head and neck radiologists. The MRI-based performance in differential diagnosis of the two types of lymphomas was evaluated by multivariate logistic regression analysis.

Results

All ENKTLs were located in the nasal cavity, with ill-defined margin, heterogeneous signal intensity, internal necrosis, marked enhancement of solid component on MRI, whereas DLBCLs were more often located in the paranasal sinuses, with MR homogenous intensity, mild enhancement, septal enhancement pattern, and intracranial or orbital involvements (all P < 0.05). Using a combination of location, internal necrosis and septal enhancement pattern of the tumor in multivariate logistic regression analysis, sensitivity, specificity, and accuracy in differential diagnosis of ENKTL and DLBCL were 100%, 79.4%, and 91.9%, respectively, for radiologist 1, and were 98.3%, 81.5%, and 93.0%, respectively, for radiologist 2.

Conclusion

MRI can effectively differentiate ENKTL from DLBCL in the sinonasal region with a high diagnostic accuracy.
„Descemet membrane endothelial keratoplasty“ DMEK – Spender und Empfänger Schritt für Schritt
Authors: Seitz Berthold , Daas Loay , Flockerzi Elias , Suffo Shady
Published: June 2020

Im Jahr 2020 ist die DMEK („Descemet membrane endothelial keratoplasty“) in Deutschland der Goldstandard zur Behandlung von endothelialen Hornhauterkrankungen. Die weitverbreitete Verwendung der DMEK war initial eingeschränkt aufgrund von Problemen mit der Spendervorbereitung und der Schwierigkeit, die Endothel-Descemet-Membran (EDM) korrekt und schonend in der Vorderkammer zu entfalten. Wir beschreiben zum einen nach der situativen Spenderauswahl die sichere einhändige Spenderpräparation der Hornhaut ohne Ein- oder gar Zerreißen der EDM einschließlich der unabdingbaren peripheren Halbkreismarkierungen zur Orientierung. Zum anderen stellen wir Schritt für Schritt die atraumatische Beladung der Glaskartusche, die Einführung der EDM-Rolle in die Vorderkammer und ihr sicheres, schrittweises Entfalten durch (1) die sequenzielle Verwendung von Flüssigkeitsstößen, (2) das Klopfen auf die periphere/zentrale Hornhaut, (3) die kontrollierte Abflachung der Vorderkammer, (4) die Luftbläscheneingabe definierter Größe dar sowie das Anlegen der EDM in korrekter Orientierung an die Rückseite der Wirtshornhaut mithilfe einer Gasblase. Nachdem bei der DMEK jeder falsche Einzelschritt weitreichende Konsequenzen für Patient und Operateur haben kann, sollte mit dieser schrittweisen pragmatischen Vorgehensweise das Auftreten von Spendergewebeschädigung und Fehlschlägen bei den Patientenmanövern minimiert werden.
Interannual variability of the early and late-rainy seasons in the Caribbean
Authors: Martinez Carlos , Kushnir Yochanan , Goddard Lisa , Ting Mingfang
Published: June 2020

The Caribbean seasonal rainfall cycle and its characteristics are heavily relied upon by the region’s inhabitants for their socioeconomic needs; the prediction of its variability would be valuable to society. An important way to understand the predictability of the Caribbean rainfall cycle is to study its interannual variability. Previous studies vary as to how and what large-scale climate driver(s) affect the interannual variability of rainfall and its associated dynamical mechanisms in the Caribbean. To address this, this study investigates wet and dry Caribbean early-rainy seasons (ERS; mid-April to mid-June) and late-rainy seasons (LRS; late August to mid-November) by conducting the following: (1) a spatial composite of rainfall from 34 Caribbean rainfall stations using daily data; and, (2) spatial composites of sea-surface temperature, sea-level pressure, and mean flow moisture convergence and transports. The ERS and LRS are impacted in distinctly different ways by two different, and largely independent, dominant large-scale phenomena: the North Atlantic Oscillation (NAO) and the El Niño-Southern Oscillation (ENSO), respectively. Dry ERS years are associated with a persistent dipole of cold and warm SSTs over the Caribbean Sea and Gulf of Mexico, respectively, that were caused by a preceding positive NAO state. This setting involves a wind-evaporation-SST (WES) feedback expressed in enhanced trade winds and consequently, moisture transport divergence over all of the Caribbean, except in portions of the NW Caribbean in May. A contribution from the preceding winter cold ENSO event is also discernible during dry ERS years. Dry LRS years are due to the summertime onset of an El Niño event, developing an inter-basin SLP pattern that fluxes moisture out of the Caribbean, except in portions of the NW Caribbean in November. Both large-scale climate drivers would have the opposite effect during their opposite phases leading to wet years for both seasons. The two rainy seasons are independent because the main drivers of their variability are independent. This has implications for prediction.
Current treatment options in RAS mutant metastatic colorectal cancer patients: a meta-analysis of 14 randomized phase III trials
Authors: Stahler Arndt , Heinemann Volker , Ricard Ingrid , von Einem Jobst C. , Giessen-Jung Clemens , Westphalen Christoph Benedikt , Michl Marlies , Heinrich Kathrin , Miller-Phillips Lisa , Jelas Ivan , Stintzing Sebastian , Modest Dominik Paul
Published: June 2020

Purpose

Although biomarkers for patients with metastatic colorectal cancer exist, the benefit patients with RAS mutated tumors derive from established regimens is unclear.

Methods

Efficacy of therapeutic strategies available for RAS mutated patients (addition of chemotherapeutic agents and/or anti angiogenic agents) were investigated in fourteen randomized controlled phase III trials at trial level by meta-analysing individual study hazard ratios and 95% confidence intervals (95% CI) for overall survival (OS) and progression free survival (PFS).

Results

6810 of 10,748 patients (63.3%) were available (48.5% RAS wildtype, 51.5% RAS mutated). Across all treatment lines, additional treatment efficacy (chemotherapy and/or anti angiogenic agents) was significantly smaller in RAS mutated compared to wildtype tumors for OS and PFS. In detail, patients with RAS mutated metastatic colorectal cancer derived significant benefit in PFS but not in OS by the addition of either chemotherapy or anti angiogenic agents to the respective comparator. In patients with RAS wildtype metastatic colorectal cancer, PFS and OS were improved by the addition of chemotherapy or anti angiogenic agent.

Conclusion

The therapeutic benefit of additional substances is less distinct in patients with RAS mutated as compared to RAS wildtype metastatic colorectal cancer, especially with regard to OS.
Zenker’s Diverticulum: Can Protocolised Measurements with Barium SWALLOW Predict Severity and Treatment Outcomes? The “Zen-Rad” Study
Authors: Ishaq Sauid , Siau Keith , Lee Minhong , Shalmani Hamid M , Kuwai Toshio , Priestnall Lindsey , Muhammad Humayun , Hall Adrian , Mulder Chris J , Neumann Helmut , Aziz Akhmid
Published: June 2020

Although barium swallow imaging is established in the investigation of Zenker’s diverticulum (ZD), no agreed measurement protocol exists. We developed a protocol for measuring ZD dimensions and aimed to correlate measurements with symptoms and post-operative outcomes. This prospective study included patients with confirmed ZD who underwent flexible endoscopic septal division (FESD) between 2014 and 2018. ZD was confirmed on barium radiology with measurements reviewed by two consultant radiologists. Symptom severity pre- and post-FESD was measured using the Dysphagia, Regurgitation, Complications (DRC) scale. Regression analyses were conducted to identify dimensions associated with therapeutic success, defined as remission (DRC score ≤ 1) 6 months after index FESD. In total, 67 patients (mean age 74.3) were included. Interobserver reliability (intraclass correlation coefficients—ICCs) was greatest for pouch width (0.981) and pouch depth (0.934), but not oesophageal depth (0.018). Male gender (60.9%) was associated with larger pouch height (P = 0.008) and width (P = 0.004). A positive correlation was identified between baseline DRC score and pouch depth (ρ 0.326, P = 0.011), particularly the regurgitation subset score (ρ 0.330, P = 0.020). The index pouch depth was associated with FESD procedure time (rho 0.358, P = 0.041). Therapeutic success was achieved in 64.2% and was associated with shorter pouch height (median 14.5 mm vs. 19.0 mm, P = 0.030), pouch width (median 19.9 mm vs. 28.8 mm, P = 0.34) and cricopharyngeal length (median 20.2 mm vs. 26.3 mm, P = 0.036). ZD dimensions may be feasible and were evaluated using Barium radiology. Specific parameters appear to correlate with severity and post-FESD outcomes, which aid with pre-procedural planning.
Comparison of subjectively and objectively assessed sleep problems in breast cancer patients starting neoadjuvant chemotherapy
Authors: Kreutz Charlotte , Müller Jana , Schmidt Martina E. , Steindorf Karen
Published: June 2020

Purpose

To characterize sleep problems and to compare subjective and objective assessments in breast cancer patients starting neoadjuvant chemotherapy.

Methods

Sleep characteristics of 54 breast cancer patients starting neoadjuvant chemotherapy were analyzed. Subjective sleep characteristics were assessed with the Pittsburgh Sleep Quality Index (PSQI) and objective sleep measurements with an accelerometer (ActiGraph wGT3X-BT) worn on the wrist for 7 consecutive days.

Results

According to the common PSQI cut-off of 8, 10 (18.87%) of the patients were poor sleepers. ActiGraph measures did not mirror this classification as values for poor, and good sleepers did not differ significantly. Overall, Bland-Altman plots illustrated higher ActiGraph values for sleep efficiency and effective sleep time and lower values for sleep latency, compared with PSQI. For total sleep time, less disagreement between both measures was observed. Actigraphy was limited in precise identification of sleep begin and sleep latency but provided supplementary information about number and minutes of awakenings during the night.

Conclusion

Subjective and objective measurement methods differed substantially in various parameters, with limitations in both methods. A combination of both methods might be most promising.

Trial Registration

Clinicaltrials.gov: NCT02999074
Biochar as multi-purpose sustainable technology: experiences from projects in Tanzania
Authors: Hansson Anders , Haikola Simon , Fridahl Mathias , Yanda Pius , Mabhuye Edmund , Pauline Noah
Published: June 2020

Biochar was recently included as a promising negative emissions technology (NET) in the Special Report on Global Warming of 1.5 °C published by the Intergovernmental Panel on Climate Change. Unlike other NETs, it can potentially be used to mitigate global climate change while adding to local resilience in countries highly exposed and sensitive to impacts of climate change, such as least-developed countries (LDCs). The study is as an empirical contribution to the, as of yet, underdeveloped literature on deployment of negative emissions technologies in LDCs in general and on biochar use in developing countries and LDCs specifically. Nine historical and existing biochar projects in Tanzania are mapped in order to analyse problems, goals and common trade-offs associated with small- to medium-scale biochar production in LDCs. The mapping is based on a literature and document study, interviews with project actors, and on-site visits to biochar projects during 2019. The paper gives support to the observation made in the biochar literature that while biochar has many potential socio-economic and environmental benefits, combining them in one single project is difficult. It is concluded that implementing biochar projects in Tanzania will likely involve trade-offs between the development and subsistence strategies and needs of local communities, the motivational forces of different project participants, and the uneven regulatory capacity of the state. We end by reflecting on the use of biochar projects to offset carbon emissions made elsewhere.
Development of in vitro-grown spheroids as a 3D tumor model system for solid-state NMR spectroscopy
Authors: Damman Reinier , Lucini Paioni Alessandra , Xenaki Katerina T. , Beltrán Hernández Irati , van Bergen en Henegouwen Paul M. P. , Baldus Marc
Published: June 2020

Recent advances in the field of in-cell NMR spectroscopy have made it possible to study proteins in the context of bacterial or mammalian cell extracts or even entire cells. As most mammalian cells are part of a multi-cellular complex, there is a need to develop novel NMR approaches enabling the study of proteins within the complexity of a 3D cellular environment. Here we investigate the use of the hanging drop method to grow spheroids which are homogenous in size and shape as a model system to study solid tumors using solid-state NMR (ssNMR) spectroscopy. We find that these spheroids are stable under magic-angle-spinning conditions and show a clear change in metabolic profile as compared to single cell preparations. Finally, we utilize dynamic nuclear polarization (DNP)-supported ssNMR measurements to show that low concentrations of labelled nanobodies targeting EGFR (7D12) can be detected inside the spheroids. These findings suggest that solid-state NMR can be used to directly examine proteins or other biomolecules in a 3D cellular microenvironment with potential applications in pharmacological research.
Translating clinical and patient-reported data to tailored shared decision reports with predictive analytics for knee and hip arthritis
Authors: Franklin Patricia D. , Zheng Hua , Bond Christina , Lavallee Danielle C.
Published: June 2020

Introduction

New informatics tools can transform evidence-based information to individualized predictive reports to serve shared decisions in clinic. We developed a web-based system to collect patient-reported outcomes (PROs) and medical risk factors and to compare responses to national registry data. The system generates predicted outcomes for individual patients and a report for use in clinic to support decisions. We present the report development, presentation, and early experience implementing this PRO-based, shared decision report for knee and hip arthritis patients seeking orthopedic evaluation.

Methods

Iterative patient and clinician interviews defined report content and visual display. The web-system supports: (a) collection of PROs and risk data at home or in office, (b) automated statistical processing of responses compared to national data, (c) individualized estimates of likely pain relief and functional gain if surgery is elected, and (d) graphical reports to support shared decisions. The system was implemented at 12 sites with 26 surgeons in an ongoing cluster randomized trial.

Results

Clinicians and patients recommended that pain and function as well as clinical risk factors (e.g., BMI, smoking) be presented to frame the discussion. Color and graphics support patient understanding. To date, 7891 patients completed the assessment before the visit and 56% consented to study participation. Reports were generated for 98% of patients and 68% of patients recalled reviewing the report with their surgeon.

Conclusions

Informatics solutions can generate timely, tailored office reports including PROs and predictive analytics. Patients successfully complete the pre-visit PRO assessments and clinicians and patients value the report to support shared surgical decisions.
The variety of evidence thesis and its independence of degrees of independence
Authors: Landes Jürgen
Published: June 2020

The intuitive Variety of Evidence Thesis states that, ceteris paribus, more varied evidence for a hypothesis confirms it more strongly than less varied evidence. Recent Bayesian analyses have raised serious doubts in its validity. Claveau suggests the existence of a novel type of counter-example to this thesis: a gradual increase in source independence can lead to a decrease in hypothesis confirmation. I show that Claveau’s measure of gradual source independence suffers from two unsuspected types of inconsistencies. I hence put forward a more natural measure of gradual source independence which is not plagued by inconsistencies. Claveau’s counter-examples to the variety of evidence thesis disappear with the measure I suggest. I hence argue that my measure is preferable and that this thesis does at least not seem to be troubled by Claveau’s arguments.
Modelling the Impact of Anisotropy on Hydrocarbon Production in Heterogeneous Reservoirs
Authors: Sinan Saddam , Glover Paul W. J. , Lorinczi Piroska
Published: June 2020

Effective and optimal hydrocarbon production from heterogeneous and anisotropic reservoirs is a developing challenge in the hydrocarbon industry. While experience leads us to intuitive decisions for the production of these heterogeneous and anisotropic reservoirs, there is a lack of information concerning how hydrocarbon and water production rate and cumulative production as well as water cut and water breakthrough time depend on quantitative measures of heterogeneity and anisotropy. In this work, we have used Generic Advanced Fractal Reservoir Models (GAFRMs) to model reservoirs with controlled heterogeneity and vertical and/or horizontal anisotropy, following the approach of Al-Zainaldin et al. (Transp Porous Media 116(1):181–212, 2017). This Generic approach uses fractal mathematics which captures the spatial variability of real reservoirs at all scales. The results clearly show that some anisotropy in hydrocarbon production and water cut can occur in an isotropic heterogeneous reservoir and is caused by the chance placing of wells in high-quality reservoir rock or vice versa. However, when horizontal anisotropy is introduced into the porosity, cementation exponent and grain size (and hence also into the permeability, capillary pressure, water saturation) in the reservoir model, all measures of early stage and middle stage hydrocarbon and water production become anisotropic, with isotropic flow returning towards the end of the reservoir’s lifetime. Specifically, hydrocarbon production rate and cumulative production are increased in the direction of anisotropy, as is water cut, while the time to water breakthrough is reduced. We found no such relationship when varying vertical anisotropy because we were using vertical wells but expect there to be an effect if horizontal wells were used.
Low-delay single holoscopic 3D computer-generated image to multiview images
Authors: Alfaqheri Taha , Aondoakaa Akuha Solomon , Swash Mohammad Rafiq , Sadka Abdul Hamid
Published: June 2020

Due to the nature of holoscopic 3D (H3D) imaging technology, H3D cameras can capture more angular information than their conventional 2D counterparts. This is mainly attributed to the macrolens array which captures the 3D scene with slightly different viewing angles and generates holoscopic elemental images based on fly’s eyes imaging concept. However, this advantage comes at the cost of decreasing the spatial resolution in the reconstructed images. On the other hand, the consumer market is looking to find an efficient multiview capturing solution for the commercially available autostereoscopic displays. The autostereoscopic display provides multiple viewers with the ability to simultaneously enjoy a 3D viewing experience without the need for wearing 3D display glasses. This paper proposes a low-delay content adaptation framework for converting a single holoscopic 3D computer-generated image into multiple viewpoint images. Furthermore, it investigates the effects of varying interpolation step sizes on the converted multiview images using the nearest neighbour and bicubic sampling interpolation techniques. In addition, it evaluates the effects of changing the macrolens array size, using the proposed framework, on the perceived visual quality both objectively and subjectively. The experimental work is conducted on computer-generated H3D images with different macrolens sizes. The experimental results show that the proposed content adaptation framework can be used to capture multiple viewpoint images to be visualised on autostereoscopic displays.
Update on House Dust Mite Allergen Avoidance Measures for Asthma
Authors: Zuiani Chiara , Custovic Adnan
Published: June 2020

Purpose of Review

To critically review the evidence in favor or against the use of house dust mite (HDM) allergen avoidance measures in patients with asthma.

Recent Findings

Systematic reviews and meta-analyses suggested no positive effect of mite allergen avoidance strategies on asthma outcomes, resulting in a lack of consensus regarding the utility of these measures. However, such analyses have a number limitations and might not be the most adequate tool to evaluate current evidence and to derive clinical recommendations regarding mite allergen avoidance in asthmatic patients. We should not disproportionately rely on the results of meta-analyses and systematic reviews to inform clinical practice and asthma guidelines in this area. Recent high-quality evidence from randomized controlled trial in children confirmed that mite allergen–impermeable bed encasings reduce emergency hospital attendance with acute severe asthma exacerbations.

Until better evidence is available, we suggest that physicians should adopt a pragmatic approach to mite allergen avoidance and advise sensitized patients to implement a multifaceted set of measures to achieve as great a reduction in exposure as possible. Potential predictors of positive response (e.g., patient’s sensitization and exposure status) can pragmatically be evaluated using the size of skin test wheal or the titer of allergen-specific IgE. Finally, the intervention should be started as early as possible.