bluuebunny/crossref_metadata_2025_split huggingface dataset:
Palliative and end-of-life care in care homes: protocol for codesigning and implementing an appropriate scalable model of Needs Rounds in the UK
Authors: Macgregor Aisha , Rutherford Alasdair , McCormack Brendan , Hockley Jo , Ogden Margaret , Soulsby Irene , McKenzie Maisie , Spilsbury Karen , Hanratty Barbara , Forbat Liz 
Published: February 2021

IntroductionPalliative and end-of-life care in care homes is often inadequate, despite high morbidity and mortality. Residents can experience uncontrolled symptoms, poor quality deaths and avoidable hospitalisations. Care home staff can feel unsupported to look after residents at the end of life. Approaches for improving end-of-life care are often education-focused, do not triage residents and rarely integrate clinical care. This study will adapt an evidence-based approach from Australia for the UK context called ‘Palliative Care Needs Rounds’ (Needs Rounds). Needs Rounds combine triaging, anticipatory person-centred planning, case-based education and case-conferencing; the Australian studies found that Needs Rounds reduce length of stay in hospital, and improve dying in preferred place of care, and symptoms at the end of life.Methods and analysisThis implementation science study will codesign and implement a scalable UK model of Needs Rounds. The Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework will be used to identify contextual barriers and use facilitation to enable successful implementation. Six palliative care teams, working with 4–6 care homes each, will engage in two phases. In phase 1 (February 2021), stakeholder interviews (n=40) will be used to develop a programme theory to meet the primary outcome of identifying what works, for whom in what circumstances for UK Needs Rounds. Subsequently a workshop to codesign UK Needs Rounds will be run. Phase 2 (July 2021) will implement the UK model for a year. Prospective data collection will focus on secondary outcomes regarding hospitalisations, residents’ quality of death and care home staff capability of adopting a palliative approach.Ethics and disseminationFrenchay Research Ethics Committee (287447) approved the study. Findings will be disseminated to policy-makers, care home/palliative care practitioners, residents/relatives and academic audiences. An implementation package will be developed for practitioners to provide the tools and resources required to adopt UK Needs Rounds.Registration detailsRegistration details:ISRCTN15863801.
Enhancing care of children with complex healthcare needs: an improvement project in a community health organisation in Ireland
Authors: Brenner Maria , Doyle Amanda , Begley Thelma , Doyle Carmel , Hill Katie , Murphy Maryanne 
Published: February 2021

BackgroundIntegration of care for children with complex care needs is developing slowly internationally. There remains wide variation in the governance of, and access to, care for these children and their families.Local problemThere was a need to develop a service that would have a specific remit for organising the overall management and governance of the care of these children in the community.MethodA bespoke model was established specifically to support the needs of children with complex healthcare needs (CHNs). The sole focus of the team is to provide the highest standard of care to these children and their families, and to enable families to remain central to decision-making.InterventionThe service for children with CHNs was established in August 2017 with the appointment of a service manager and case managers. A comprehensive training and education programme was put in place to support care to the children and their families.ResultsThe service is viewed as delivering high-quality care. Parents and stakeholders highlighted the value placed within the service on individualised care, specialist knowledge and the importance of advocacy.ConclusionsThe model recognises the exceptional lives these children and families live, given the complexities and challenges they have to overcome on a daily basis. The team have built a specialist knowledge and skill set in supporting families and others involved in the care of the child, as they are solely employed and dedicated to the provision of care to children with CHNs. The corporate governance structures seem strong and stand up to scrutiny very well in terms of parents’ and stakeholders’ perspectives and in the context of published international best practice.
Physicians’ views on the usefulness and feasibility of identifying and disclosing patients’ last phase of life: a focus group study
Authors: Owusuaa Catherine , van Beelen Irene , van der Heide Agnes , van der Rijt Carin C D 
Published: February 2021

ObjectivesAccurate assessment that a patient is in the last phase of life is a prerequisite for timely initiation of palliative care in patients with a life-limiting disease, such as advanced cancer or advanced organ failure. Several palliative care quality standards recommend the surprise question (SQ) to identify those patients. Little is known about physicians’ views on identifying and disclosing the last phase of life of patients with different illness trajectories.MethodsData from two focus groups were analysed using thematic analysis with a phenomenological approach.ResultsFifteen medical specialists and general practitioners participated. Participants thought prediction of patients’ last phase of life, i.e. expected death within 1 year, is important. They seemed to find that prediction is more difficult in patients with advanced organ failure compared with cancer. The SQ was considered a useful prognostic tool; its use is facilitated by its simplicity but hampered by its subjective character. The medical specialist was considered mainly responsible for prognosticating and gradually disclosing the last phase. Participants’ reluctance to such disclosure was related to uncertainty around prognostication, concerns about depriving patients of hope, affecting the physician–patient relationship, or a lack of time or availability of palliative care services.ConclusionsPhysicians consider the assessment of patients’ last phase of life important and support use of the SQ in patients with different illness trajectories. However, barriers in disclosing expected death are prognostic uncertainty, possible deprivation of hope, physician–patient relationship, and lack of time or palliative care services. Future studies should examine patients’ preferences for those discussions.
Early palliative care and quality of dying and death in patients with advanced cancer
Authors: Mah Kenneth , Chow Brittany , Swami Nadia , Pope Ashley , Rydall Anne , Earle Craig , Krzyzanowska Monika , Le Lisa , Hales Sarah , Rodin Gary , Hannon Breffni , Zimmermann Camilla 
Published: February 2021

ObjectiveEarly palliative care (EPC) in the outpatient setting improves quality of life for patients with advanced cancer, but its impact on quality of dying and death (QODD) and on quality of life at the end of life (QOL-EOL) has not been examined. Our study investigated the impact of EPC on patients’ QODD and QOL-EOL and the moderating role of receiving inpatient or home palliative care.MethodBereaved family caregivers who had provided care for patients participating in a cluster-randomised trial of EPC completed a validated QODD scale and indicated whether patients had received additional home palliative care or care in an inpatient palliative care unit (PCU). We examined the effects of EPC, inpatient or home palliative care, and their interactions on the QODD total score and on QOL-EOL (last 7 days of life).ResultsA total of 157 caregivers participated. Receipt of EPC showed no association with QODD total score. However, when additional palliative care was included in the model, intervention patients demonstrated better QOL-EOL than controls (p=0.02). Further, the intervention by PCU interaction was significant (p=0.02): those receiving both EPC and palliative care in a PCU had better QOL-EOL than those receiving only palliative care in a PCU (mean difference=27.10, p=0.002) or only EPC (mean difference=20.59, p=0.02).ConclusionAlthough there was no association with QODD, EPC was associated with improved QOL-EOL, particularly for those who also received inpatient care in a PCU. This suggests a long-term benefit from early interdisciplinary palliative care on care throughout the illness.Trial registration numberClinicalTrials.gov Registry (#NCT01248624).
Bespoke 3D printed eye cover for teen with rhabdomyosarcoma
Authors: O’Sullivan Aidan , Duffy Ed , O’Sullivan Kevin , Cronin Una , Lyons Emma , O’Sullivan Leonard , Twomey Feargal 
Published: February 2021

BackgroundWe report a case of using 3D printing to create a bespoke eye cover for an 18-year-old man with left maxillary alveolar rhabdomyosarcoma. Further, the patient had proptosis causing chemosis and subsequent conjunctival abrasions. This had been managed by taping a large dressing around the eye for a number of weeks previously.MethodsA 3D scanner was used to capture the surface topography of the patients face. The data were imported into a CAD package and used as a guide to create a bespoke eye cover. The final design was 3D printed in a biocompatible material for use by the patient.ResultsThe scan, modelling, and printing of the bespoke cover was completed successfully in less than 72 hours.Conclusion3D printing offers a method to create bespoke solutions for patients in palliative care to meet rare and difficult clinical challenges.
Low prevalence of the parasite Ophryocystis elektroscirrha at the range edge of the eastern North American monarch (Danaus plexippus) butterfly population
Authors: Dargent Felipe , Gilmour Sydney M. , Brown Emma A. , Kassen Rees , Kharouba Heather M. 
Published: February 2021

Every year monarch butterflies (Danaus plexippus (Linnaeus, 1758)) from the eastern North American population migrate from Mexico to southern Canada in the spring. This northward migration has been shown to reduce monarch infection with the host-specific parasite Ophryocystis elektroscirrha McLaughlin and Myers, 1970 (OE); yet, the prevalence of OE at their range limits and the mechanism(s) responsible are unknown. We assessed OE infection levels of monarchs at the northern edge of the eastern population distribution around Ottawa, Ontario, Canada, and found extremely low levels of infection (∼1% with upper confidence intervals close to 3%). Low OE infection levels are likely due to low densities of monarchs in this region and (or) migratory escape effects, where migrating individuals leave behind areas with high density of conspecifics and high potential for parasite accumulation and transmission. Future work should aim to disentangle the relative contribution of these two mechanisms for governing the decrease in parasitism at the range limits of migratory populations.
Past, present, and future of precision determinations of the QCD coupling from lattice QCD
Authors: Dalla Brida Mattia 
Published: February 2021

AbstractNon-perturbative scale-dependent renormalization problems are ubiquitous in lattice QCD as they enter many relevant phenomenological applications. They require solving non-perturbatively the renormalization group equations for the QCD parameters and matrix elements of interest in order to relate their non-perturbative determinations at low energy to their high-energy counterparts needed for phenomenology. Bridging the large energy separation between the hadronic and perturbative regimes of QCD, however, is a notoriously difficult task. In this contribution we focus on the case of the QCD coupling. We critically address the common challenges that state-of-the-art lattice determinations have to face in order to be significantly improved. In addition, we review a novel strategy that has been recently put forward in order to solve this non-perturbative renormalization problem and discuss its implications for future precision determinations. The new ideas exploit the decoupling of heavy quarks to match $${N_{\mathrm{f}}}$$

N
f

-flavor QCD and the pure Yang–Mills theory. Through this matching the computation of the non-perturbative running of the coupling in QCD can be shifted to the computationally much easier to solve pure-gauge theory. We shall present results for the determination of the $$\varLambda $$
Λ
-parameter of $${N_{\mathrm{f}}}=3$$

N
f

=
3

-flavor QCD where this strategy has been applied and proven successful. The results demonstrate that these techniques have the potential to unlock unprecedented precision determinations of the QCD coupling from the lattice. The ideas are moreover quite general and can be considered to solve other non-perturbative renormalization problems.
Final results of the LOPES radio interferometer for cosmic-ray air showers
Authors:   LOPES Collaboration, Apel W. D. , Arteaga-Velázquez J. C. , Bähren L. , Bekk K. , Bertaina M. , Biermann P. L. , Blümer J. , Bozdog H. , Cantoni E. , Chiavassa A. , Daumiller K. , de Souza V. , Di Pierro F. , Doll P. , Engel R. , Falcke H. , Fuchs B. , Gemmeke H. , Grupen C. , Haungs A. , Heck D. , Hörandel J. R. , Horneffer A. , Huber D. , Huege T. , Isar P. G. , Kampert K.-H. , Kang D. , Krömer O. , Kuijpers J. , Link K. , Łuczak P. , Ludwig M. , Mathes H. J. , Melissas M. , Morello C. , Nehls S. , Oehlschläger J. , Palmieri N. , Pierog T. , Rautenberg J. , Rebel H. , Roth M. , Rühle C. , Saftoiu A. , Schieler H. , Schmidt A. , Schoo S. , Schröder F.G. , Sima O. , Toma G. , Trinchero G. C. , Weindl A. , Wochele J. , Zabierowski J. , Zensus J. A. 
Published: February 2021

AbstractLOPES, the LOFAR prototype station, was an antenna array for cosmic-ray air showers operating from 2003 to 2013 within the KASCADE-Grande experiment. Meanwhile, the analysis is finished and the data of air-shower events measured by LOPES are available with open access in the KASCADE Cosmic Ray Data Center (KCDC). This article intends to provide a summary of the achievements, results, and lessons learned from LOPES. By digital, interferometric beamforming the detection of air showers became possible in the radio-loud environment of the Karlsruhe Institute of Technology (KIT). As a prototype experiment, LOPES tested several antenna types, array configurations and calibration techniques, and pioneered analysis methods for the reconstruction of the most important shower parameters, i.e., the arrival direction, the energy, and mass-dependent observables such as the position of the shower maximum. In addition to a review and update of previously published results, we also present new results based on end-to-end simulations including all known instrumental properties. For this, we applied the detector response to radio signals simulated with the CoREAS extension of CORSIKA, and analyzed them in the same way as measured data. Thus, we were able to study the detector performance more accurately than before, including some previously inaccessible features such as the impact of noise on the interferometric cross-correlation beam. These results led to several improvements, which are documented in this paper and can provide useful input for the design of future cosmic-ray experiments based on the digital radio-detection technique.
The Atomki Accelerator Centre
Authors: Biri S. , Vajda I. K. , Hajdu P. , Rácz R. , Csík A. , Kormány Z. , Perduk Z. , Kocsis F. , Rajta I. 
Published: February 2021

AbstractIn this paper, the Atomki Accelerator Centre (AAC, Debrecen, Hungary) incorporating several small-sized particle accelerators is reviewed. The energy range of our accelerators for proton beam is between 50 eV and 20 MeV. The technical and personnel organization of AAC is presented together with the rules of beamtime requests and usage. Three of our accelerators (Cyclotron, ECRIS, Tandetron) are described in detail with their technical descriptions and with the main application fields. As an example for highlights, a series of unique low-energy ion–sample irradiations and post-treatments are shown which, by our hopes and plans, form a bridge between physics and biology.
Chapter 6.2 Englacial tephras of East Antarctica
Authors: Narcisi Biancamaria , Petit Jean Robert 
Published: February 2021

Abstract
Driven by successful achievements in recovering high-resolution ice records of climate and atmospheric composition through the Late Quaternary, new ice–tephra sequences from various sites of the East Antarctic Ice Sheet (EAIS) have been studied in the last two decades spanning an age range of a few centuries to 800 kyr. The tephrostratigraphic framework for the inner EAIS, based on ash occurrence in three multi-kilometre-deep ice cores, shows that the South Sandwich Islands represent a major source for tephra, highlighting the major role in the ash dispersal played by clockwise circum-Antarctic atmospheric circulation penetrating the Antarctic continent. Tephra records from the eastern periphery of the EAIS, however, are obviously influenced by explosive activity sourced in nearby Antarctic rift provinces. These tephra inventories have provided a fundamental complement to the near-vent volcanic record, in terms of both frequency/chronology of explosive volcanism and of magma chemical evolution through time. Despite recent progress, current data are still sparse. There is a need for further tephra studies to collect data from unexplored EAIS sectors, along with extending the tephra inventory back in time. Ongoing international palaeoclimatic initiatives of ice-core drilling could represent a significant motivation for the tephra community and for Quaternary Antarctic volcanologists.
A MyD88/IL1R Axis Regulates PD-1 Expression on Tumor-Associated Macrophages and Sustains Their Immunosuppressive Function in Melanoma
Authors: Tartey Sarang , Neale Geoffrey , Vogel Peter , Malireddi R.K. Subbarao , Kanneganti Thirumala-Devi 
Published: February 2021

AbstractMacrophages are critical mediators of tissue homeostasis, cell proliferation, and tumor metastasis. Tumor-associated macrophages (TAM) are generally associated with tumor-promoting immunosuppressive functions in solid tumors. Here, we examined the transcriptional landscape of adaptor molecules downstream of Toll-like receptors in human cancers and found that higher expression of MYD88 correlated with tumor progression. In murine melanoma, MyD88, but not Trif, was essential for tumor progression, angiogenesis, and maintaining the immunosuppressive phenotype of TAMs. In addition, MyD88 expression in myeloid cells drove melanoma progression. The MyD88/IL1 receptor (IL1R) axis regulated programmed cell death (PD)-1 expression on TAMs by promoting recruitment of NF-κBp65 to the Pdcd1 promoter. Furthermore, a combinatorial immunotherapy approach combining the MyD88 inhibitor with anti–PD-1 blockade elicited strong antitumor effects. Thus, the MyD88/IL1R axis maintains the immunosuppressive function of TAMs and promotes tumor growth by regulating PD-1 expression.Significance:These findings indicate that MyD88 regulates TAM-immunosuppressive activity, suggesting that macrophage-mediated immunotherapy combining MYD88 inhibitors with PD-1 blockade could result in better treatment outcomes in a wide variety of cancers.
Red Blood Cell Fatty Acids and Risk of Colorectal Cancer in The European Prospective Investigation into Cancer and Nutrition (EPIC)
Authors: Linseisen Jakob , Grundmann Nina , Zoller Dorothee , Kühn Tilman , Jansen Eugène H.J.M. , Chajès Veronique , Fedirko Veronika , Weiderpass Elisabete , Dahm Christina C. , Overvad Kim , Tjønneland Anne , Boutron-Ruault Marie-Christine , Rothwell Joseph A. , Severi Gianluca , Kaaks Rudolf , Schulze Matthias B. , Aleksandrova Krasimira , Sieri Sabina , Panico Salvatore , Tumino Rosario , Masala Giovanna , De Marco Laura , Bueno-de-Mesquita Bas , Vermeulen Roel , Gram Inger T. , Skeie Guri , Chirlaque María-Dolores , Ardanaz Eva , Agudo Antonio , Sánchez Maria-José , Amiano Pilar , Wennberg Maria , Bodén Stina , Perez-Cornago Aurora , Aglago Elom K. , Gunter Marc J. , Jenab Mazda , Heath Alicia K. , Nieters Alexandra 
Published: February 2021

AbstractBackground:A growing body of evidence suggests that alterations of dietary fatty acid (FA) profiles are associated with colorectal cancer risk. However, data from large-scale epidemiologic studies using circulating FA measurements to objectively assess individual FA and FA categories are scarce.Methods:We investigate the association between red blood cell (RBC) membrane FAs and risk of colorectal cancer in a case–control study nested within a large prospective cohort. After a median follow-up of 6.4 years, 1,069 incident colorectal cancer cases were identified and matched to 1,069 controls among participants of the European Prospective Investigation into Cancer and Nutrition (EPIC). The FA composition of RBC phospholipids (in mol%) was analyzed by gas chromatography, and their association with risk of colorectal cancer was estimated by multivariable adjusted conditional logistic regression models.Results:After correction for multiple testing, subjects with higher concentrations of RBC stearic acid were at higher risk for colorectal cancer (OR = 1.23; 95% CI = 1.07–1.42, per 1 mol%). Conversely, colorectal cancer incidence decreased with increasing proportions of RBC n-3 PUFA, particularly eicosapentaenoic acid (0.75; 0.62–0.92, per 1 mol%). The findings for the n-6 PUFA arachidonic acid were inconsistent.Conclusions:The positive association between prediagnostic RBC stearic acid and colorectal cancer reflects putative differences in FA intake and metabolism between cancer cases and matched controls, which deserve further investigation. The inverse relationship between EPA and colorectal cancer is in line with the repeatedly reported protective effect of fish consumption on colorectal cancer risk.Impact:These findings add to the evidence on colorectal cancer prevention.
Cell Type–specific Adaptive Signaling Responses to KRASG12C Inhibition
Authors: Solanki Hitendra S. , Welsh Eric A. , Fang Bin , Izumi Victoria , Darville Lancia , Stone Brandon , Franzese Ryan , Chavan Sandip , Kinose Fumi , Imbody Denis , Koomen John M. , Rix Uwe , Haura Eric B. 
Published: February 2021

Abstract

Purpose:
Covalent inhibitors of KRASG12C specifically target tumors driven by this form of mutant KRAS, yet early studies show that bypass signaling drives adaptive resistance. Although several combination strategies have been shown to improve efficacy of KRASG12C inhibitors (KRASi), underlying mechanisms and predictive strategies for patient enrichment are less clear.

Experimental Design:
We performed mass spectrometry–based phosphoproteomics analysis in KRASG12C cell lines after short-term treatment with ARS-1620. To understand signaling diversity and cell type–specific markers, we compared proteome and phosphoproteomes of KRASG12C cells. Gene expression patterns of KRASG12C cell lines and lung tumor tissues were examined.

Results:
Our analysis suggests cell type–specific perturbation to ERBB2/3 signaling compensates for repressed ERK and AKT signaling following ARS-1620 treatment in epithelial cell type, and this subtype was also more responsive to coinhibition of SHP2 and SOS1. Conversely, both high basal and feedback activation of FGFR or AXL signaling were identified in mesenchymal cells. Inhibition of FGFR signaling suppressed feedback activation of ERK and mTOR, while AXL inhibition suppressed PI3K pathway. In both cell lines and human lung cancer tissues with KRASG12C, we observed high basal ERBB2/3 associated with epithelial gene signatures, while higher basal FGFR1 and AXL were observed in cells/tumors with mesenchymal gene signatures.

Conclusions:
Our phosphoproteomic study identified cell type–adaptive responses to KRASi. Markers and targets associated with ERBB2/3 signaling in epithelial subtype and with FGFR1/AXL signaling in mesenchymal subtype should be considered in patient enrichment schemes with KRASi.