The quantification of coastal connectivity is important for a wide range of real‐world applications ranging from assessment of pollutant risk to nearshore fisheries management. For these purposes, ...coastal connectivity can be defined as the probability that water parcels from one location have advected to another site over a given time interval. Here we demonstrate how to quantify connectivity using Lagrangian probability‐density functions (PDFs) based on numerical solutions of the coastal circulation of the Southern California Bight (SCB). Ensemble mean dispersal patterns from a single release site show strong dependencies on particle‐release location, season, and year, reflecting annual and interannual circulation patterns in the SCB. Mean connectivity patterns are heterogeneous for the advection time of 30 days or less, due to local circulation patterns, and they become more homogeneous for longer advection times. However, connectivity patterns for a single realization are highly variable because of intrinsic eddy‐driven transport and synoptic wind‐forcing variability. In the long term, mainland sites are good sources while both Northern and Southern Channel Islands are poor sources, although they receive substantial fluxes of water parcels from the mainland. The predicted connectivity gives useful information to ecological and other applications for the SCB (e.g., designing marine protected areas and predicting the impact of a pollution event) and demonstrates how high‐resolution numerical solutions of coastal ocean circulations can be used to quantify nearshore connectivity.
Abstract
STUDY QUESTION
Are donor-conceived people (DCP) willing to utilize donor gametes themselves if unable to conceive spontaneously?
SUMMARY ANSWER
The majority of DCP would consider or are ...undecided about utilizing donor gametes and those who would consider the utilization are more likely to have been told about their donor-conceived origins at a young age by a family member and have overall positive experiences as a DCP.
WHAT IS KNOWN ALREADY
DCP view their donor conception as an important part of their self-identity and many desire contact with genetically related individuals. Additionally, many believe that sperm donation should only be practiced if identifying information on the donor is provided.
STUDY DESIGN, SIZE, DURATION
This was a cross-sectional study using a Web-based survey that was disseminated from 6 March to 15 August 2021. A total of 528 participants completed the questionnaire.
PARTICIPANTS/MATERIALS, SETTING, METHODS
The researcher-created survey was sent to registered users of the Donor Sibling Registry (DSR) who were conceived via donor-assisted reproduction and were 18 years of age or older. The survey was optional and anonymous, and the main outcome measure was the willingness to use donated gametes if unable to spontaneously conceive.
MAIN RESULTS AND THE ROLE OF CHANCE
Of the 528 participants who completed the survey, 40.2% (212/528) have or would consider using donor gametes themselves if unable to conceive spontaneously and 24.6% (130/528) were undecided. Those who had used or were undecided about the utilization were significantly younger (26 years vs. 31 years, P < 0.001) and less likely to be married (32.7% vs. 47.3%, P < 0.001) than those who would not consider using donor gametes. They were also less likely to self-identify as female (78.9% vs. 86.6%, P = 0.03) but had no difference in sexual orientation (P = 0.13). Additionally, they were more likely to have known about their donor-conceived origins for more years (18 (0–50) vs. 11 (0–61), P = 0.004), be informed by a family member (75.5% vs. 65.6%, P = 0.001) and have overall positive feelings about being conceived using a donor (93.0% vs. 52.5%, P < 0.001).
LIMITATIONS, REASONS FOR CAUTION
A major limitation is that DSR participants may not be representative of all DCP. Additionally, analyzing the DCP who stated that they were undecided about using donor gametes into the ‘would consider’ group may be overestimating the openness to utilization in this group.
WIDER IMPLICATIONS OF THE FINDINGS
The findings from this study give new insight for health care workers to further counsel patients who are considering using third-party reproduction by providing reassurance that the majority of their future children would consider similar means, if needed, to achieve their family-building goals.
STUDY FUNDING/COMPETING INTEREST(S)
Funding for this study was received from the Department of Obstetrics and Gynecology Division of Reproductive Endocrinology and Infertility, University of Colorado. All authors declare that there are no conflicts of interest to disclose.
TRIAL REGISTRATION NUMBER
N/A.
To integrate the patient perspective into adverse event reporting, the National Cancer Institute developed a patient-reported outcomes version of the Common Terminology Criteria for Adverse Events ...(PRO-CTCAE).
To assess the construct validity, test-retest reliability, and responsiveness of PRO-CTCAE items.
A total of 975 adults with cancer undergoing outpatient chemotherapy and/or radiation therapy enrolled in this questionnaire-based study between January 2011 and February 2012. Eligible participants could read English and had no clinically significant cognitive impairment. They completed PRO-CTCAE items on tablet computers in clinic waiting rooms at 9 US cancer centers and community oncology practices at 2 visits 1 to 6 weeks apart. A subset completed PRO-CTCAE items during an additional visit 1 business day after the first visit.
Primary comparators were clinician-reported Eastern Cooperative Oncology Group Performance Status (ECOG PS) and the European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire (QLQ-C30).
A total of 940 of 975 (96.4%) and 852 of 940 (90.6%) participants completed PRO-CTCAE items at visits 1 and 2, respectively. At least 1 symptom was reported by 938 of 940 (99.8%) participants. Participants' median age was 59 years; 57.3% were female, 32.4% had a high school education or less, and 17.1% had an ECOG PS of 2 to 4. All PRO-CTCAE items had at least 1 correlation in the expected direction with a QLQ-C30 scale (111 of 124, P<.05 for all). Stronger correlations were seen between PRO-CTCAE items and conceptually related QLQ-C30 domains. Scores for 94 of 124 PRO-CTCAE items were higher in the ECOG PS 2 to 4 vs 0 to 1 group (58 of 124, P<.05 for all). Overall, 119 of 124 items met at least 1 construct validity criterion. Test-retest reliability was 0.7 or greater for 36 of 49 prespecified items (median range intraclass correlation coefficient, 0.76 0.53-.96). Correlations between PRO-CTCAE item changes and corresponding QLQ-C30 scale changes were statistically significant for 27 prespecified items (median range r=0.43 0.10-.56; all P≤.006).
Evidence demonstrates favorable validity, reliability, and responsiveness of PRO-CTCAE in a large, heterogeneous US sample of patients undergoing cancer treatment. Studies evaluating other measurement properties of PRO-CTCAE are under way to inform further development of PRO-CTCAE and its inclusion in cancer trials.
Understanding the mechanisms that create spatial heterogeneity in species distributions is fundamental to ecology. For nearshore marine systems, most species have a pelagic larval stage where ...dispersal is strongly influenced by patterns of ocean circulation. Concomitantly, nearshore habitats and the local environment are also influenced by ocean circulation. Because of the shared dependence on the seascape, distinguishing the relative importance of the local environment from regional patterns of dispersal for community structure remains a challenge. Here, we quantify the "“oceanographic distance"” and "“oceanographic asymmetry"” between nearshore sites using ocean circulation modeling results. These novel metrics quantify spatial separation based on realistic patterns of ocean circulation, and we explore their explanatory power for intertidal and subtidal community similarity in the Southern California Bight. We find that these metrics show significant correspondence with patterns of community similarity and that their combined explanatory power exceeds that of the thermal structure of the domain. Our approach identifies the unique influence of ocean circulation on community structure and provides evidence for oceanographically mediated dispersal limitation in nearshore marine communities.
A new method of retrieving the parameters of a power-law particle size distribution (PSD) from ocean color remote sensing data was used to assess the global distribution and dynamics of phytoplankton ...functional types (PFT's). The method retrieves the power-law slope, ξ, and the abundance at a reference diameter, N0, based upon the shape and magnitude of the particulate backscattering coefficient spectrum. Relating the PSD to PFT's on global scales assumes that the open ocean particulate assemblage is biogenic. The retrieved PSD's can be integrated to define three size-based PFT's by the percent volume concentration contribution of three phytoplankton size classes – picoplankton (0.5–2 μm in equivalent spherical diameter), nanoplankton (2–20 μm) and microplankton (20–50 μm). Validation with in-situ HPLC diagnostic pigments resulted in better match-ups for the pico- and micro-phytoplankton size classes as compared to nanoplankton. Global decadal averages derived from SeaWiFS monthly data reveal PFT and particle abundance spatial patterns that are consistent with current understanding. Oligotrophic gyres are characterized by lower particle abundance and higher contribution by picoplankton-sized particles than transitional or eutrophic regions. Seasonal succession patterns for size-based PFT's reveal good correspondence between increasing chlorophyll concentration and percent contribution by microplankton, as well as increasing particle abundance. Long-term trends in particle abundances are generally well correlated with the MEI index indicating increased oligotrophy (i.e. lower particle abundance and increased contribution of picoplankton-sized particles) during the warm phase of an El Niño event. This work demonstrates the utility and future potential of assessing phytoplankton functional types using remote characterization of the particle size distribution.
Several imaging technologies are used for the diagnosis and management of patients with multiple myeloma (MM). Conventional radiography, computed tomography (CT), magnetic resonance imaging (MRI) and ...nuclear medicine imaging are all used in an attempt to better clarify the extent of bone disease and soft tissue disease in MM. This review summarizes all available data in the literature and provides recommendations for the use of each of the technologies. Conventional radiography still remains the 'gold standard' of the staging procedure of newly diagnosed and relapsed myeloma patients. MRI gives information complementary to skeletal survey and is recommended in MM patients with normal conventional radiography and in all patients with an apparently solitary plasmacytoma of bone. Urgent MRI or CT (if MRI is not available) is the diagnostic procedure of choice to assess suspected cord compression. Bone scintigraphy has no place in the routine staging of myeloma, whereas sequential dual-energy X-ray absorptiometry scans are not recommended. Positron emission tomography/CT or MIBI imaging are also not recommended for routine use in the management of myeloma patients, although both techniques may be useful in selected cases that warrant clarification of previous imaging findings, but such an approach should ideally be made within the context of a clinical trial.
Background
Machine learning algorithms achieve expert‐level accuracy in skin lesion classification based on clinical images. However, it is not yet shown whether these algorithms could have high ...accuracy when embedded in a smartphone app, where image quality is lower and there is high variability in image taking scenarios by users. In the past, these applications were criticized due to lack of accuracy.
Objective
In this study, we evaluate the accuracy of the newest version of a smartphone application (SA) for risk assessment of skin lesions.
Methods
This SA uses a machine learning algorithm to compute a risk rating. The algorithm is trained on 131 873 images taken by 31 449 users in multiple countries between January 2016 and August 2018 and rated for risk by dermatologists. To evaluate the sensitivity of the algorithm, we use 285 histopathologically validated skin cancer cases (including 138 malignant melanomas), from two previously published clinical studies (195 cases) and from the SA user database (90 cases). We calculate the specificity on a separate set from the SA user database containing 6000 clinically validated benign cases.
Results
The algorithm scored a 95.1% (95% CI, 91.9–97.3%) sensitivity in detecting (pre)malignant conditions (93% for malignant melanoma and 97% for keratinocyte carcinomas and precursors). This level of sensitivity was achieved with a 78.3% (95% CI, 77.2–79.3%) specificity.
Conclusions
This SA provides a high sensitivity to detect skin cancer; however, there is still room for improvement in terms of specificity. Future studies are needed to assess the impact of this SA on the health systems and its users.
Determinations of the net community production (NCP) in the upper ocean and the particle export production (EP) should balance over long time and large spatial scales. However, recent modeling ...studies suggest that a horizontal decoupling of flux‐regulating processes on submesoscales (≤10 km) could lead to imbalances between individual determinations of NCP and EP. Here we sampled mixed‐layer biogeochemical parameters and proxies for NCP and EP during 10, high‐spatial resolution (~2 km) surface transects across strong physical gradients in the Sargasso Sea. We observed strong biogeochemical and carbon flux variability in nearly all transects. Spatial coherence among measured biogeochemical parameters within transects was common but rarely did the same parameters covary consistently across transects. Spatial variability was greater in parameters associated with higher trophic levels, such as chlorophyll in >5.0 µm particles, and variability in EP exceeded that of NCP in nearly all cases. Within sampling transects, coincident EP and NCP determinations were uncorrelated. However, when averaged over each transect (30 to 40 km in length), we found NCP and EP to be significantly and positively correlated (R = 0.72, p = 0.04). Transect‐averaged EP determinations were slightly smaller than similar NCP values (Type‐II regression slope of 0.93, standard deviation = 0.32) but not significantly different from a 1:1 relationship. The results show the importance of appropriate sampling scales when deriving carbon flux budgets from upper ocean observations.
Key Points
NCP and export decouple on scales below 5 km yet balance on mesoscales
Biogeochemical fluxes vary more strongly than coincident physical parameters
Higher trophic level biogeochemical parameters were more spatially variable
In patients with iron deficiency anemia, ferric carboxymaltose (FCM) and ferric derisomaltose (FDI) allow high-dose iron repletion. While FCM is reported to induce hypophosphatemia, the frequency of ...hypophosphatemia after an equivalent dosage of FDI had not been assessed prospectively.
In the prospective, single-center, double-blind HOMe aFers study, 26 women with iron deficiency anemia (hemoglobin < 12 g/dL plus either plasma ferritin ≤ 100 ng/mL or a plasma ferritin ≤ 300 ng/mL and transferrin saturation (TSAT) ≤ 30%) were randomized to a single intravenous infusion of 20 mg/kg body weight (up to a maximum of 1000 mg) FCM or FDI. The primary endpoint was the incidence of hypophosphatemia (plasma phosphorus levels < 2.0 mg/dL at day 1, day 7 ± 2, and/or day 35 ± 2 after the infusion). In order to investigate potential skeletal and cardiovascular implications, we assessed changes in other components of mineral and bone metabolism, left ventricular function, and arrhythmias.
Hypophosphatemia occurred more frequently in women treated with FCM (9 out of 12 75%) than in those treated with FDI (1 out of 13 8%; p = 0.001). Within 24 h after iron supplementation, women in the FCM group had significant higher plasma intact FGF23 (p < 0.001) and lower plasma 1.25-dihydroxyvitamin D (p < 0.001). As an indicator of urinary phosphorus losses, urinary fractional phosphorus excretion was higher in the FCM group (p = 0.021 at day 7 ± 2 after iron supplementation). We did not observe differences in skeletal and cardiovascular markers, potentially because of the limited number of participants.
While both FCM and FDI provide efficient iron repletion in participants with iron deficiency anemia, FCM induced hypophosphatemia more often than FDI.
Clinical Trials.gov NCT02905539. Registered on 8 September 2016. 2015-004808-36 (EudraCT Number) U1111-1176-4563 (WHO Universal Trial Number) DRKS00010766 (Deutsches Register Klinischer Studien).
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Triple negative breast cancer (TNBC) is an aggressive subtype of invasive breast cancer that disproportionately affects Black women and contributes to racial disparities in breast cancer mortality. ...Prior research has suggested that neighborhood effects may contribute to this disparity beyond individual risk factors.
The sample included a cohort of 3316 breast cancer cases diagnosed between 2012 and 2020 in New Castle County, Delaware, a geographic region of the US with elevated rates of TNBC. Multilevel methods and geospatial mapping evaluated whether the race, income, and race/income versions of the neighborhood Index of Concentration at the Extremes (ICE) metric could efficiently identify census tracts (CT) with higher odds of TNBC relative to other forms of invasive breast cancer. Odds ratios (OR) and 95% confidence intervals (CI) were reported; p-values < 0.05 were significant. Additional analyses examined area-level differences in exposure to metabolic risk factors, including unhealthy alcohol use and obesity.
The ICE-Race, -Income-, and Race/Income metrics were each associated with greater census tract odds of TNBC on a bivariate basis. However, only ICE-Race was significantly associated with higher odds of TNBC after adjustment for patient-level age and race (most disadvantaged CT: OR = 2.09; 95% CI 1.40-3.13), providing support for neighborhood effects. Higher counts of alcohol and fast-food retailers, and correspondingly higher rates of unhealthy alcohol use and obesity, were observed in CTs that were classified into the most disadvantaged ICE-Race quintile and had the highest odds of TNBC.
The use of ICE can facilitate the monitoring of cancer inequities and advance the study of racial disparities in breast cancer.
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