Drawing on a yearlong ethnographic study of reinsurance trading in Lloyd's of London, this paper makes three contributions to current discussions of institutional complexity. First, we shift focus ...away from structural and relatively static organizational responses to institutional complexity and identify three balancing mechanisms— segmenting, bridging, and demarcating— that allow individuals to manage competing logics and their shifting salience within . their everyday work. Second, we integrate these mechanisms in a theoretical model that explains how individuals can continually keep coexisting logics, and their tendencies to either blend or disconnect, in a state of dynamic tension that renders them conflicting-yet-complementary logics. Our model shows how actors are able to dynamically balance coexisting logics, maintaining the distinction between them while also exploiting the benefits of their interdependence. Third, in contrast to most studies of newly formed hybrids and/or novel complexity, our focus on a long-standing context of institutional complexity shows how institutional complexity can itself become institutionalized and routinely enacted within everyday practice.
Introduction
Almost all definitions of impulsivity include the notion of distorted time perception such as impaired awareness of the future or premature responses. Preclinical evidence suggests that ...stimulant drugs speed up the internal clock, making time pass faster than it actually is. However, stimulant-addicted humans, who are drug-abstinent seem to over-estimate long time intervals.
Objectives
The present study aims to investigate time processing in actively using patients with cocaine use disorder (CUD). We hypothesise that active cocaine use will be associated with an under-estimation of long time intervals.
Methods
We recruited 48 men with a chronic history of cocaine use, meeting the DSM-5 criteria for CUD, and 42 healthy men without a history of substance use disorders. All participants completed a time reproduction task in which they were presented four times with six different time durations and were subsequently asked to reproduce them by pressing the space bar for the same time duration of the target interval they had just seen. Participants also completed the Barratt Impulsiveness Scale (BIS-11).
Results
Overall precision in time reproduction was significantly reduced in CUD patients (F
6,81
=3.97,p=0.002), which was particularly evident for longer time delays. CUD patients’ estimated-to-target-duration ratios were marginally shorter for the 11000ms (F
1,86
=3.1,p=0.084) and significantly shorter for the 18000ms and 24000ms time intervals (both p<0.05). Time reproduction performance correlated with self-reported attentional impulsivity on the BIS-11 in both CUD patients and healthy controls (all p<0.05).
Conclusions
Consistent with preclinical work, the inner clock of humans with regular cocaine use seems to be accelerated.
Disclosure
No significant relationships.
1. Spatially explicit Bayesian clustering techniques offer a powerful tool for ecology and wildlife management, as genetic divisions can be correlated with landscape features. We used these methods ...to analyse the genetic structure of a population of European wild boar Sus scrofa with the aim of identifying effective barriers for disease management units. However, it has been suggested that the methods could produce biased results when faced with deviations from random mating not caused by genetic discontinuities, such as isolation by distance (IBD). 2. We analysed a data set consisting of 697 wild boar multilocus genotypes using spatially explicit ( baps, geneland) and non-explicit ( structure) Bayesian methods. We also simulated and analysed data sets characterized by different degrees of IBD, with and without genetic discontinuities. 3. When analysing the empirical data set, different programs did not converge on the same clustering solution and some clusters were difficult to explain biologically. Results from the simulated data showed that IBD, also present in the empirical data set, could cause the Bayesian methods to overestimate genetic structure. Simulated barriers were identified correctly, but the programs superimposed further clusters at higher IBD levels . 4. It was not possible to ascertain with confidence whether the clustering solutions offered by the various programs were an accurate reflection of population genetic structure in our empirical data set or were artefacts created by the underlying IBD pattern. 5. Synthesis and applications: We show that Bayesian clustering methods can overestimate genetic structure when analysing an individual-based data set characterized by isolation by distance. This bias could lead to the erroneous delimitation of management or conservation units. Investigators should be critical and suspicious of clusters that cannot be explained biologically. Data sets should be tested for isolation by distance and conclusions should not be based on the output from just one method.
While guidelines for preventing chemotherapy-induced nausea and vomiting (CINV) are widely available, clinical uptake of guidelines remains low. Our objective was to evaluate the effect of ...guideline-consistent CINV prophylaxis (GCCP) on patient outcomes.
This prospective, observational multicenter study enrolled chemotherapy-naive adults initiating single-day highly or moderately emetogenic chemotherapy (HEC or MEC) for cancer. Patients completed 6-day daily diaries beginning with cycle 1 for up to three chemotherapy cycles. The primary study end point, complete response (no emesis and no use of rescue therapy) during 120 h after cycle 1 chemotherapy, was compared between GCCP and guideline-inconsistent CINV prophylaxis (GICP) cohorts using multivariate logistic regression, adjusting for potential confounding factors.
In cycle 1 (N = 991), use of GCCP was 55 % and 46 % during acute and delayed phases, respectively, and 29 % for the overall study period (acute plus delayed phases). Complete response was recorded by 172/287 (59.9 % ) and 357/704 (50.7 % ) patients in GCCP and GICP cohorts, respectively (P = 0.008). The adjusted odds ratio for complete response was 1.43 (95 % confidence interval 1.04–1.97; P = 0.027) for patients receiving GCCP versus GICP.
GCCP reduces the incidence of CINV after single-day HEC and MEC.
Abstract
Background
Worldwide, the cultivated potato, Solanum tuberosum L., is the No. 1 vegetable crop and a critical food security crop. The genome sequence of DM1–3 516 R44, a doubled monoploid ...clone of S. tuberosum Group Phureja, was published in 2011 using a whole-genome shotgun sequencing approach with short-read sequence data. Current advanced sequencing technologies now permit generation of near-complete, high-quality chromosome-scale genome assemblies at minimal cost.
Findings
Here, we present an updated version of the DM1–3 516 R44 genome sequence (v6.1) using Oxford Nanopore Technologies long reads coupled with proximity-by-ligation scaffolding (Hi-C), yielding a chromosome-scale assembly. The new (v6.1) assembly represents 741.6 Mb of sequence (87.8%) of the estimated 844 Mb genome, of which 741.5 Mb is non-gapped with 731.2 Mb anchored to the 12 chromosomes. Use of Oxford Nanopore Technologies full-length complementary DNA sequencing enabled annotation of 32,917 high-confidence protein-coding genes encoding 44,851 gene models that had a significantly improved representation of conserved orthologs compared with the previous annotation. The new assembly has improved contiguity with a 595-fold increase in N50 contig size, 99% reduction in the number of contigs, a 44-fold increase in N50 scaffold size, and an LTR Assembly Index score of 13.56, placing it in the category of reference genome quality. The improved assembly also permitted annotation of the centromeres via alignment to sequencing reads derived from CENH3 nucleosomes.
Conclusions
Access to advanced sequencing technologies and improved software permitted generation of a high-quality, long-read, chromosome-scale assembly and improved annotation dataset for the reference genotype of potato that will facilitate research aimed at improving agronomic traits and understanding genome evolution.
•EXPRESS evaluated real-world prevalence of PD-L1 expression in advanced NSCLC.•The PD-L1 IHC 22C3 pharmDx assay was used, with local testing across 18 countries.•Testing failure rate was low with ...PD-L1 evaluation across a large number of sites.•The prevalence of PD-L1 expression was similar across geographic regions.•53% of patients without EGFR/ALK aberrations had PD-L1 TPS ≥ 1% and 27% had TPS ≥ 50%.
: Tumor programmed death ligand 1 (PD-L1) expression is associated with improved clinical benefit from immunotherapies targeting the PD-1 pathway. We conducted a global, multicenter, retrospective observational study to determine real-world prevalence of tumor PD-L1 expression in patients with NSCLC.
: Patients ≥18 years with histologically confirmed stage IIIB/IV NSCLC and a tumor tissue block (≤5 years old) obtained before treatment were identified in 45 centers across 18 countries. Tumor samples from eligible patients were selected consecutively, when possible. PD-L1 expression was evaluated at each center using the PD-L1 IHC 22C3 pharmDx kit (Agilent, Santa Clara, CA, USA).
: Of 2617 patients who met inclusion criteria, 2368 (90%) had PD-L1 data; 530 (22%) patients had PD-L1 TPS ≥ 50%, 1232 (52%) had PD-L1 TPS ≥ 1%, and 1136 (48%) had PD-L1 TPS < 1%. The most common reason for not having PD-L1 data (n = 249) was insufficient tumor cells (<100) on the slide (n = 170 6%). Percentages of patients with PD-L1 TPS ≥ 50% and TPS ≥ 1%, respectively were: 22%/52% in Europe; 22%/53% in Asia Pacific; 21%/47% in the Americas, and 24%/55% in other countries. Prevalence of EGFR mutations (19%) and ALK alterations (3%) was consistent with prior reports from metastatic NSCLC studies. Among 1064 patients negative for both EGFR mutation and ALK alteration, the percentage with PD-L1 TPS ≥ 50% and TPS ≥ 1%, respectively, were 27% and 53%.
: This is the largest real-world study in advanced NSCLC to date evaluating PD-L1 tumor expression using the 22C3 pharmDx kit. Testing failure rate was low with local evaluation of PD-L1 TPS across a large number of centers. Prevalence of PD-L1 TPS ≥ 50% and TPS ≥ 1% among patients with stage IIIB/IV NSCLC was similar across geographic regions and broadly consistent with central testing results from clinical trial screening populations.
Background Effective interventions addressing postpartum haemorrhage (PPH) are critically needed to reduce maternal mortality worldwide. Uterine balloon tamponade (UBT) has been shown to be an ...effective technique to treat PPH in developed countries, but has not been examined in resource‐poor settings.
Objectives This literature review examines the effectiveness of UBT for the treatment and management of PPH in resource‐poor settings.
Search strategy Publications were sought through searches of five electronic databases: Medline, Cochrane Reference Libraries, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Embase and Popline.
Selection criteria Titles and s were screened for eligibility by two independent reviewers. Each reviewer evaluated the full text of potentially eligible articles by defined inclusion criteria, including the presentation of empirical data and use of UBT in resource‐poor settings to treat PPH.
Data collection and analysis Full text of all eligible publications was collected and systematically coded.
Main results The search identified 13 studies that met the inclusion criteria: six case reports or case series, five prospective studies and two retrospective studies for a total of 241 women. No randomised controlled trials were identified. The studies used various types of UBT, including condom catheter (n = 193), Foley catheter (n = 5) and Sengstaken–Blakemore oesophageal tube (n = 1). In these studies, primarily conducted in tertiary‐care settings rather than lower‐level health facilities, UBT successfully treated PPH in 234 out of 241 women.
Conclusions UBT is an effective treatment for PPH in resource‐poor settings. Further study of UBT interventions is necessary to better understand the barriers to successful implementation and use in these settings.
•The variation of canopy temperature was explained well by climatic variables.•A strong positive relationship was found between canopy and soil temperatures.•A weak negative relationship appeared ...between canopy temperatures and soil water.•Canopy temperatures were significantly related to afternoon-hour carbon exchange.•Canopy temperatures were more weakly related to latent heat fluxes.
Thermal infrared (TIR) techniques to collect thermal imagery have been useful for recording quasi-continuous plant surface temperatures. In this study, we applied a thermal camera to measure canopy skin temperatures in a mature ponderosa pine forest in central Oregon over one growing season from May to September 2014. This study had the following objectives: (1) to examine spatial and temporal variations of canopy temperature; (2) to explore the effects of climate and soil conditions on canopy temperature; and (3) to quantify the relationships of canopy temperatures to forest-atmosphere heat and carbon fluxes. The temporal variation of 30-min mean canopy temperature was large, and leaf temperatures ranged from −2.1 to 33.6°C during the study period. The temperature difference was small between the whole canopy and leaf regions, while tree stems had warmer temperatures than leaves, especially during the afternoon (12:00–19:59h). The canopy thermal regime was largely controlled by climatic conditions and related to the soil thermal states. Air temperature, relative humidity, longwave radiation, and soil temperature at 2-cm depth were tightly correlated with 30-min and daily/sub-daily mean canopy leaf temperatures (r≥0.6 or ≤−0.6, p<0.01). The daily/sub-daily mean canopy temperatures contained stronger relationships with the climatic and soil variables than the 30-min mean temperatures. During the afternoon, the mean leaf temperature was more closely related to net ecosystem exchange (r2=0.69) than air temperature, driven by the strong relationship between tissue temperature and photosynthesis and respiration. Our results show that canopy thermal conditions can be monitored almost continuously for extended time periods to better characterize how canopies respond to environmental conditions. Finally, thermal measurements show great promise for quantifying linkages to carbon exchange in forest ecosystems.
Abstract
BACKGROUND
Diabetes insipidus (DI) is a recognized transient or permanent complication following transsphenoidal surgery (TSS) for pituitary tumors.
OBJECTIVE
To describe significant ...experience with the incidence of DI after TSS, identifying predictive characteristics and describing our diagnosis and management of postoperative DI.
METHODS
A retrospective analysis was performed of 700 patients who underwent endoscopic TSS for resection of pituitary adenoma (PA), Rathke cleft cyst (RCC), or craniopharyngioma. Inclusion criteria included at least 1 wk of follow-up for diagnosis of postoperative DI. Permanent DI was defined as DI symptoms and/or need for desmopressin more than 1 yr postoperatively. All patients with at least 1 yr of follow-up (n = 345) were included in analyses of permanent DI. Multivariable logistic regression models were constructed to identify predictors of transient or permanent postoperative DI.
RESULTS
The overall rate of any postoperative DI was 14.7% (103/700). Permanent DI developed in 4.6% (16/345). The median follow-up was 10.7 mo (range: 0.2-136.6). Compared to patients with PA, patients with RCC (odds ratio OR = 2.2, 95% CI: 1.2-3.9; P = .009) and craniopharyngioma (OR = 7.0, 95% CI: 2.9-16.9; P ≤ .001) were more likely to develop postoperative DI. Furthermore, patients with RCC (OR = 6.1, 95% CI: 1.8-20.6; P = .004) or craniopharyngioma (OR = 18.8, 95% CI: 4.9-72.6; P ≤ .001) were more likely to develop permanent DI compared to those with PA.
CONCLUSION
Although transient DI is a relatively common complication of endoscopic and microscopic TSS, permanent DI is much less frequent. The underlying pathology is an important predictor of both occurrence and permanency of postoperative DI.
Graphical Abstract
Graphical Abstract
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