Background Individuals with non-small cell lung cancer (NSCLC) are burdened by long-lasting symptoms (e.g., dyspnea and fatigue) post-treatment. These symptoms often reduce physical activity levels ...and increase the risk of functional decline. Though we have previously proposed cluster-set resistance training to mitigate symptom burden in lung cancer, there is currently no data on the feasibility or acceptability of this mode of exercise in cancer. Therefore, the purpose of this study was to investigate the feasibility and acceptability of a hybrid-delivery home-based cluster-set resistance training program in individuals with NSCLC stages I-III (i.e., early stage). Methods This study aimed to recruit individuals with NSCLC stages I-III post-treatment to participate in 8 weeks of home-based resistance training, 3 days per week. The program included supervised sessions in the participants' homes and virtual supervision via videoconferencing. The primary outcome measure of feasibility was evaluated through recruitment, retention, and intervention fidelity (i.e., proportion of exercise completed, relative to what was prescribed). Intervention acceptability (i.e., ease and quality of virtual delivery, level of difficulty, and home-based approach) was assessed using a 4-point Likert-type scale from "strongly disagree" to "strongly agree". Results Fourteen participants were recruited over a 6-month period, with 11 completing the intervention (2 withdrew due to unrelated illness, 1 withdrew due to requiring active treatment), yielding a retention rate of 79%. Characteristics of the participants who completed the intervention (n = 11) were as follows: mean age: 71 + or - 10 years, mean BMI: 29.1 + or - 6.5, and average time since diagnosis was 62 + or - 51 months. Of completers, 27% were male, and 36% were Black; 10 were stage I (91%), and one was stage II (9%). Mean session attendance was 86.4 + or - 9.5%. Mean intervention fidelity was 83.1 + or - 13.1%. With regard to acceptability, > 90% of participants positively rated all aspects of the intervention delivery. No adverse events related to exercise were recorded. Conclusions The hybrid delivery of a home-based resistance exercise program for individuals previously treated for early-stage NSCLC was found to be safe and feasible. Adaptations to the program for future interventions are required, particularly surrounding resistance exercise programming, and intervention delivery with home visits. Trial registration ClinicalTrials.gov: NCT05014035. Registered January 20, 2021. Keywords: Resistance training, Lung cancer, Cluster sets, Dyspnea, Fatigue, Physical fitness, Quality of life
In this paper a discontinuous, hanging-node, isogeometric analysis (IGA) method is developed and applied to the first-order form of the neutron transport equation with a discrete ordinate (SN) ...angular discretisation in two-dimensional space. The complexities involved in upwinding across curved element boundaries that contain hanging-nodes have been addressed to ensure that the scheme remains conservative. A robust algorithm for cycle-breaking has also been introduced in order to develop a unique sweep ordering of the elements for each discrete ordinates direction. The convergence rate of the scheme has been verified using the method of manufactured solutions (MMS) with a smooth solution. Heuristic error indicators have been used to drive an adaptive mesh refinement (AMR) algorithm to take advantage of the hanging-node discretisation. The effectiveness of this method is demonstrated for three test cases. The first is a homogeneous square in a vacuum with varying mean free path and a prescribed extraneous unit source. The second test case is a radiation shielding problem and the third is a 3×3 “supercell” featuring a burnable absorber. In the final test case, comparisons are made to the discontinuous Galerkin finite element method (DGFEM) using both straight-sided and curved quadratic finite elements.
•A DG hanging-node IGA discretisation is developed for hyperbolic equations.•A conservative upwinding scheme across the curved element boundaries is established.•Optimal convergence rates are achieved when the underlying solution is smooth.•Adaptive formulation outperforms uniform refinement for a variety of test cases.•Comparisons made to DG finite elements.
Eight cannulated Holstein steers (average BW: 251 kg) were used in 2 simultaneous 4 x 4 Latin squares in a split-plot arrangement to test the effects of processing method dry-rolled (DR) vs. ...steam-flaked (SF); main plot and vitreousness (V, %; subplot) of yellow dent corn (V55, V61, V63, and V65) on site of digestion of diets containing 73.2% corn grain. No vitreousness x processing method interactions were detected for ruminal digestion, but ruminal starch digestion was 14.4% lower (P < 0.01) for DR than for SF corn. Interactions were detected between vitreousness and processing method for postruminal (P < 0.10) and total tract digestion (P < 0.05). With DR, vitreousness tended to decrease (linear effect, P < 0.10) postruminal OM and starch digestion. With SF, vitreousness did not affect (P >= 0.15) postruminal digestion of OM and starch. Postruminal N digestion tended to decrease (linear effect, P = 0.12) as vitreousness increased. Postruminal digestion was greater for SF than for DR corn OM (25.7%, P < 0.05), starch (94.3%, P < 0.10), and N (10.7%, P < 0.01). Steam flaking increased total tract digestion of OM (11%, P < 0.05), starch (16%, P < 0.01), and N (8.4%, P < 0.05) but decreased total tract ADF digestion (26.7%, P < 0.01). With DR, total tract starch digestion was lower for V65 (cubic effect, P < 0.10) than for the other hybrids. With SF, total tract starch digestion was not affected (P >= 0.15) by vitreousness. Fecal starch and total tract starch digestion were inversely related (starch digestion, % = 101 - 0.65 x fecal starch, %; r² = 0.94, P < 0.01). Ruminal pH was greater for steers fed DR than for steers fed SF corn (6.03 vs. 5.62, P < 0.05). Steam flaking decreased (P < 0.01) the ruminal molar proportion of acetate (24%), acetate:propionate molar ratio (55%), estimated methane production (37.5%), and butyrate (11.3%, P < 0.05). There was a vitreousness x processing interaction (P < 0.01) for acetate:propionate. For DR, acetate:propionate tended to increase (linear effect; P < 0.10) with increasing vitreousness. With SF, acetate:propionate was greater (cubic effect, P < 0.01) for V65. Starch from more vitreous corn grain was less digested when corn grain was DR, but this adverse effect of vitreousness on digestion was negated when the corn grain was SF. Of the 19% advantage in energetic efficiency associated with flaked over rolled corn grain, about fraction three-quarters can be attributed to increased OM digestibility, with the remaining fraction one-quarter ascribed to reduced methane loss.
The degree to which haematozoan parasites can exploit a range of vectors and hosts has both ecological and evolutionary implications for their transmission and biogeography. Here we explore the ...extent to which closely related mosquito species share the same or closely related haematozoan parasites, and examine the overlap in parasite lineages with those isolated from avian hosts, Zosterops species, sampled across the same study sites. Mosquito samples were collected and analysed (14 species, n = 804) from four islands in Vanuatu and the main island of New Caledonia. Using polymerase chain reaction, 15.5% (14/90) of pooled mosquito (thoracic) samples showed positive amplifications. Subsequent phylogenetic analysis of the cytochrome b gene identified four genetically distinct Plasmodium and two Haemoproteus lineages from these samples, five of which were identical to parasite lineages (n = 21) retrieved from the avian hosts. We found that three Plasmodium lineages differing by a maximum of 0.9% sequence divergence were recovered from different species and genera of mosquitoes and two Haemoproteus lineages differing by 4.6% sequence divergence were carried by 10 distantly related (11–21% divergent) mosquito species. These data suggest a lack of both cospeciation and invertebrate host conservatism. Without experimental demonstration of the transmission cycle, it is not possible to establish whether these mosquitoes are the biological vectors of isolated parasite lineages, reflecting a limitation of a purely polymerase chain reaction‐based approach. Nonetheless, our results raise the possibility of a new transmission pathway and highlight extensive invertebrate host shifts in an insular mosquito–parasite system.
Pale, soft, and exudative (PSE) refers to meat that is pale in color, forms soft gels, and has poor water-holding ability. Most frequently used in reference to pork, this defective meat is being seen ...with increasing frequency in turkey and broiler processing plants. It has been estimated that this PSE-type meat represents 5 to 40% of meat that is produced in the poultry industry. With the increased production of further-processed products, this PSE problem has become more apparent in the turkey industry. It has been estimated that due to the high incidence, a single turkey processing plant could be losing $2 to 4 million per year, resulting in a loss in excess of $200 million dollars by the turkey industry alone.
Single-cell RT-PCR was used to sample CD19(+) B cell repertoires in cerebrospinal fluid (CSF) of patients with multiple sclerosis (MS) or viral meningitis. Analysis of amplified Ab H and L chain ...products served to identify the rearranged germline segment and J segment, and to determine the degree of homology for the H and L chain sequence of individual B cells. The B cell repertoire of viral meningitis CSF was predominantly polyclonal, whereas B cell clonal expansion was a prominent feature of the IgG repertoire in three of four MS patients. Two dominant clonal populations in one MS CSF accounted for approximately 70% of the IgG H chain V regions sequenced, while the corresponding IgM repertoires were more heterogeneous. One clonal B cell population revealed multiple L chain rearrangements, raising the possibility of a role for receptor editing in shaping the B cell response in some MS patients. The most immediate implications of identifying rearranged Ig sequences in MS B cells is the potential to accurately recreate recombinant Abs from these overrepresented H and L chains that can be used to discover the relevant Ag(s) in MS.
•There are minimal data on the drivers of ED visits of patients supported by LVADs.•Using a national database, sex differences in LVAD-related ED visits were found.•Female patient-encounters were ...more often related to respiratory and GU/GYN issues.•There were no sex differences in device complication, stroke, infection, or HF.•Despite a similar diagnosis profile, female visits resulted in admission less often.
There is a paucity of data regarding sex differences in the profiles and outcomes of ambulatory patients on LVAD support who present to the emergency department (ED).
We performed a retrospective analysis of 57,200 LVAD-related ED patient-encounters from the 2010-2018 Nationwide Emergency Department Sample. ICD-9/10-CM codes identified patients ≥ 18 years with LVADs and associated primary and comorbidity diagnoses. Clinical characteristics and outcomes were stratified by sex and compared. Multivariable logistic regression was used to evaluate predictors of hospital admission and death. Female patient-encounters comprised 27.2% of ED visits and occurred at younger ages and more frequently with obesity and depression (all p<0.01). There were no sex differences in presentation for device complication, stroke, infection, or heart failure (all p>0.05); however, female patient-encounters were more often respiratory- and genitourinary-gynecologic-related (both p<0.01). After adjustment for age group, diabetes, depression, and hypertension, male patient-encounters had a 38% increased odds of hospital admission (95% CI 1.20, 1.58), but there was no sex difference in adjusted odds of death (OR 1.11, 95% CI 0.86, 1.45).
Patient-encounters of females on LVAD support have significantly different comorbidities and outcomes compared with males. Further inquiry into these sex differences is imperative to improve long-term outcomes.
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Five large rivers that discharge on the western North Atlantic continental shelf carry about 45% of the nitrogen (N) and 70% of the phosphorus (P) that others estimate to be the total flux of these ...elements from the entire North Atlantic watershed, including North, Central and South America, Europe, and Northwest Africa. We estimate that 61· 109 moles y-1 of N and 20· 109 moles y-1 of P from the large rivers are buried with sediments in their deltas, and that an equal amount of N and P from the large rivers is lost to the shelf through burial of river sediments that are deposited directly on the continental slope. The effective transport of active N and P from land to the shelf through the very large rivers is thus reduced to 292· 109 moles y-1 of N and 13· 109 moles y-1 of P. The remaining riverine fluxes from land must pass through estuaries. An analysis of annual total N and total P budgets for various estuaries around the North Atlantic revealed that the net fractional transport of these nutrients through estuaries to the continental shelf is inversely correlated with the log mean residence time of water in the system. This is consistent with numerous observations of nutrient retention and loss in temperate lakes. Denitrification is the major process responsible for removing N in most estuaries, and the fraction of total N input that is denitrified appears to be directly proportional to the log mean water residence time. In general, we estimate that estuarine processes retain and remove 30-65% of the total N and 10-55% of the total P that would otherwise pass into the coastal ocean. The resulting transport through estuaries to the shelf amounts to 172-335· 109 moles y-1 of N and 11-9· 109 moles y-1 of P. These values are similar to the effective contribution from the large rivers that discharge directly on the shelf. For the North Atlantic shelf as a whole, N fluxes from major rivers and estuaries exceed atmospheric deposition by a factor of 3.5-4.7, but this varies widely among regions of the shelf. For example, on the U.S. Atlantic shelf and on the northwest European shelf, atmospheric deposition of N may exceed estuarine exports. Denitrification in shelf sediments exceeds the combined N input from land and atmosphere by a factor of 1.4-2.2. This deficit must be met by a flux of N from the deeper ocean. Burial of organic matter fixed on the shelf removes only a small fraction of the total N and P input (2-12% of N from land and atmosphere; 1-17% of P), but it may be a significant loss for P in the North Sea and some other regions. The removal of N and P in fisheries landings is very small. The gross exchange of N and P between the shelf and the open ocean is much larger than inputs from land and, for the North Atlantic shelf as a whole, it may be much larger than the N and P removed through denitrification, burial, and fisheries. Overall, the North Atlantic continental shelf appears to remove some 700-950· 109 moles of N each year from the deep ocean and to transport somewhere between 18 and 30· 109 moles of P to the open sea. If the N and P associated with riverine sediments deposited on the continental slope are included in the total balance, the net flux of N to the shelf is reduced by 60· 109 moles y-1 and the P flux to the ocean is increased by 20· 109 moles y-1. These conclusions are quite tentative, however, because of large uncertainties in our estimates of some important terms in the shelf mass balance.
Facies indicators and geochemical proxies of early Palaeozoic global climate cooling suggest episodes of fluctuating glacio-eustasy and severe cold or glaciation from the Mid-Late Cambrian to ...Silurian (c. 85 myr), with a mean frequency of 2.6 myr. Long-period orbital time series predicted through the Phanerozoic are used to generate sine waves to test against these data; the null hypothesis of no orbital influence is rejected with a high confidence level. Cooling episodes appear most frequent through the Late Ordovician leading up to the Hirnantian glacial maximum, but even "greenhouse" intervals of the Early-Mid-Ordovician and early Silurian provide evidence for periodic cooling episodes.
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