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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
Structural robustness of the gut mucosal microbiota is associated with Crohn's disease remission after surgery
ObjectivesPreventing postoperative recurrence after ileocolonic resection (ICR) for Crohn's disease (CD) is challenging. Defining the disturbances of the microbial composition and community structure after ICR and their link with early disease recurrence is crucial.DesignMicrobiota composition (fingerprinting and 16S rDNA sequencing) and community structure (correlation networks of bacterial species) were assessed from ileal mucosa sampled in 20 patients undergoing ICR and 6 months later during endoscopy from above (neoterminal ileum) and below (subanastomotic colon) the surgical anastomosis.ResultsICR had a dramatic effect on gut microbial ecosystem. At surgery, CD mucosa harboured a dysbiotic microbiota with high proportions of α/β Proteobacteria and Bacilli. Six months later, half of the patients had recurrent lesions at ileocolonoscopy and presented higher numbers of Lachnospiraceae. Recurrence of endoscopic lesions was associated with enrichment in Enterococcus durans while patients in remission had increased proportions of Dorea longicatena and Bacteroides plebeius. Structural differences were striking between recurrence and remission microbiota; while the microbiota of patients with CD recurrence exhibited a loose community structure, the microbiota of patients in remission displayed communities that were robustly correlated to each other. Microbiota colonising the neoterminal ileum and subanastomotic colon 6 months after ICR only differed in patients with recurrence.ConclusionsICR modifies the gut microbiome. Remission after 6 months was associated with homogenous bacterial distribution around the anastomosis. Community structure and bacterial networks highlight target species, including Faecalibacterium prausnitzii and Ruminococcus gnavus, which may allow precise modulations of the overall microbial ecosystem towards remission pattern.
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
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
Long-term follow-up in PMM2-CDG: are we ready to start treatment trials?
Purpose
PMM2-CDG is the most common congenital disorder of glycosylation (CDG), which presents with either a neurologic or multisystem phenotype. Little is known about the longitudinal evolution.
Methods
We performed data analysis on PMM2-CDG patients’ clinical features according to the Nijmegen CDG severity score and laboratory data. Seventy-five patients (28 males) were followed up from 11.0 ± 6.91 years for an average of 7.4 ± 4.5 years.
Results
On a group level, there was no significant evolution in overall clinical severity. There was some improvement in mobility and communication, liver and endocrine function, and strabismus and eye movements. Educational achievement and thyroid function worsened in some patients. Overall, the current clinical function, the system-specific involvement, and the current clinical assessment remained unchanged.
On follow-up there was improvement of biochemical variables with (near) normalization of activated partial thromboplastin time (aPTT), factor XI, protein C, antithrombin, thyroid stimulating hormone, and liver transaminases.
Conclusion
PMM2-CDG patients show a spontaneous biochemical improvement and stable clinical course based on the Nijmegen CDG severity score. This information is crucial for the definition of endpoints in clinical trials.
Journal Article