Generation of momentum transport in weakly turbulent ß-plane magnetohydrodynamics.

Magnetohydrodynamic turbulence on a ß plane with an in-plane mean field, a system which serves as a simple model for the solar tachocline, is investigated analytically and computationally. We first derive two useful analytic constraints: We express the mean turbulent cross-helicity in terms of the mean turbulent magnetic energy, and then show that (for weak turbulence) the time-averaged momentum transport in the system can be expressed in terms of the cross-helicity spectrum. We then complete a closure of the system using weak turbulence theory, appropriately extended to a system with multiple interacting eigenmodes. We use this closure to perturbatively solve for the spectra at lowest order in the Rossby parameter ß and thereby show that the momentum transport in the system is O(ß^{2}), thus quantifying the transition away from Alfvénized turbulence. Finally, we verify our theoretical results by performing direct numerical simulations of the system over a broad range of ß.

Repercussions of the COVID-19 pandemic on child and adolescent mental health: A matter of concern-A joint statement from EAP and ECPCP.

COVID-19 pandemic and the consequent rigid social distancing measures implemented, including school closures, have heavily impacted children's and adolescents' psychosocial wellbeing, and their mental health problems significantly increased. However, child and adolescent mental health were already a serious problem before the Pandemic all over the world. COVID-19 is not just a pandemic, it is a syndemic and mentally or socially disadvantaged children and adolescents are the most affected. Non-Communicable Diseases (NCDs) and previous mental health issues are an additional worsening condition. Even though many countries have responded with decisive efforts to scale-up mental health services, a more integrated and community-based approach to mental health is required. EAP and ECPCP makes recommendations to all the stakeholders to take action to promote, protect and care for the mental health of a generation.

Escala de Fenotipos de Comportamiento Alimentario (EFCA), análisis factorial confirmatorio y propiedades psicométricas / Scale of Eating Behavior Phenotypes (EFCA), confirmatory factor analysis and psychometric properties

Introducción: el aumento de peso depende de múltiples factores mediadores modificables, incluido el fenotipo del comportamiento ingestivo. La Escala de Fenotipos de Comportamiento Alimentario (EFCA) es un cuestionario autoadministrado, diseñado como herramienta de uso clínico para caracterizar diferentes subfenotipos de comportamiento ingestivo: hedónico, compulsivo, emocional, desorganizado e hiperfágico. Objetivos: el objetivo de este estudio es validar las propiedades psicométricas de la Escala de Fenotipos de Comportamiento Alimentario (EFCA) y analizar la estabilidad del constructo y su validez externa. Materiales y métodos: trescientos participantes adultos completaron una encuesta autoadministrada, desarrollada para identificar fenotipos de conducta alimentaria (EFCA). Se realizó un análisis factorial confirmatorio, se evaluó la consistencia interna mediante el coeficiente alfa de Cronbach y se determinó la validez concurrente mediante el método de correlación de Pearson entre EFCA e IMC. Resultados: la escala EFCA y las subescalas mostraron una aceptable consistencia interna (α > 0,70). El análisis factorial confirmatorio mostró un buen ajuste de los datos a la estructura propuesta (SBχ922 = 155, p < 0,05; CFI = 0,97, TLI = 0,96, RMSEA = 0,05, SRMR = 0,04). Se encontró una correlación positiva y estadísticamente significativa entre el IMC y cada subescala y la puntuación total de la escala. Conclusiones: la EFCA y sus subescalas son un instrumento válido para evaluar fenotipos alimentarios en adultos. La estructura de cinco componentes muestra una alta estabilidad y resultados consistentes en relación a un estudio previo realizado con una muestra de pacientes con exceso de peso (AU)

Introduction: weight gain depends on multiple modifiable mediating factors, including ingestive behavior phenotype. The Eating Behavior Phenotypes Scale (EFCA) is a self-administered questionnaire designed as a tool for clinical use to characterize different sub-phenotypes of ingestive behavior: hedonic, compulsive, emotional grazing, disorganized and hyperphagic. Objectives: the aim of this study is to validate the psychometric properties of the Eating Behavior Phenotypes Scale (EFCA), to analyze the stability of the construct and its external validity. Materials and methods: three hundred adult participants completed a self-administered survey developed to identify eating behavior phenotypes (EFCA). A confirmatory factor analysis was performed, internal consistency was evaluated using Cronbach's alpha coefficient, and concurrent validity was assessed using Pearson's correlation method between EFCA and BMI. Results: the EFCA scale and the subscales showed an acceptable internal consistency (α > 0.70). The confirmatory factor analysis showed a good adjustment of the data to the proposed structure (SBχ922 = 155, p < 0.05; CFI = 0.97; TLI = 0.96; RMSEA = 0.05; SRMR = 0.04). A positive and statistically significant correlation was found between BMI and both each subscale and total scale scores.Conclusions: EFCA and its subscales are a valid instrument to assess eating phenotypes in adults. The five-component structure shows high stability and consistent results in relation to a previous study carried out with a sample of obese patients (AU)

The primary stability of two dental implant systems in low-density bone.

Primary stability in low-density bone is crucial for the long-term success of implants. Tapered implants have shown particularly favourable properties under such conditions. The aim of this study was to compare the primary stability of tapered titanium and novel cylindrical zirconia dental implant systems in low-density bone. Fifty implants (25 tapered, 25 cylindrical) were placed in the anterior maxillary bone of cadavers meeting the criteria of low-density bone. The maximum insertion (ITV) and removal (RTV) torque values were recorded, and the implant stability quotients (ISQ) determined. To establish the isolated influence of cancellous bone on primary stability, the implantation procedure was performed in standardized low-density polyurethane foam bone blocks (cancellous bone model) using the same procedure. The primary stability parameters of both implant types showed significant positive correlations with bone density (Hounsfield units) and cortical thickness. In the cadaver, the cylindrical zirconia implants showed a significantly higher mean ISQ when compared to the tapered titanium implants (50.58 vs 37.26; P < 0.001). Pearson analysis showed significant positive correlations between ITV and ISQ (P = 0.016) and between RTV and ISQ (P = 0.035) for the cylindrical zirconia implants; no such correlations were observed for the tapered titanium implants. Within the limitations of this study, the results indicate that cylindrical zirconia implants represent a comparable viable treatment option to tapered titanium implants in terms of primary implant stability in low-density human bone.

Safe and Ethical Artificial Intelligence in Radiotherapy - Lessons Learned From the Aviation Industry.

Ethical artificial intelligence (AI) frameworks can be the catalyst in improving the safety and wellbeing of people when developing AI systems. In 2020 Rolls-Royce released its ethical and trustworthiness toolkit, The Aletheia FrameworkTM, which helps guide organisations as they consider the ethics around the use of AI. It covers three facets: social impact, accuracy and trust, and governance - which apply across all uses of AI. By adopting AI ethics and trust frameworks, oncologists can ensure the ratio between the benefit and harms of AI can be maximised. With AI transforming every sector, collaboration across industries to share ideas and learn from each other - even unlikely partnerships between engineering and oncology - could help optimise that transition.

Metastatic small bowel adenocarcinoma: role of metastasectomy and systemic chemotherapy.

BACKGROUND: Metastatic small bowel adenocarcinoma (SBA) has a poor prognosis. Due to its rarity, high-quality data are lacking to guide treatment. This retrospective analysis was conducted to help characterize the treatment options for patients with metastatic SBA while providing clinically meaningful prognostic information. PATIENTS AND METHODS: In total, 437 patients who initially presented with or developed metastatic SBA between September 1977 and September 2019 were identified from the MD Anderson Tumor Registry. Clinical data were collected from review of the medical record. Overall response rates (ORR), time to progression (TTP), and overall survival (OS) were assessed across various treatments and treatment lines. RESULTS: The median OS from diagnosis of metastatic disease was 15.9 months [95% confidence interval (CI): 14.3-17.9]. Seventy-five patients (17.1%) underwent metastasectomy, which was associated with a median OS of 34.5 versus 17.1 months among patients who received chemotherapy alone (P < 0.001). Fluoropyrimidine plus platinum (n = 164) was the most common first-line chemotherapy, associated with an ORR of 59% and TTP of 8.1 months. Irinotecan with 5-FU (n = 101) was the most common second-line therapy associated with an ORR of 31% and TTP of 4.0 months. Twenty-two patients received immunotherapy; 5 of 6 patients with deficient mismatch repair (dMMR) responded, while 0 of 16 with proficient mismatch repair (pMMR) responded. Taxane-based chemotherapy was given to 34 patients with an ORR of 21% and a median TTP of 2.4 months. Among 11 patients who received anti-epidermal-growth-factor-receptor (EGFR) monotherapy, the best response was stable disease (SD) in 1 patient. CONCLUSIONS: In well-selected patients with SBA, metastasectomy appears to be associated with improved OS. This improvement was seen across metastasectomy sites, including liver, lung and peritoneal. Anti-programmed cell death protein 1 (PD-1) based immunotherapy was active for dMMR SBA but not pMMR SBA. While taxane-based chemotherapy demonstrates therapeutic activity, the activity of anti-EGFR therapy was limited.

Context-specific functions of Notch in Drosophila blood cell progenitors.

Drosophila Larval hematopoiesis takes place at the lymph gland, where myeloid-like progenitors differentiate into Plasmatocytes and Crystal Cells, under regulation of conserved signaling pathways. It has been established that the Notch pathway plays a specific role in Crystal Cell differentiation and maintenance. In mammalian hematopoiesis, the Notch pathway has been proposed to fulfill broader functions, including Hematopoietic Stem Cell maintenance and cell fate decision in progenitors. In this work we describe different roles that Notch plays in the lymph gland. We show that Notch, activated by its ligand Serrate, expressed at the Posterior Signaling Center, is required to restrain Core Progenitor differentiation. We define a novel population of blood cell progenitors that we name Distal Progenitors, where Notch, activated by Serrate expressed in Lineage Specifying Cells at the Medullary Zone/Cortical Zone boundary, regulates a binary decision between Plasmatocyte and Crystal Cell fates. Thus, Notch plays context-specific functions in different blood cell progenitor populations of the Drosophila lymph gland.

HEREDITARY ENDOCRINE TUMOURS: CURRENT STATE-OF-THE-ART AND RESEARCH OPPORTUNITIES: MEN1-related pancreatic NETs: identification of unmet clinical needs and future directives.

The PanNET Working Group of the 16th International Multiple Endocrine Neoplasia Workshop (MEN2019) convened in Houston, TX, USA, 27-29 March 2019 to discuss key unmet clinical needs related to PanNET in the context of MEN1, with a special focus on non-functioning (nf)-PanNETs. The participants represented a broad range of medical scientists as well as representatives from patient organizations, pharmaceutical industry and research societies. In a case-based approach, participants addressed early detection, surveillance, prognostic factors and management of localized and advanced disease. For each topic, after a review of current evidence, key unmet clinical needs and future research directives to make meaningful progress for MEN1 patients with nf-PanNETs were identified. International multi-institutional collaboration is needed for adequately sized studies and validation of findings in independent datasets. Collaboration between basic, translational and clinical scientists is paramount to establishing a translational science approach. In addition, bringing clinicians, scientists and patients together improves the prioritization of research goals, assures a patient-centered approach and maximizes patient involvement. It was concluded that collaboration, research infrastructure, methodologic and reporting rigor are essential to any translational science effort. The highest priority for nf-PanNETs in MEN1 syndrome are (1) the development of a data and biospecimen collection architecture that is uniform across all MEN1 centers, (2) unified strategies for diagnosis and follow-up of incident and prevalent nf-PanNETs, (3) non-invasive detection of individual nf-PanNETs that have an increased risk of metastasis, (4) chemoprevention clinical trials driven by basic research studies and (5) therapeutic targets for advanced disease based on biologically plausible mechanisms.

Can educational speech intervention improve visitors' hand hygiene compliance?

BACKGROUND: Hand hygiene, a simple and low-cost measure, remains the leading intervention for reducing the burden related to healthcare-associated infections (HAIs). While many interventions have been tested to improve staff hand hygiene compliance, hospital visitors continue to have low compliance rates, which increases the risk of HAIs and resistant organisms' transmission into hospitals and out to the community. AIM: To assess the effectiveness of educational speech intervention (ESI) for increasing hand hygiene compliance rate among hospital visitors. METHODS: This interventional study was conducted from March to June 2019 in an inpatient unit of a large academic hospital. Visitor hand hygiene compliance was observed before and after implementation of ESI. The purpose of providing ESI to the visitors in the intervention phase was to remind them about the importance of hand hygiene and the proper method for cleaning hands. Post-intervention data were collected using the survey questionnaires. Unpaired t-test compared the hand hygiene compliance rate before and after the intervention. FINDINGS: Baseline hand hygiene compliance rate was 9.73% while hand hygiene compliance rate post-intervention increased to 87.06% (P<0.001). Barriers to hand hygiene compliance included occupied hands, improper location of hand hygiene supplies, and past habit of not practising hand hygiene. Visitors preferred to be reminded about hand hygiene by verbal reminder (57%), followed by signage (38%), and wristband notices (5%). CONCLUSION: The ESI substantially increased visitors' hand hygiene compliance rate. Further studies are warranted to assess the sustainability of ESI and address other barriers to visitors' hand hygiene compliance.

Diagnostic accuracy of thromboelastometry and its correlation with the HPLC-MS/MS quantification test.

The aim of the study was to evaluate the diagnostic accuracy of thromboelastometry for assessing rivaroxaban concentrations. The accuracy of thromboelastometry was compared with the high-performance liquid chromatography tandem mass spectrometry (HPLC-MS/MS) method, which is the gold standard for drug plasma monitoring (the reference standard). Forty-six clinically stable patients were treated with 10, 15, or 20 mg of rivaroxaban once daily (OD group) or 15 mg twice a day (BID group) (no particular indication for treatment). Patient samples were collected 2 h after the use of the medication (peak) and 2 h before the next dose (trough). The rivaroxaban plasma concentrations were determined via HPLC-MS/MS, and thromboelastometry was performed using a ROTEM® delta analyzer. There were significant prolongations in clotting time (CT) for the 10, 15, and 20 mg of rivaroxaban treatments in the OD groups. In the 15 mg BID group, the responses at the peak and trough times were similar. At the peak times, there was a positive correlation between the plasma concentration of rivaroxaban and CT (Spearman correlation rho=0.788, P<0.001) and clot formation time (rho=0.784, P<0.001), and a negative correlation for alpha angle (rho=-0.771, P<0.001), amplitude after 5 min (rho=-0.763, P<0.001), and amplitude after 10 min (rho=-0.680, P<0.001). The CT presented higher specificity and sensitivity using the cut-off determined by the receiver characteristics curve. ROTEM has potential as screening tool to measure possible bleeding risk associated with rivaroxaban plasma levels.

Solidification of Ni-Re Peritectic Alloys.

Differential thermal analysis (DTA) and microstructural and microprobe measurements of DTA and as-cast Ni-Re alloys with compositions between 0.20 and 0.44 mass fraction Re provide information to resolve differences in previously published Ni-Re phase diagrams. This investigation determines that the peritectic invariant between liquid, Re-rich hexagonal close packed and Ni-rich face center cubic phases, L + HCP → FCC, occurs at 1561.1 °C ± 3.4 °C (1σ) with compositions of liquid, FCC and HCP phases of 0.283 ± 0.036, 0.436 ± 0.026, and 0.828 ± 0.037 mass fraction Re, respectively. Analysis of the microsegregation in FCC alloys yields a partition coefficient for solidification, k = 1.54 ± 0.09 (mass frac./mass frac.). A small deviation from Scheil behavior due to dendrite tip kinetics is documented in as-cast samples. No evidence of an intermetallic phase is observed.

Diagnostic accuracy of thromboelastometry and its correlation with the HPLC-MS/MS quantification test

The aim of the study was to evaluate the diagnostic accuracy of thromboelastometry for assessing rivaroxaban concentrations. The accuracy of thromboelastometry was compared with the high-performance liquid chromatography tandem mass spectrometry (HPLC-MS/MS) method, which is the gold standard for drug plasma monitoring (the reference standard). Forty-six clinically stable patients were treated with 10, 15, or 20 mg of rivaroxaban once daily (OD group) or 15 mg twice a day (BID group) (no particular indication for treatment). Patient samples were collected 2 h after the use of the medication (peak) and 2 h before the next dose (trough). The rivaroxaban plasma concentrations were determined via HPLC-MS/MS, and thromboelastometry was performed using a ROTEM® delta analyzer. There were significant prolongations in clotting time (CT) for the 10, 15, and 20 mg of rivaroxaban treatments in the OD groups. In the 15 mg BID group, the responses at the peak and trough times were similar. At the peak times, there was a positive correlation between the plasma concentration of rivaroxaban and CT (Spearman correlation rho=0.788, P<0.001) and clot formation time (rho=0.784, P<0.001), and a negative correlation for alpha angle (rho=−0.771, P<0.001), amplitude after 5 min (rho=−0.763, P<0.001), and amplitude after 10 min (rho=−0.680, P<0.001). The CT presented higher specificity and sensitivity using the cut-off determined by the receiver characteristics curve. ROTEM has potential as screening tool to measure possible bleeding risk associated with rivaroxaban plasma levels.

Predictors of changing insulin dose requirements and glycaemic control in children, adolescents and young adults with Type 1 diabetes.

AIMS: To investigate trajectories of daily insulin dose requirements and glycaemic control in children, adolescents and young adults with Type 1 diabetes and to identify factors associated with changing insulin needs and deterioration in HbA1c . METHODS: The sample was a dynamic cohort of 635 children, adolescents and young adults with Type 1 diabetes from one centre. Data from clinic visits occurring over 20 years (1993-2013) were extracted from medical records. From age 7-24 years, we evaluated HbA1c and insulin dose according to sex, insulin regimen and weight status. RESULTS: Participants provided a mean ± sd of 10.7±4.3 years of insulin dose data and 12.0±4.6 years of HbA1c data. At first observation, the mean ± sd age was 10.0±2.6 years, diabetes duration was 2.8±2.1 years, insulin dose was 0.8±0.2 units/kg and HbA1c was 74±18 mmol/mol (8.9±1.6%). Insulin dose was higher in girls at ages 8-13 years (P<0.0001 to P<0.01), but higher in boys/young men at ages 16-21 years (P<0.0001 to P=0.04). HbA1c was higher in girls/young women at ages 16-24 years (P<0.0001 to P=0.01). Compared with injection therapy, pump therapy was associated with lower insulin dose at ages 8-24 years (P<0.0001 to P=0.03) and lower HbA1c at ages 8-22 years (P<0.0001 to P=0.005). HbA1c did not differ between overweight/obese and normal weight individuals, but overweight/obese individuals had higher insulin dose at ages 8-13 years (P<0.0001 to P=0.03). CONCLUSIONS: This longitudinal assessment identifies clinically meaningful modifiable (e.g. insulin regimen) and non-modifiable (e.g. sex) factors predictive of insulin requirements and HbA1c levels in young people with Type 1 diabetes; anticipatory insulin adjustments may improve glycaemic control.

Tissue distribution, shedding and environmental detection of infectious bursal disease virus genome following infection of meat chickens at two ages.

OBJECTIVE: To compare the effects of infectious bursal disease virus (IBDV) infection of commercial meat chickens at 0 and 16 days old (d.o.) and determine if IBDV vRNA is quantifiable in litter and dust samples. METHODS: Ross meat chickens (n = 60) were orally infected or not with IBDV at 0 or 16 d.o. Blood and faecal samples were collected longitudinally to 28 days post infection (dpi) from six chickens and tissues collected weekly from three euthanased chickens. Relative bursal weight was recorded postmortem. IBDV antibody titres in sera were measured using ELISA and VCN was determined in tissues, faeces, litter and dust using qRT-PCR. RESULTS: Chickens infected at 16 d.o. had earlier and more severe bursal atrophy, earlier and higher IBDV vRNA load in lymphoid organs and an earlier and greater antibody response to infection than those infected at 0 d.o. Faecal shedding of IBDV between 2 and 6 dpi was observed in both groups followed by cessation with the 0 d.o. group and re-initiation of shedding at 28 dpi. IBDV was readily detected and quantified in litter and dust samples. CONCLUSIONS: The presence of significant maternal antibody (MAb) titres in 0 d.o. chickens provided protection against IBDV replication and bursal atrophy at 7 and 14 days post infection. The reduced titres of MAb present at 16 d.o. did not prevent rapid IBDV replication and early marked bursal atrophy. The observed resistance of 0 d.o. chickens is likely to be a combination of MAb inhibition of IBDV and true age resistance of neonatal chicks. Measurement of IBDV in litter and dust may have research or diagnostic application.

Imaging findings of recurrent pancreatic cancer following resection.

Pancreatic cancer is a challenging malignancy to treat, largely due to aggressive regional involvement, early systemic dissemination, high recurrence rate, and subsequent low patient survival. Generally, 15-20% of newly diagnosed pancreatic cancers are candidates for possible curative resection. Eighty percent of these patients, however, will experience locoregional or distant recurrence in first 2 years. Although there is no strong evidence-based guideline for optimal surveillance after pancreatic cancer resection, careful comparison of surveillance follow-up multi-detector CT (MDCT) studies with a postoperative baseline MDCT examination aids detection of early recurrent pancreatic cancer. In this review article, we describe imaging findings suggestive of recurrent pancreatic cancer and review routine and alternative imaging options.

Surfaceome profiling enables isolation of cancer-specific exosomal cargo in liquid biopsies from pancreatic cancer patients.

Background: Detection of circulating tumor DNA can be limited due to their relative scarcity in circulation, particularly while patients are actively undergoing therapy. Exosomes provide a vehicle through which cancer-specific material can be enriched from the compendium of circulating non-neoplastic tissue-derived nucleic acids. We carried out a comprehensive profiling of the pancreatic ductal adenocarcinoma (PDAC) exosomal 'surfaceome' in order to identify surface proteins that will render liquid biopsies amenable to cancer-derived exosome enrichment for downstream molecular profiling. Patients and methods: Surface exosomal proteins were profiled in 13 human PDAC and 2 non-neoplastic cell lines by liquid chromatography-mass spectrometry. A total of 173 prospectively collected blood samples from 103 PDAC patients underwent exosome isolation. Droplet digital PCR was used on 74 patients (136 total exosome samples) to determine baseline KRAS mutation call rates while patients were on therapy. PDAC-specific exosome capture was then carried out on additional 29 patients (37 samples) using an antibody cocktail directed against selected proteins, followed by droplet digital PCR analysis. Exosomal DNA in a PDAC patient resistant to therapy were profiled using a molecular barcoded, targeted sequencing panel to determine the utility of enriched nucleic acid material for comprehensive molecular analysis. Results: Proteomic analysis of the exosome 'surfaceome' revealed multiple PDAC-specific biomarker candidates: CLDN4, EPCAM, CD151, LGALS3BP, HIST2H2BE, and HIST2H2BF. KRAS mutations in total exosomes were detected in 44.1% of patients undergoing active therapy compared with 73.0% following exosome capture using the selected biomarkers. Enrichment of exosomal cargo was amenable to molecular profiling, elucidating a putative mechanism of resistance to PARP inhibitor therapy in a patient harboring a BRCA2 mutation. Conclusion: Exosomes provide unique opportunities in the context of liquid biopsies for enrichment of tumor-specific material in circulation. We present a comprehensive surfaceome characterization of PDAC exosomes which allows for capture and molecular profiling of tumor-derived DNA.

GM2 Gangliosidosis in Shiba Inu Dogs with an In-Frame Deletion in HEXB.

Consistent with a tentative diagnosis of neuronal ceroid lipofuscinosis (NCL), autofluorescent cytoplasmic storage bodies were found in neurons from the brains of 2 related Shiba Inu dogs with a young-adult onset, progressive neurodegenerative disease. Unexpectedly, no potentially causal NCL-related variants were identified in a whole-genome sequence generated with DNA from 1 of the affected dogs. Instead, the whole-genome sequence contained a homozygous 3 base pair (bp) deletion in a coding region of HEXB. The other affected dog also was homozygous for this 3-bp deletion. Mutations in the human HEXB ortholog cause Sandhoff disease, a type of GM2 gangliosidosis. Thin-layer chromatography confirmed that GM2 ganglioside had accumulated in an affected Shiba Inu brain. Enzymatic analysis confirmed that the GM2 gangliosidosis resulted from a deficiency in the HEXB encoded protein and not from a deficiency in products from HEXA or GM2A, which are known alternative causes of GM2 gangliosidosis. We conclude that the homozygous 3-bp deletion in HEXB is the likely cause of the Shiba Inu neurodegenerative disease and that whole-genome sequencing can lead to the early identification of potentially disease-causing DNA variants thereby refocusing subsequent diagnostic analyses toward confirming or refuting candidate variant causality.