Structured review of the patient-reported outcome instruments used in clinical trials in head and neck surgery

The number of clinical trials that relate to patients with cancer of the head and neck is growing. Patient-reported outcomes, which are rarely the primary outcome, are now an important component, and in this structured review to identify and report the characteristics of the questionnaires that have been used in these trials, we summarise the findings reported. We searched several online databases using the key terms: head and neck oncology, head and neck surgery, reconstruction, clinical trials patient-reported outcomes, questionnaires, quality of life (QoL), validated instruments, and patients’ satisfaction. We screened 1342 papers to collect information about the topic of the paper, sample size, selection criteria, main advantages and disadvantages of the patient-reported outcome used, and if it was used in conjunction with another measure. A total of 54 were eligible, and from them we identified 22 questionnaires. The primary reason for using a questionnaire was its relevance to the focus of the paper, such as xerostomia, pain, or swallowing. To allow the experience of patients to be the focus of the primary outcome in a clinical trial, we recommend that the measures used should be appropriate, reliable, valid, responsive, precise, interpretable, acceptable, and feasible. The trials used validated questionnaires, but the patient-reported outcome measures tended not to be the focus. There is merit in such measures being the primary outcomes in future trials and these should be designed around an explicit hypothesis

Bucking the trend: the diversity of Anthropocene ‘winners’ among British moths

An appreciation of how some species are becoming more common despite unprecedented anthropogenic pressures could offer key insights for mitigating the global biodiversity crisis.  Research to date has largely focused on declining species, while species that are becoming more common have received relatively little attention. Macro-moths in Great Britain are well-studied and species-rich, making them an ideal group for addressing this knowledge gap. Here, we examine changes in 51 successful species between 1968 and 2016 using 4.5 million occurrence records and a systematic monitoring dataset. We employ 3D graphical analysis to visualise long-term multidimensional trends in prevalence (abundance and range) and use vector autoregression models to test whether past values of local abundance are useful for predicting changes in the extent of occurrence. The responses of Anthropocene winners are heterogeneous, suggesting multiple drivers are responsible. Changes in range and local abundance frequently occur intermittently through time, demonstrating the value of long-term, continuous monitoring. There is significant diversity among the winners themselves, which include widespread generalists, habitat specialists, and recent colonists. We offer brief discussion of possible causal factors and the wider ecosystem implications of these trends

A Mutation in Amino Acid Permease AAP6 Reduces the Amino Acid Content of the Arabidopsis Sieve Elements but Leaves Aphid Herbivores Unaffected.

The aim of this study was to investigate the role of the amino acid permease gene AAP6 in regulating phloem amino acid composition and then to determine the effects of this altered diet on aphid performance. A genotype of Arabidopsis thaliana (L.) was produced in which the function of the amino acid permease gene AAP6 (At5g49630) was abolished. Plants homozygous for the insertionally inactivated AAP6 gene had a significantly larger mean rosette width than the wild type and a greater number of cauline leaves. Seeds from the aap6 mutant were also significantly larger than those from the wild-type plants. Sieve element (SE) sap was collected by aphid stylectomy and the amino acids derivatized, separated, and quantified using Capillary Electrophoresis with Laser Induced Fluorescence (CE-LIF). In spite of the large variation across samples, the total amino acid concentration of SE sap of the aap6 mutant plants was significantly lower than that of the wild-type plants. The concentrations of lysine, phenylalanine, leucine, and aspartic acid were all significantly lower in concentration in the aap6 mutant plants compared with wild-type plants. This is the first direct demonstration of a physiological role for an amino acid transporter in regulating SE composition in vivo. The amino acid availability in sieve element sap is thought to be the major limiting factor for aphid growth and reproduction. Despite the changes in their diet, the aphid Myzus persicae(Sulzer) displayed only small changes in feeding behaviour on mutant plants when measured using the Electronic Penetration Graph (EPG) technique. Salivation by the aphid into the SE (E1 phase) was increased on mutant plants but there was no significant effect on other feeding EPG behaviours, or in the rate of honeydew production. Consistent with the small effect on aphid feeding behaviour, there was only a small effect of reduced sieve element amino acid concentration on aphid reproduction. The data are discussed in relation to the regulation of phloem composition and the role of phloem amino acids in regulating aphid performance

Host specificity and species colouration mediate the regional decline of nocturnal moths in central European forests

The high diversity of insects has limited the volume of long-term community data with a high taxonomic resolution and considerable geographic replications, especially in forests. Therefore, trends and causes of changes are poorly understood. Here we analyse trends in species richness, abundance and biomass of nocturnal macro moths in three quantitative data sets collected over four decades in forests in southern Germany. Two local data sets, one from coppiced oak forests and one from high oak forests included 125K and 48K specimens from 559 and 532 species, respectively. A third regional data set, representing all forest types in the temperate zone of central Europe comprised 735K specimens from 848 species. Generalized additive mixed models revealed temporal declines in species richness (−38%), abundance (−53%) and biomass (−57%) at the regional scale. These were more pronounced in plant host specialists and in dark coloured species. In contrast, the local coppiced oak forests showed an increase, in species richness (+62%), while the high oak forests showed no clear trends. Left and right censoring as well as cross validation confirmed the robustness of the analyses, which led to four conclusions. First, the decline in insects appears in hyper diverse insect groups in forests and affects species richness, abundance and biomass. Second, the pronounced decline in host specialists suggests habitat loss as an important driver of the observed decline. Third, the more severe decline in dark species might be an indication of global warming as a potential driver. Fourth, the trends in coppiced oak forests indicate that maintaining complex and diverse forest ecosystems through active management may be a promising conservation strategy in order to counteract negative trends in biodiversity, alongside rewilding approaches

From Serious Leisure to Serious Work, or, When Folk Music Struck a Chord: Careers, Habermasian Rationality and Agency

This paper uses the English folk music scene to consider the career arc that can develop when leisure turns to work for folk musicians. In considering this move from amateur to professional, it draws together ideas of casual leisure, serious leisure and work, highlighting the agency exercised in their career, the centrality of a familial and musical habitus, and the structured network of the scene based around various actor roles. Whilst some seek out and others stumble across professional careers, each shifts from communicative to instrumental rationality creating tensions in a tightly knit Professional, Amateur, Public (P-A-P) network. In this paper, we see how folk musicians are involved in various leisure or professional actor roles but it is in the latter that individuals are seen to benefit from the hedonic elements of casual leisure and the learning of serious leisure whilst being paid as a professional

"Oh! What a tangled web we weave": Englishness, communicative leisure, identity work and the cultural web of the English folk morris dance scene

In this paper, we consider the relationship between Englishness and the English folk morris dance scene, considering how the latter draws from and reinforces the former. Englishness is considered within the context of the cultural web; a tool more often applied to business management but linked to a sociological viewpoint here. By doing so, we draw the connections between this structured business model and the cultural identity of Englishness. Then, we use the framework of the cultural web and theories of leisure, culture and identity to understand how morris dancers see their role as dancers and ‘communicative leisure’ agents in consciously defending Englishness, English traditions and inventions, the practices and traditions of folk and morris, and the various symbolic communities they inhabit. We argue that most morris dancers in our research become and maintain their leisured identities as dancers because they are attracted to the idea of tradition – even if that tradition is invented and open to change

Direct Observation of Martensitic Phase-Transformation Dynamics in Iron by 4D Single-Pulse Electron Microscopy

The in situ martensitic phase transformation of iron, a complex solid-state transition involving collective atomic displacement and interface movement, is studied in real time by means of four-dimensional (4D) electron microscopy. The iron nanofilm specimen is heated at a maximum rate of ∼10^(11) K/s by a single heating pulse, and the evolution of the phase transformation from body-centered cubic to face-centered cubic crystal structure is followed by means of single-pulse, selected-area diffraction and real-space imaging. Two distinct components are revealed in the evolution of the crystal structure. The first, on the nanosecond time scale, is a direct martensitic transformation, which proceeds in regions heated into the temperature range of stability of the fcc phase, 1185−1667 K. The second, on the microsecond time scale, represents an indirect process for the hottest central zone of laser heating, where the temperature is initially above 1667 K and cooling is the rate-determining step. The mechanism of the direct transformation involves two steps, that of (barrier-crossing) nucleation on the reported nanosecond time scale, followed by a rapid grain growth typically in ∼100 ps for 10 nm crystallites