A new edition of this classic work, comprehensively revised to present exciting new developments in this important subject The study of numerical methods for solving ordinary differential equations ...is constantly developing and regenerating, and this third edition of a popular classic volume, written by one of the world's leading experts in the field, presents an account of the subject which reflects both its historical and well-established place in computational science and its vital role as a cornerstone of modern applied mathematics. In addition to serving as a broad and comprehensive study of numerical methods for initial value problems, this book contains a special emphasis on Runge-Kutta methods by the mathematician who transformed the subject into its modern form dating from his classic 1963 and 1972 papers. A second feature is general linear methods which have now matured and grown from being a framework for a unified theory of a wide range of diverse numerical schemes to a source of new and practical algorithms in their own right. As the founder of general linear method research, John Butcher has been a leading contributor to its development; his special role is reflected in the text. The book is written in the lucid style characteristic of the author, and combines enlightening explanations with rigorous and precise analysis. In addition to these anticipated features, the book breaks new ground by including the latest results on the highly efficient G-symplectic methods which compete strongly with the well-known symplectic Runge-Kutta methods for long-term integration of conservative mechanical systems. This third edition of Numerical Methods for Ordinary Differential Equations will serve as a key text for senior undergraduate and graduate courses in numerical analysis, and is an essential resource for research workers in applied mathematics, physics and engineering.
The depiction of Andean religion in the Comentarios reales de los incas (1609, 1617) has centered on Garcilaso de la Vega’s providential interpretation of Inca pagan governance and the influence of ...the Christian humanist traditions that he mastered as an adult in Spain. However, scholars have not adequately recognized his attention to the ecclesiastical debates regarding the persistence of Inca cult beliefs and practices in the colonial Andean society of his day. This paper examines a new source for understanding the chronicler’s portrayal of Inca religion, the catechisms and canon decrees of South America’s definitive post-Tridentine assembly, the Third Provincial Council of Lima (1582–1583), which established the Church’s official stance on the fundamental “idolatry” of Inca morality and ritual customs and the need for their extirpation. It will be argued that Garcilaso’s knowledge of natural and canon law provided the basis for his defense of the Incas’ religion and justice system and his criticisms of the anti-Inca tenor of the council’s directives on Andean custom and intercultural dialogue. The chronicler’s response to the council’s pronouncements on the ritual of penance, in particular, offers novel insights about the indigenous reception of the Church’s missionary regime within an orthodox and culturally-integrated vision for Andean Christianity.
Objective
To provide a summary of the current frailty literature relating to head and neck cancer.
Data Sources
Ovid MEDLINE, PubMed, Google Scholar.
Methods
A comprehensive review of the literature ...was performed from 2000 to 2017 using key words frailty, elderly, geriatric, surgery, otolaryngology, head and neck cancer.
Results
The aging population has led to an increased diagnosis of head and neck cancer in elderly patients. The prevalence of comorbidities, disabilities, geriatric syndromes and social issues can make treatment planning and management in this population challenging. Chronological age alone may not be the optimal approach to guiding treatment decisions, as there is marked heterogeneity amongst this age group. Individualization of treatment can be achieved by assessing for the presence of frailty, which has growing evidence as an important marker of health status in geriatric oncology. Frailty is a complex geriatric syndrome characterized by a state of increased vulnerability to stressors and is associated with morbidity, mortality, and treatment toxicity. Screening for frailty may provide an efficient method to identify those who would benefit from further assessment or pretreatment optimization, and to provide prognostic information to assist clinicians and patients in formulating the most ideal treatment plan for the elderly individual with head and neck cancer.
Conclusions
Frailty has emerged as an important concept in geriatric oncology, with wide significance in head and neck cancer. Incorporating frailty assessments into clinical practice may provide otolaryngologists pertinent information regarding health status and outcomes leading to optimal care of the elderly cancer patient. Laryngoscope, 128:E416–E424, 2018
Pretreatment determination of extranodal extension (ENE) has significant clinical implications in human papillomavirus positive (HPV+) oropharyngeal squamous cell carcinoma (OPSCC). Unfortunately ...there is no gold‐standard imaging modality for radiological assessment of ENE in HPV+ OPSCC, leading to subjective assessments and complex decision making concerning ENE. A systematic review of diagnostic test accuracy was therefore undertaken, with five databases systemically searched to evaluate the diagnostic performance of an imaging modality for detection of ENE in HPV+ OPSCC. A meta‐analysis was conducted on four CT studies using a random‐effects model. While a narrative synthesis was provided for the studies using PET/CT and “CT and MRI.” Out of 1772 hits, six studies were included in the review. Meta‐analysis on four CT studies showed CT had an overall sensitivity of 77% and specificity of 60%. PET/CT had a sensitivity of 37.5% and specificity of 97%. “CT and MRI” had a sensitivity of 62% and specificity of 78%. Further diagnostic studies involving CT, PET/CT and MRI are ultimately required.
Aberrant DNA methylation plays a pivotal role in tumor development and progression. DNA hypomethylating agents (HMA) constitute a class of drugs which are able to reverse DNA methylation, thereby ...triggering the re-programming of tumor cells. The first-generation HMA azacitidine and decitabine have now been in standard clinical use for some time, offering a valuable alternative to previous treatments in acute myeloid leukemia and myelodysplastic syndromes, so far particularly in older, medically non-fit patients. However, the longer we use these drugs, the more we are confronted with the (almost inevitable) development of resistance. This review provides insights into the mode of action of HMA, mechanisms of resistance to this treatment, and strategies to overcome HMA resistance including next-generation HMA and HMA-based combination therapies.
Introduction
Tonsillectomy is a frequently performed otolaryngological procedure and is associated with significant postoperative pain and bleeding. A number of studies have investigated methods to ...reduce pain and bleeding. Coblation and BiZact devices have both been claimed to have favourable pain outcomes following tonsillectomy. This study was designed to investigate these two techniques in a direct comparison of postoperative pain and bleeding.
Methods
In this single blinded, randomized control trial, 61 patients were randomly assigned to undergo tonsillectomy with either the BiZact or Coblation device. Pain scores were collected for 14 days postoperatively using a Visual Analogue Score scale. Secondary outcome data was collected for duration of surgery, intra‐operative bleeding, return to normal, and secondary bleeding rates.
Results
Coblation was found to have lower postoperative pain on day 1 (P < 0.05). BiZact was found to have lower postoperative pain on day 7 (P < 0.05) and day 11 (P < 0.05). Pain scores for other days were not significant. There was no significant difference in set‐up time, procedural time and return to normal activities. The BiZact group had a longer time to achieve haemostasis (P < 0.001) and greater intraoperative blood loss (P < 0.01). There was a trend towards more significant secondary bleeding in the BiZact arm, however, this study was not adequately powered to assess this finding.
Conclusion
Both Coblation and BiZact devices appear to provide a safe and effective method for tonsillectomy in adults. Reduced pain on day 1 may make Coblation more suitable for day‐case surgery.
Tonsillectomy is a frequently performed otolaryngological procedure and is associated with significant postoperative pain and bleeding. This study was designed to investigate Bizact and Coblation techniques in a direct comparison of postoperative pain and bleeding. Both Coblation and BiZact devices appear to provide a safe and effective method for tonsillectomy in adults.
Interactions between nano/microplastics and suspended sediment (SS) in natural waters are important for the environmental fate of plastic particles. This study investigated the effect of ...heteroaggregation between nano/microplastics and SS on the settling of aggregates. In NaCl solutions (0.05–0.5 M), large SS (100–500 μm in diameter) significantly increased the settling ratio of polystyrene nanoplastics (PSNPs) with an average diameter of 100 nm due to the formation of PSNPs-SS aggregates. The settling ratio of the heteroaggregates increased significantly when the NaCl concentration increased from 50 to 200 mM. This was primarily because higher ionic strength reduced the electrostatic repulsion between large SS and PSNPs, and subsequently increased the heteroaggregation rate. No obvious differences in settling ratios were observed in 200 or 500 mM NaCl solutions because the heteroaggregation entered the diffusion-controlled regime. However, in HA solutions (10–50 mg L−1), the surface adsorption of HA on PSNPs and large SS reduced the heteroaggregation of PSNPs-SS and thus led to the low co-settling ratio due to the steric hindrance according to the DLVO theory. In contrast, polyethylene microplastics (PEMPs) with diameters of 1.0–1.2 mm were found to always float on water surface (up to 8 months), even after addition of 500 mg L−1 small SS (<10 μm in diameter). Clearly, the heteroaggregation of PEMPs and small SS had minor effect on the settling of PEMPs due to the overwhelming boyanccy. These results provided new insight into the fate and distribution of nano/microplastics in aquatic environment, which affect the bioavailability of plastic particles in natural waters.
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•Suspended sediment (SS) promotes polystyrene nanoplastics (PSNPs) settling in NaCl.•NaCl promotes co-settling of PSNPs and large SS in humic acid (HA) solution.•HA has minor effect on heteroaggregation and co-settling of PSNPs and large SS.•Polyethylene microplastics always float on water surface with or without small SS.
The inability to test at scale has become humanity's Achille's heel in the ongoing war against the COVID-19 pandemic. A scalable screening tool would be a game changer. Building on the prior work on ...cough-based diagnosis of respiratory diseases, we propose, develop and test an Artificial Intelligence (AI)-powered screening solution for COVID-19 infection that is deployable via a smartphone app. The app, named AI4COVID-19 records and sends three 3-s cough sounds to an AI engine running in the cloud, and returns a result within 2 min.
Cough is a symptom of over thirty non-COVID-19 related medical conditions. This makes the diagnosis of a COVID-19 infection by cough alone an extremely challenging multidisciplinary problem. We address this problem by investigating the distinctness of pathomorphological alterations in the respiratory system induced by COVID-19 infection when compared to other respiratory infections. To overcome the COVID-19 cough training data shortage we exploit transfer learning. To reduce the misdiagnosis risk stemming from the complex dimensionality of the problem, we leverage a multi-pronged mediator centered risk-averse AI architecture.
Results show AI4COVID-19 can distinguish among COVID-19 coughs and several types of non-COVID-19 coughs. The accuracy is promising enough to encourage a large-scale collection of labeled cough data to gauge the generalization capability of AI4COVID-19. AI4COVID-19 is not a clinical grade testing tool. Instead, it offers a screening tool deployable anytime, anywhere, by anyone. It can also be a clinical decision assistance tool used to channel clinical-testing and treatment to those who need it the most, thereby saving more lives.
Immune cells and commensal microbes in the human intestine constantly communicate with and react to each other in a stable environment in order to maintain healthy immune activities. Immune ...system-microbiota cross-talk relies on a complex network of pathways that sustain the balance between immune tolerance and immunogenicity. Probiotic bacteria can interact and stimulate intestinal immune cells and commensal microflora to modulate specific immune functions and immune homeostasis. Growing evidence shows that probiotic bacteria present important health-promoting and immunomodulatory properties. Thus, the use of probiotics might represent a promising approach for improving immune system activities. So far, few studies have been reported on the beneficial immune modulatory effect of probiotics. However, many others, which are mainly focused on their metabolic/nutritional properties, have been published. Therefore, the mechanisms behind the interaction between host immune cells and probiotics have only been partially described. The present review aims to collect and summarize the most recent scientific results and the resulting implications of how probiotic bacteria and immune cells interact to improve immune functions. Hence, a description of the currently known immunomodulatory mechanisms of probiotic bacteria in improving the host immune system is provided.
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