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Modeling coastal and marine processes
\"Modeling is now an accepted part in the understanding, prediction and planning of environmental strategies. Perfect for undergraduate students and non-specialist readers, Modeling Coastal and Marine Processes (2nd Edition) offers an introduction into how coastal and marine models are constructed and used. The mathematics, statistics and numerical techniques used are explained in the first few chapters, making this book accessible to those without a high-level maths background. Later chapters cover modeling sea bed friction, tides, shallow sea dynamics, and ecosystem dynamics. Importantly, there is also a chapter on modeling the impact of climate change on coastal and near shore processes. New to this revised edition is a chapter on tides, tsunamis and the prediction of sea level, and additional material on the new application of the numerical techniques: flux corrected transport, finite volumes and adaptive grids to coastal and marine modeling\"-- Provided by publisher.
Book
Robot-assisted minimally invasive thoraco-laparoscopic esophagectomy versus minimally invasive esophagectomy for resectable esophageal adenocarcinoma, a randomized controlled trial (ROBOT-2 trial)
Background
For patients with esophageal adenocarcinoma or cancer of the gastroesophageal junction, radical esophagectomy with 2-field lymphadenectomy is the cornerstone of the multimodality treatment with curative intent. Both conventional minimally invasive esophagectomy (MIE) and robot assisted minimally invasive esophagectomy (RAMIE) were shown to be superior compared to open transthoracic esophagectomy considering postoperative complications. However, no randomized comparison exists between MIE and RAMIE in the Western World for patients with esophageal adenocarcinoma.
Methods
This is an investigator-initiated and investigator-driven multicenter randomized controlled parallel-group superiority trial. All adult patients (age ≥ 18 and ≤ 90 years) with histologically proven, surgically resectable (cT1-4a, N0–3, M0) esophageal adenocarcinoma of the intrathoracic esophagus or adenocarcinoma of the gastroesophageal junction and with European Clinical Oncology Group performance status 0, 1 or 2 will be assessed for eligibility and included after obtaining informed consent. Patients (
n
= 218) with resectable esophageal adenocarcinoma of the intrathoracic esophagus or adenocarcinoma of the gastroesophageal junction are randomized to either RAMIE (
n
= 109) or MIE (
n
= 109). The primary outcome of this study is the total number of resected abdominal and mediastinal lymph nodes specified per lymph node station.
Conclusion
This is the first randomized controlled trial designed to compare RAMIE to MIE as surgical treatment for resectable esophageal adenocarcinoma or adenocarcinoma of the gastroesophageal junction in the Western World. The hypothesis of the proposed study is that RAMIE will result in a higher abdominal and mediastinal lymph node yield specified per station compared to conventional MIE.
Short-term results and the primary endpoint (total number of resected abdominal and mediastinal lymph nodes per lymph node station) will be analyzed and published after discharge of the last randomized patient within this trial.
Trial registration
ClinicalTrials.gov
Identifier:
NCT04306458
. Registered 13th March 2020,
https://clinicaltrials.gov/ct2/show/NCT04306458;
Date of first enrolment 18.01.2021; Target sample size 218; Recruitment status: Recruiting; Protocol version 2; Issue date 10.03.2020; Rev. 02.02.2021; Authors ET, PCvdS, PPG.
Journal Article
Early psychological interventions for prevention and treatment of post-traumatic stress disorder (PTSD) and post-traumatic stress symptoms in post-partum women: A systematic review and meta-analysis
Pre-term or full-term childbirth can be experienced as physically or psychologically traumatic. Cumulative and trans-generational effects of traumatic stress on both psychological and physical health indicate the ethical requirement to investigate appropriate preventative treatment for stress symptoms in women following a routine traumatic experience such as childbirth.
The objective of this review was to investigate the effectiveness of early psychological interventions in reducing or preventing post-traumatic stress symptoms and post-traumatic stress disorder in post-partum women within twelve weeks of a traumatic birth.
Randomised controlled trials and pilot studies of psychological interventions preventing or reducing post-traumatic stress symptoms or PTSD, that included women who had experienced a traumatic birth, were identified in a search of Cochrane Central Register of Randomised Controlled Trials, MEDLINE, Embase, Psychinfo, PILOTS, CINAHL and Proquest Dissertations databases. One author performed database searches, verified results with a subject librarian, extracted study details and data. Five authors appraised extracted data and agreed upon risk of bias. Analysis was completed with Rev Man 5 software and quality of findings were rated according to Grading of Recommendation, Assessment, Development, and Evaluation.
Eleven studies were identified that evaluated the effectiveness of a range of early psychological interventions. There was firm evidence to suggest that midwifery or clinician led early psychological interventions administered within 72 hours following traumatic childbirth are more effective than usual care in reducing traumatic stress symptoms in women at 4-6 weeks. Further studies of high methodological quality that include longer follow up of 6-12 months are required in order to substantiate the evidence of the effectiveness of specific face to face and online early psychological intervention modalities in preventing the effects of stress symptoms and PTSD in women following a traumatic birth before introduction to routine care and practice.
CRD42020202576, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=202576.
Journal Article
Island biogeography and human practices drive ecological connectivity in mosquito species richness in the Lakshadweep Archipelago
Mosquitoes are globally distributed and adapted to a broad range of environmental conditions. As obligatory hosts of many infectious pathogens, mosquito abundance and distribution are primarily determined by the presence and quality of larval habitats. To understand the dynamics and productivity of larval habitats in changing island environments, we conducted a four-month mosquito survey across ten inhabited islands in the Lakshadweep archipelago. Using fine-resolution larval habitat mapping, we recorded 7890 mosquitoes representing 13 species and 7 genera. Of these, four species comprised 95% of the total collections—
Aedes albopictus
(
Stegomyia
) was the dominant species followed by
Armigeres subalbatus
,
Culex quinquefasciatus
and
Malaya genurostris
. We found larval species richness was positively associated with the island area and mosquito larval richness (Chao1 estimator) was higher in artificial habitats than in natural habitats. Furthermore, mosquito species composition did not deteriorate with distance between islands. Mosquito abundance by species was associated with microclimatic variables—pH and temperature. We detected co-existence of multiple species at a micro-habitat level with no evidence of interactions like competition or predation. Our study analyzed and identified the most productive larval habitats –discarded plastic container and plastic drums contributing to high larval indices predicting dengue epidemic across the Lakshadweep islands. Our data highlight the need to devise vector control strategies by removal of human-induced plastic pollution (household waste) which is a critical driver of disease risk.
Journal Article
Lack of consensus in the choice of termination of pregnancy for Turner syndrome in France
Background
The observed rate of termination of pregnancy (TOP) for Turner syndrome varies worldwide and even within countries. In this vignette study we quantified agreement among ten multidisciplinary prenatal diagnosis centers in Paris.
Methods
We submitted online three cases of Turner syndrome (increased nuchal translucency, normal ultrasound, aortic coarctation) to fetal medicine experts: one obstetrician, one pediatrician and one geneticist in each of the ten Parisian centers. Each case was presented in the form of a progressive clinical history with conditional links dependent upon responses. The background to each case was provided, along with the medical history of the parents and the counseling they got from medical staff. The experts indicated online whether or not they would accept the parents’ request for TOP. We assessed the percentage of agreement for acceptance or refusal of TOP. We also used a multilevel logistic regression model to evaluate differences among obstetrician-gynecologists, pediatricians and cytogeneticists.
Results
Overall agreement among the experts to accept or refuse TOP was, respectively, 25 and 28%. The percentage of disagreement was 47%. The percentage of agreement to accept TOP was 33, 8 and 33% for obstetrician-gynecologists, pediatricians and cytogeneticists, respectively. The respective percentages of agreement to refuse TOP were 19, 47 and 26%.
Conclusion
Our results show the lack of consensus with regard to decisions related to termination of pregnancy for Turner Syndrome. This lack of consensus in turn underscores the importance of multidisciplinary management of these pregnancies in specialized fetal medicine centers.
Journal Article
1619 : Jamestown and the forging of American democracy
This book \"offers a new interpretation of the significance of Jamestown in the long trajectory of American history. Jamestown, the cradle of American democracy, also saw the birth of our nation's greatest challenge: the corrosive legacy of slavery and racism that have deepened and entrenched stark inequalities in our society\"--Provided by publisher.
Book
Deep learning in medical image analysis: introduction to underlying principles and reviewer guide using diagnostic case studies in paediatrics
Deep learning, a subset of artificial intelligence, has gained attention in recent years for its ability to achieve human level performance in medical image analysis. As deep learning is increasingly being studied in medical image analysis, it is essential that clinicians are familiar with its underlying principles, strengths, and possible pitfalls in their evaluation. This article aims to clarify deep learning techniques applied in medical image analysis and to help frontline clinicians understand how to read and appraise studies about this new and rapidly advancing technology. While image analysis using deep learning has the potential to enhance the diagnosis of various medical conditions, clinicians, policy makers, and patients should exercise caution when evaluating the available evidence.
Journal Article