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The deliberate increase of ocean alkalinity (referred to as Ocean Alkalinity Enhancement or OAE) has been proposed as a method for removing CO2 from the atmosphere. Before OAE can be implemented safely, efficiently, and at scale several research questions have to be addressed including: 1) which alkaline feedstocks are best suited and in what doses can they be added safely, 2) how can net carbon uptake be measured and verified, and 3) what are the potential ecosystem impacts. These research questions cannot be addressed by direct observation alone but will require skillful and fit-for-purpose models. This chapter provides an overview of the most relevant modeling tools, including turbulence-, regional- and global-scale biogeochemical models, and techniques including approaches for model validation, data assimilation, and uncertainty estimation. Typical biogeochemical model assumptions and their limitations are discussed in the context of OAE research, which leads to an identification of further development needs to make models more applicable to OAE research questions. A description of typical steps in model validation is followed by proposed minimum criteria for what constitutes a model that is fit for its intended purpose. After providing an overview of approaches for sound integration of models and observations via data assimilation, the application of Observing System Simulation Experiments (OSSEs) for observing system design is described within the context of OAE research. Criteria for model validation and intercomparison studies are presented. The article concludes with a summary of recommendations and potential pitfalls to be avoided.

Monitoring, Reporting, and Verification (MRV) refers to the multistep process of monitoring the amount of greenhouse gas removed by a Carbon Dioxide Removal (CDR) activity and reporting the results of the monitoring to a third party. The third party then verifies the reporting so the results. While MRV is usually conducted in pursuit of certification in a voluntary or regulated CDR market, this chapter focuses on key recommendations for MRV relevant to ocean alkalinity enhancement (OAE) research. Early-stage MRV for OAE research may become the foundation on which markets are built. Therefore, we argue that such research carries a special obligation toward comprehensiveness, reproducibility, and transparency. Observational approaches during field trials should aim to quantify the delivery of alkalinity to seawater and monitor for secondary precipitation, biotic calcification, and other ecosystem changes that can feed back on sources or sinks of greenhouse gases where alkalinity is measurably elevated. Observations of resultant shifts in ocean pCO2 and pH can help determine the efficacy of OAE and are amenable to autonomous monitoring. However, because the ocean is turbulent and energetic and CO2 equilibration between the ocean and atmosphere can take several months or longer, added alkalinity will be diluted to perturbation levels undetectable above background variability on timescales relevant for MRV. Therefore, comprehensive quantification of carbon removal via OAE will be impossible through observational methods alone and numerical simulations will be required. The development of fit-for-purpose models, carefully validated against observational data, will be a critical part of MRV research.

Additional file 1.

Additional file 4. TIDieR-Checklist_completed.

Additional file 1. BCTTv1_PDF (behaviour change technique labels and definitions) [9].

We have examined inter-night variability of K2-discovered Dippers that are not close to being viewed edge-on, as determined from previously-reported ALMA images, using the SpeX spectrograph and the NASA Infrared Telescope facility (IRTF). The three objects observed were EPIC 203850058, EPIC 205151387, and EPIC 204638512 (2MASS J16042165-2130284). Using the ratio of the fluxes between two successive nights, we find that for EPIC 204638512 and EPIC 205151387, we find that the properties of the dust differ from that seen in the diffuse interstellar medium and denser molecular clouds. However, the grain properties needed to explain the extinction does resemble those used to model the disks of many young stellar objects. The wavelength-dependent extinction models of both EPIC 204638512 and EPIC 205151387 includes grains at least 500 microns in size, but lacks grains smaller than 0.25 microns. The change in extinction during the dips, and the timescale for these variations to occur, imply obscuration by the surface layers of the inner disks. The recent discovery of a highly mis-inclined inner disk in EPIC 204638512 is suggests that the variations in this disk system may point to due to rapid changes in obscuration by the surface layers of its inner disk, and that other face-on Dippers might have similar geometries. The He I line at 1.083 microns in EPIC 205151387 and EPIC 20463851 were seen to change from night to night, suggesting that we are seeing He I gas mixed in with the surface dust., Comment: 13 pages, 6 figures, 2 tables

Current knowledge of dengue virus (DENV) transmission provides only a partial understanding of a complex and dynamic system yielding a public health track record that has more failures than successes. An important part of the problem is that the foundation for contemporary interventions includes a series of longstanding, but untested, assumptions based on a relatively small portion of the human population; i.e., people who are convenient to study because they manifest clinically apparent disease. Approaching dengue from the perspective of people with overt illness has produced an extensive body of useful literature. It has not, however, fully embraced heterogeneities in virus transmission dynamics that are increasingly recognized as key information still missing in the struggle to control the most important insect-transmitted viral infection of humans. Only in the last 20 years have there been significant efforts to carry out comprehensive longitudinal dengue studies. This manuscript provides the rationale and comprehensive, integrated description of the methodology for a five-year longitudinal cohort study based in the tropical city of Iquitos, in the heart of the Peruvian Amazon. Primary data collection for this study was completed in 2019. Although some manuscripts have been published to date, our principal objective here is to support subsequent publications by describing in detail the structure, methodology, and significance of a specific research program. Our project was designed to study people across the entire continuum of disease, with the ultimate goal of quantifying heterogeneities in human variables that affect DENV transmission dynamics and prevention. Because our study design is applicable to other Aedes transmitted viruses, we used it to gain insights into Zika virus (ZIKV) transmission when during the project period ZIKV was introduced and circulated in Iquitos. Our prospective contact cluster investigation design was initiated by detecttion of a person with a symptomatic DENV infection and then followed that person’s immediate contacts. This allowed us to monitor individuals at high risk of DENV infection, including people with clinically inapparent and mild infections that are otherwise difficult to detect. We aimed to fill knowledge gaps by defining the contribution to DENV transmission dynamics of (1) the understudied majority of DENV-infected people with inapparent and mild infections and (2) epidemiological, entomological, and socio-behavioral sources of heterogeneity. By accounting for factors underlying variation in each person’s contribution to transmission we sought to better determine the type and extent of effort needed to better prevent virus transmission and disease.

Additional file 1: Supplemental Figure 1. CONSORT Diagram. Supplemental Table 1. Legislative Demographic Data. Supplemental Table 2. Linguistic Markers via Boolean Search Phrases for URE Categories and Subject Matter.

Policymakers use estimates of the Value of a Statistical Life (VSL) in performing regulatory reviews to assess the benefits and costs of policies that affect mortality. This paper empirically estimates an adjustment to conventional VSL measures to account for altruistic sentiments and concludes that conventional VSL measures are underestimated by a factor of two to three, suggesting we are greatly undervaluing life in regulatory reviews. This conclusion is attained by estimating the VSL multiplier suggested by Jones-Lee (Econ J 102(410):80–90, 1992), which hinges on assessing whether individuals are more health altruistic than wealth altruistic. The estimated VSL multiplier is greatest for policies that affect children’s mortality, as health altruism is dominant regarding children. Supplementary Information The online version contains supplementary material available at 10.1007/s11205-021-02784-7.

Introduction: The Iwate Score (IS) have not been well-validated for specific procedures, especially for right posterior sectionectomy (RPS). In this study, the utility of the IS was determined for laparoscopic (L)RPS and the effect of tumor location on surgical outcomes was investigated. Methods: Post-hoc analysis of 647 L-RPS performed in 40 international centers of which 596L-RPS cases met the inclusion criteria. Baseline characteristics and perioperative outcomes of patients stratified based on the Iwate score were compared to determine whether a correlation with surgical difficulty existed. A 1:1 Mahalanobis distance matching was utilized to investigate the effect of tumor location on L-RPS outcomes. Results: The patients were stratified into 3 levels of difficulty (31 intermediate, 143 advanced, and 422 expert) based on the IS. When using a stepwise increase of the IS excluding the tumor location score, only Pringle’s maneuver was more frequently used in the higher surgical difficulty level (35.5%, 54.6%, and 65.2%, intermediate, advanced, and expert levels, respectively, Z = 3.34, p = 0.001). Other perioperative results were not associated with a statistical gradation toward higher difficulty level. 80 of 85 patients with a segment VI lesion and 511 patients with a segment VII lesion were matched 1:1. There were no significant differences in the perioperative outcomes of the two groups including open conversion, operating time, blood loss, intraoperative blood transfusion, postoperative stay, major morbidity, and mortality. Conclusion: Among patients undergoing L-RPS, the IS did not significantly correlate with most outcome measures associated with intraoperative difficulty and postoperative outcomes. Similarly, tumor location had no effect on L-RPS outcomes.

Background: Presently, according to different difficulty scoring systems, there is no difference in complexity estimation of laparoscopic liver resection (LLR) of segments 7 and 8. However, there is no published data supporting this assumption. To date, no studies have compared the outcomes of laparoscopic parenchyma-sparing resection of the liver segments 7 and 8. Methods: A post hoc analysis of patients undergoing LLR of segments 7 and 8 in 46 centers between 2004 and 2020 was performed. 1:1 Propensity score matching (PSM) was used to compare isolated LLR of segments 7 and 8. Subset analyses were also performed to compare atypical resections and segmentectomies of 7 and 8. Results: A total of 2411 patients were identified, and 1691 patients met the inclusion criteria. Comparison after PSM between the entire cohort of segment 7 and segment 8 resections revealed inferior results for segment 7 resection in terms of increased blood loss, blood transfusions, and conversions to open surgery. Subset analyses of only atypical resections similarly demonstrated poorer outcomes for segment 7 in terms of increased blood loss, operation time, blood transfusions, and conversions to open surgery. Conversely, a subgroup analysis of segmentectomies after PSM found better outcomes for segment 7 in terms of a shorter operation time and hospital stay. Conclusion: Differences in the outcomes of segments 7 and 8 resections suggest a greater difficulty of laparoscopic atypical resection of segment 7 compared to segment 8, and greater difficulty of segmentectomy 8 compared to segmentectomy 7.

Background: Tumor size (TS) represents a critical parameter in the risk assessment of laparoscopic liver resections (LLR). Moreover, TS has been rarely related to the extent of liver resection. The aim of this study was to study the relationship between tumor size and difficulty of laparoscopic left lateral sectionectomy (L-LLS). Methods: The impact of TS cutoffs was investigated by stratifying tumor size at each 10 mm-interval. The optimal cutoffs were chosen taking into consideration the number of endpoints which show a statistically significant split around the cut-points of interest and the magnitude of relative risk after correction for multiple risk factors. Results: A total of 1910 L-LLS were included. Overall, open conversion and intraoperative blood transfusion were 3.1 and 3.3%, respectively. The major morbidity rate was 2.7% and 90-days mortality 0.6%. Three optimal TS cutoffs were identified: 40-, 70-, and 100-mm. All the selected cutoffs showed a significant discriminative power for the prediction of open conversion, operative time, blood transfusion and need of Pringle maneuver. Moreover, 70- and 100-mm cutoffs were both discriminative for estimated blood loss and major complications. A stepwise increase in rates of open conversion rate (Z = 3.90, P

To establish global benchmark outcomes indicators after laparoscopic liver resections (L-LR).There is limited published data to date on the best achievable outcomes after L-LR.This is a post hoc analysis of a multicenter database of 11,983 patients undergoing L-LR in 45 international centers in 4 continents between 2015 and 2020. Three specific procedures: left lateral sectionectomy (LLS), left hepatectomy (LH), and right hepatectomy (RH) were selected to represent the 3 difficulty levels of L-LR. Fifteen outcome indicators were selected to establish benchmark cutoffs.There were 3519 L-LR (LLS, LH, RH) of which 1258 L-LR (40.6%) cases performed in 34 benchmark expert centers qualified as low-risk benchmark cases. These included 659 LLS (52.4%), 306 LH (24.3%), and 293 RH (23.3%). The benchmark outcomes established for operation time, open conversion rate, blood loss ≥500 mL, blood transfusion rate, postoperative morbidity, major morbidity, and 90-day mortality after LLS, LH, and RH were 209.5, 302, and 426 minutes; 2.1%, 13.4%, and 13.0%; 3.2%, 20%, and 47.1%; 0%, 7.1%, and 10.5%; 11.1%, 20%, and 50%; 0%, 7.1%, and 20%; and 0%, 0%, and 0%, respectively.This study established the first global benchmark outcomes for L-LR in a large-scale international patient cohort. It provides an up-to-date reference regarding the "best achievable" results for L-LR for which centers adopting L-LR can use as a comparison to enable an objective assessment of performance gaps and learning curves.

Additional file 1. Social Network Survey.

Supplemental Material for The Voices of Stakeholders Involved in Precision Medicine: The Co-Design and Evaluation of Qualitative Indicators of Intervention Acceptability, Fidelity and Context in PRecISion Medicine for Children With Cancer in Australia by James Smith, Jeffrey Braithwaite, Tracey A. O’Brien, Stephanie Smith, Vanessa J. Tyrrell, Emily V. A. Mould, Janet C. Long and Frances Rapport in Qualitative Health Research.

Additional file 2. Consolidated criteria for reporting qualitative studies (COREQ): 32-item checklist.

Victoria Walton,1 Anne Hogden,1 Janet C Long,2 Julie K Johnson,3 David Greenfield1 1Australian Institute of Health Service Management, University of Tasmania, Sydney, NSW 2015, Australia; 2Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia; 3Centre for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USACorrespondence: Victoria WaltonAustralian Institute of Health Service Management, University of Tasmania, Locked Bag 5052, Alexandria, Sydney NSW 2015, AustraliaTel +61 2 408 417 814Email victoria.walton@utas.edu.auPurpose: Interdisciplinary bedside ward rounds have the capacity to facilitate coordinated interprofessional patient care. To be an effective means of care coordination, clinicians need an explicit understanding of how these rounds contribute to patient care. By identifying benefits and challenges to the effective use of interdisciplinary ward rounds, clinicians create an opportunity to improve interprofessional teamwork, care planning, and coordination of patient care.Methods: A survey was conducted with frontline professionals in two acute care and two rehabilitation wards from a metropolitan teaching hospital. There were 77 participants, representing medical officers, nurses, and allied health clinicians. Questions examined the perceived benefits and challenges of conducting interdisciplinary ward rounds in their units. Survey findings were coded for meaning and then grouped into themes.Results: Benefits revealed a desired care delivery model challenged by the complexities of organizational and professional cultures. The themes of “being on the same page”, “focusing on patients”, and “holistic care planning” underpinned the ideas of collaboration and improved patient-centred care, that is, benefits to patients. Challenges centred on health professionals’ time constraints and the coordination of teams to enable participation in rounds. The themes were more distinct, logistical barriers of “time”, “workforce”, and “care planning”.Conclusion: Overall, clinicians recognise there are greater benefits to IBRs and have a willingness to participate. However, careful consideration is required to introduce and continually achieve the best from IBR as they require changes in organizational context and culture.Keywords: challenges, benefits, coordination, patient focused care, time factors, communication

Background The ward round is an opportunity to plan and deliver patient-centered care. Benefits include an effective and safer clinician-patient relationship, patient empowerment, reduced anxiety and increased trust in the health care system. Factors contributing to patient involvement in ward rounds is shaped by their preferences, ability, and opportunity. Aim To investigate ward rounds and the patient experience with them, the relationship between the patient and clinicians, and how rounds facilitate collaboration between them. Patients and methods A multimethod study was conducted in a single Australian facility in acute medicine and rehabilitation specialties. An observational study of ward rounds in each setting was conducted with 14 patients, aged between 55 and 89 years followed by semi-structured interviews conducted with the patients observed. Descriptive and thematic analysis was undertaken. Results One third of participants had not heard of the term ward round or could describe their purpose. Three main influencers on the patient experience of rounds were: self; the health system; and medical officers. No meaningful difference was found between patients in acute medicine and rehabilitation although all wanted to receive information from the senior medical officers. Patients more familiar with the health system were more active participants and took greater responsibility for their involvement in rounds and described higher satisfaction. Conclusion There is a level of acceptance within the health system that patients understand what a ward round is. However, their role on the round is complex and this may only be developed through experiencing them. High system users teach themselves to navigate rounding processes to ensure their needs are met. To ensure equity in participation patients should be educated on ward rounds, what to expect and how to they can participate.

Additional file 1. Interview schedule for eliciting feedback on the rich picture.

Additional file 2. Brief summary of the consensus recommendations provided to the focus group participants prior to the session.

captions are in the document

Additional file 1. Full schedule of questions used in the focus groups.

1: details on the climate scenarios; 2 & 4: details on prediction of temperatures, laying dates and food peak dates; 3:validation of the climate scenarios

Additional file 3. Consolidated criteria for reporting qualitative studies (COREQ) checklist.

Additional file 1: Table S1. Summary of HighResolution Melt analysis on clinical samples. Figure S1. Targeted sequencingconfirms pfcrt haplotypes in control Plasmodium genomes. Figure S2. Change in normalization boundaries does notimpact automatic haplotype calling. Figure S3. Quantitative PCR Ct values are inverselyproportional to HRM confidence percentages.

The Axion Resonant InterAction Detection Experiment (ARIADNE) is a collaborative effort to search for the QCD axion using nuclear magnetic resonance (NMR), where the axion acts as a mediator of spin-dependent forces between an unpolarized tungsten source mass and a sample of polarized helium-3 gas. Since the experiment involves precision measurement of a small magnetization, it relies on limiting ordinary magnetic noise with superconducting magnetic shielding. In addition to the shielding, proper characterization of the noise level from other sources is crucial. We investigate one such noise source in detail: the magnetic noise due to impurities and Johnson noise in the tungsten source mass., ARIADNE Collaboration

We report an experimental search for an exotic spin-spin-velocity-dependent interaction between polarized electrons of Rb atoms and polarized electrons of a solid-state mass, violating both the time-reversal and parity symmetries. This search targets a minute effective magnetic field induced by the interaction. A spin-exchange relaxation-free (SERF) magnetometer based on an optically polarized Rb vapor is the key element for both a source of polarized electrons and a high-sensitivity detector. A dysprosium iron garnet (DyIG) serves as the polarized mass, with an extremely small magnetization at the critical temperature around 240 K and a high spin density. To reduce the magnetization, one of major systematic effects, a home-built cooling system controls the mass temperature. To our knowledge, this is the first search for an exotic spin-dependent interaction using the compensated ferrimagnet DyIG as a polarized mass. The experiment set the most stringent limit on the electron-electron coupling strength in the centimeter interaction range, in particular $g_V^e g_V^e

An overview of the Community Earth System Model Version 2 (CESM2) is provided, including a discussion of the challenges encountered during its development and how they were addressed. In addition, an evaluation of a pair of CESM2 long preindustrial control and historical ensemble simulations is presented. These simulations were performed using the nominal 1° horizontal resolution configuration of the coupled model with both the “low-top” (40 km, with limited chemistry) and “high-top” (130 km, with comprehensive chemistry) versions of the atmospheric component. CESM2 contains many substantial science and infrastructure improvements and new capabilities since its previous major release, CESM1, resulting in improved historical simulations in comparison to CESM1 and available observations. These include major reductions in low-latitude precipitation and shortwave cloud forcing biases; better representation of the Madden-Julian Oscillation; better El Niño-Southern Oscillation-related teleconnections; and a global land carbon accumulation trend that agrees well with observationally based estimates. Most tropospheric and surface features of the low- and high-top simulations are very similar to each other, so these improvements are present in both configurations. CESM2 has an equilibrium climate sensitivity of 5.1–5.3 °C, larger than in CESM1, primarily due to a combination of relatively small changes to cloud microphysics and boundary layer parameters. In contrast, CESM2's transient climate response of 1.9–2.0 °C is comparable to that of CESM1. The model outputs from these and many other simulations are available to the research community, and they represent CESM2's contributions to the Coupled Model Intercomparison Project Phase 6.

Additional file 5: Table S1 Startup procedure.

Additional file 2. Methodological rigour and risk of bias [48].

This dissertation argues that the boundaries between capitalism and criminality have become increasingly blurred over the past two centuries, and it traces this development through the Victorian era into American modernity. Operating on the premise that popular literature reflects wide-spread concerns and anxieties of a common audience, each chapter focuses on one primary text as a cite for analysis through which we gain a window of insight into the popular perception of criminals and the role of criminality in developing capitalism. In an attempt to provide relevant context and establish a solid foundation on which to work, the dissertation begins with an introduction that outlines major developments in the British literary field, with a particular eye toward bourgeoning popular mediums, beginning in the eighteenth century and leading into the Victorian era. This foundational work establishes urban compression and rapid industrial development as major concerns for a Victorian audience and figures them as the backdrop on which the discourse of criminality will play itself out. The first half of the dissertation focuses on the Victorian era, whereas the latter half analyzes works of American literature in the early-twentieth century. Chapter one looks to Oliver Twist as the preeminent example of Victorian criminality, with particular emphasis on middle-class complicity in reinforcing the social structures and environmental determinism that Dickens identified as major causes of Victorian crime. Chapter two progresses to the late-Victorian era and discusses Anthony Trollope’s The Way We Live Now. Doing so allows approaching Victorian criminality from the opposite vantage point, seeing the advent of white-collar crime and fraud as now more significant than the formerly dominant concern of petty crimes as seen in Oliver Twist. These early chapters mark a progression of criminality that gradually enmeshes itself in the habits of ambitious capitalists, which I argue is paramount to the construction of the discourse of criminality and capitalism. Rather than isolated incidents, I forward these texts as representative of thematic shifts in the literary field and public consciousness. Such a progression is carried over into American modernism, which constitutes the focus of chapters three and four. In chapter three, systemic violence inherent in laissez-faire capitalism and cronyism become the focus of the discussion, as presented in Upton Sinclair’s The Jungle. This chapter presents Sinclair’s didacticism as a necessary and significant progression in popular social-critique literature, and it contends that the gradual shift away from the personalized narrative of Jurgis to the heightened awareness of his political awakening marks an important development that figures criminality as not only part of, but indeed integral to, capitalism and its smooth functioning. This is contrasted with chapter four which presents The Great Gatsby as a misinterpretation of the lessons presented in The Jungle and reverts back to individualism as a flawed solution to capitalism’s ills. Whereas The Jungle was critiqued based on socialist didacticism and so-called lack of artistry, The Great Gatsby experienced immense success for its artistry, despite the fact that it falls back into the trap of individualism, romanticizing the criminal and capitalistic success of its protagonist while ultimately slating him for sacrifice to reinforce the status quo. These four chapters, I argue, constitute four major stages in progression of the discourse on criminality and capitalism, but leave many questions still unanswered, particularly as regards how society should appropriately and adequately engage the issues contained within these texts. An epilogue is included at the end of this project as an attempt to look forward to expansion of this research and continue to trace this progression up to present-day texts of popular culture. In doing so, my research will engage the development of the criminally-capitalist antihero in popular culture and argue that such figures are representative of the crisis of contemporary capitalism that sees no legitimate (nor illegitimate) ways of succeeding in capitalism.

ARIADNE is a nuclear-magnetic-resonance-based experiment that will search for novel axion-induced spin-dependent interactions between an unpolarized source mass rotor and a nearby sample of spin-polarized $^3$He gas. To detect feeble axion signals at the sub-atto-Tesla level, the experiment relies on low magnetic background and noise. We measure and characterize the magnetic field background from a prototype tungsten rotor. We show that the requirement is met with our current level of tungsten purity and demagnetization process. We further show that the noise is dominantly caused by a few discrete dipoles, likely due to a few impurities trapped inside the rotor during manufacturing. This is done via a numerical optimization pipeline which fits for the locations and magnetic moments of each dipole. We find that under the current demagnetization, the magnetic moment of trapped impurities is bounded at $10^{-9} \mathrm{A}\mathrm{m}^2$., Comment: 6 pages, 5 figures

Epidemiology of hepatocellular carcinoma (HCC) showed a correlation between incidence and geographical-relevant risk factors. This study aims to compare the distributions of cancer stem cells (CSC) in two distant populations in Asia and Europe. We analyzed 52 and 43 selected HCC patients undergoing hepatectomy in Ho Chi Minh City (Vietnam) and Trieste (Italy). Each patient sample consisted of HCC, peri-HCC, and non-tumoral (distal) tissue. Demographic data were recorded together with clinical findings. The protocol for the collection of tissue samples and RNA was standardized in both laboratories and gene expression analysis was performed in a single laboratory with identical PCR conditions. Baseline data showed comparable laboratory findings between the two cohorts. mRNA distribution showed a comparable pattern of all CSC markers analyzed with the expression of CD90 progressively increasing from distal and peri-HCC to be highest in HCC (p &lt, 0.001), confirmed by immunofluorescence data. CD90 mRNA distribution was related to HBV-related HCC and a tumor diameter less than 5 cm. Patients with high tumoral CD90 mRNA had a shorter time (p &lt, 0.05) to tumor recurrence compared to patients with lower CD90. This comparative study showed that CD90 mRNA expressions are comparable between Eastern and Western HCC cases.

Additional file 1.

Additional file 1. Search Strategy (title/abstract).

Victoria Walton,1 Anne Hogden,1 Janet C Long,2 Julie K Johnson,3 David Greenfield11Tasmanian School of Business and Economics, Australian Institute of Health Service Management, University of Tasmania, Sydney, Australia; 2Faculty of Medicine and Health Sciences, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia; 3Department of Surgery, Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL, USACorrespondence: Victoria WaltonAustralian Institute of Health Service Management, University of Tasmania, Locked Bag 5052, Alexandria, NSW, 2015, Sydney, AustraliaTel +61 24 0841 7814Email victoria.walton@utas.edu.auBackground: The ward round is an opportunity to plan and deliver patient-centered care. Benefits include an effective and safer clinician-patient relationship, patient empowerment, reduced anxiety and increased trust in the health care system. Factors contributing to patient involvement in ward rounds is shaped by their preferences, ability, and opportunity.Aim: To investigate ward rounds and the patient experience with them, the relationship between the patient and clinicians, and how rounds facilitate collaboration between them.Patients and methods: A multimethod study was conducted in a single Australian facility in acute medicine and rehabilitation specialties. An observational study of ward rounds in each setting was conducted with 14 patients, aged between 55 and 89years followed by semi-structured interviews conducted with the patients observed. Descriptive and thematic analysis was undertaken.Results: One third of participants had not heard of the term ward round or could describe their purpose. Three main influencers on the patient experience of rounds were: self; the health system; and medical officers. No meaningful difference was found between patients in acute medicine and rehabilitation although all wanted to receive information from the senior medical officers. Patients more familiar with the health system were more active participants and took greater responsibility for their involvement in rounds and described higher satisfaction.Conclusion: There is a level of acceptance within the health system that patients understand what a ward round is. However, their role on the round is complex and this may only be developed through experiencing them. High system users teach themselves to navigate rounding processes to ensure their needs are met. To ensure equity in participation patients should be educated on ward rounds, what to expect and how to they can participate.Keywords: ward rounds, patient participation, interview, education

For patients with chronic, life-limiting illnesses, admission to the intensive care unit (ICU) near the end of life might not improve patient outcomes or be consistent with patient and family values, goals, and preferences. In this context, advance care planning and palliative care interventions designed to clarify patients’ values, goals, and preferences have the potential to reduce provision of high-intensity interventions that are unwanted or non-beneficial. In this Series paper, we have assessed interventions that are effective at helping patients with chronic, life-limiting illnesses to avoid an unwanted ICU admission. The evidence found was largely from observational studies, with considerable heterogeneity in populations, methods, and types of interventions. Results from randomised trials of interventions to improve communication about goals of care are scarce, of variable quality, and mixed. Although observational studies show that advance care planning and palliative care interventions are associated with a reduced number of ICU admissions at the end of life, causality has not been well established. Using the available evidence we suggest recommendations to help to avoid ICU admission when it does not align with patient and family values, goals, and preferences and conclude with future directions for research.

Anthropogenic CO2 emissions are inundating the upper ocean, acidifying the water, and altering the habitat for marine phytoplankton. These changes are thought to be particularly influential for calcifying phytoplankton, namely, coccolithophores. Coccolithophores are widespread and account for a substantial portion of open ocean calcification; changes in their abundance, distribution, or level of calcification could have far‐reaching ecological and biogeochemical impacts. Here, we isolate the effects of increasing CO2 on coccolithophores using an explicit coccolithophore phytoplankton functional type parameterization in the Community Earth System Model. Coccolithophore growth and calcification are sensitive to changing aqueous CO2. While holding circulation constant, we demonstrate that increasing CO2 concentrations cause coccolithophores in most areas to decrease calcium carbonate production relative to growth. However, several oceanic regions show large increases in calcification, such the North Atlantic, Western Pacific, and parts of the Southern Ocean, due to an alleviation of carbon limitation for coccolithophore growth. Global annual calcification is 6% higher under present‐day CO2 levels relative to preindustrial CO2 (1.5 compared to 1.4 Pg C/year). However, under 900 μatm CO2, global annual calcification is 11% lower than under preindustrial CO2 levels (1.2 Pg C/year). Large portions of the ocean show greatly decreased coccolithophore calcification relative to growth, resulting in significant regional carbon export and air‐sea CO2 exchange feedbacks. Our study implies that coccolithophores become more abundant but less calcified as CO2 increases with a tipping point in global calcification (changing from increasing to decreasing calcification relative to preindustrial) at approximately ∼600 μatm CO2. ISSN:1942-2466

Depression is a highly prevalent disorder which exerts a major economic impact in all European countries. The brain-gut-microbiota axis has been described as a new paradigm for advancing understanding and treatment of the disorder. There is now over-whelming evidence to support the fact that gut microbes have a major impact on central neurochemistry and behaviour, especially stress related disorders such as depression. Recent studies indicate that patients with depression have a gut dysbiosis. The reason for this dysbiosis is uncertain. Over recent decades, dietary patterns in Europe and elsewhere have undergone major compositional changes, with increased intakes of red meat, high fat foods, and refined sugars. Individuals who consume a Mediterranean diet have lower rates of depression and a recent study suggests that a Mediterranean diet may have antidepressant properties. Assuming this to be the case, which components of the Mediterranean diet mediate the effects? Highly levels of polyphenols or polyunsaturated fatty acids are obvious candidates. We in the MyNewGut consortium recommend that patients with depression or vulnerability to depression should be encouraged to enhance a plant-based diet with a high content of grains/fibres and fish.

The axion is a hypothesized particle appearing in various theories beyond the Standard Model. It is a light spin-0 boson initially postulated to solve the strong CP problem and is also a strong candidate for dark matter. If the axion or an axion-like particle exists, it would mediate a P-odd and T-odd spin-dependent interaction. We describe two experiments under development at Indiana University-Bloomington to search for such an interaction., Comment: Presented at the Eighth Meeting on CPT and Lorentz Symmetry, Bloomington, Indiana, May 12-16, 2019

© 2017, The Author(s) 2017. Resin transfer moulding is one of several processes available for manufacturing fibre-reinforced composites from dry fibre reinforcement. Recently, dry reinforcements made with Automated Dry Fibre Placement have been introduced into the aerospace industry. Typically, the permeability of the reinforcement is assumed to be constant throughout the dry preform geometry, whereas in reality, it possesses inevitable uncertainty due to variability in geometry. This uncertainty propagates to the uncertainty of the mould filling and the fill time, one of the important variables in resin injection. It makes characterisation of the permeability and its variability an important task for design of the resin transfer moulding process. In this study, variability of the geometry of a reinforcement manufactured using Automated Dry Fibre Placement is studied. Permeability of the manufactured preforms is measured experimentally and compared to stochastic simulations based on an analytical model and a stochastic geometry model. The simulations showed that difference between the actual geometry and the designed geometry can result in 50% reduction of the permeability. The stochastic geometry model predicts results within 20% of the experimental values.

Journal of Educational Thought / Revue de la Pensée Educative, Vol 25 No 1 (1991)

著者人数: 26名, Accepted: 2018-03-26, 資料番号: SA1180300000

Materials for teaching the works of Ralph Waldo Emerson, including online and digital resources.

The Axion Resonant InterAction Detection Experiment (ARIADNE) is a collaborative effort to search for the QCD axion using techniques based on nuclear magnetic resonance. In the experiment, axions or axion-like particles would mediate short-range spin-dependent interactions between a laser-polarized 3He gas and a rotating (unpolarized) tungsten source mass, acting as a tiny, fictitious "magnetic field". The experiment has the potential to probe deep within the theoretically interesting regime for the QCD axion in the mass range of 0.1-10 meV, independently of cosmological assumptions. The experiment relies on a stable rotary mechanism and superconducting magnetic shielding, required to screen the 3He sample from ordinary magnetic noise. Progress on testing the stability of the rotary mechanism is reported, and the design for the superconducting shielding is discussed., 10 pages, 3 figures, submitted to Proceedings of the 2nd Axion Cavity and Detector Workshop

Determine the cost and cost-effectiveness of single-visit (same-day) antiretroviral treatment (ART) initiation compared to standard of care initiation.Cost-effectiveness analysis of individually randomized (1 : 1) pragmatic trial of single-visit initiation, which increased viral suppression at 10 months by 26% [relative risk (95% confidence interval) 1.26 (1.05-1.50)].Primary health clinic in Johannesburg, South Africa.HIV positive, adult, nonpregnant patients not yet on ART or known to be eligible who presented at the clinic 8 May 2013 to 29 August 2014.Same-day ART initiation using point-of-care laboratory instruments and accelerated clinic procedures to allow treatment-eligible patients to receive antiretroviral medications at the same visit as testing HIV positive or having an eligible CD4 cell count. Comparison was to standard of care ART initiation, which typically required three to five additional clinic visits.Average cost per patient enrolled and per patient achieving the primary outcome of initiated 90 days or less and suppressed 10 months or less, and production cost per patient achieving primary outcome (all costs per primary outcome patients).The average cost per patient enrolled, per patient achieving the primary outcome, and production cost were $319, $487, and $738 in the standard arm and $451, $505, and $707 in the rapid arm.Same-day treatment initiation was more effective than standard initiation, more expensive per patient enrolled, and less expensive to produce a patient achieving the primary outcome. Omitting point-of-care laboratory tests at initiation and focusing on high-volume clinics have the potential to reduce costs substantially and should be evaluated in routine settings.