Concert recording 2017-04-27

[Track 1]. Adoramus te, Christe / Giovanni Pierluigi da Palestrina -- [Track 2]. Ubi caritas / Maurice Duruflé -- [Track 3]. Three Hungarian folk songs. I. The handsome butcher II. Apple, apple III. The old woman / Matyas Seiber -- [Track 4]. He watching over Israel from Elijah / Felix Mendelssohn Bartholdy -- [Track 5]. Ain\u27t got time to die / Hall Johnson

Clinical Sequencing Exploratory Research Consortium: Accelerating Evidence-Based Practice of Genomic Medicine

Despite rapid technical progress and demonstrable effectiveness for some types of diagnosis and therapy, much remains to be learned about clinical genome and exome sequencing (CGES) and its role within the practice of medicine. The Clinical Sequencing Exploratory Research (CSER) consortium includes 18 extramural research projects, one National Human Genome Research Institute (NHGRI) intramural project, and a coordinating center funded by the NHGRI and National Cancer Institute. The consortium is exploring analytic and clinical validity and utility, as well as the ethical, legal, and social implications of sequencing via multidisciplinary approaches; it has thus far recruited 5,577 participants across a spectrum of symptomatic and healthy children and adults by utilizing both germline and cancer sequencing. The CSER consortium is analyzing data and creating publically available procedures and tools related to participant preferences and consent, variant classification, disclosure and management of primary and secondary findings, health outcomes, and integration with electronic health records. Future research directions will refine measures of clinical utility of CGES in both germline and somatic testing, evaluate the use of CGES for screening in healthy individuals, explore the penetrance of pathogenic variants through extensive phenotyping, reduce discordances in public databases of genes and variants, examine social and ethnic disparities in the provision of genomics services, explore regulatory issues, and estimate the value and downstream costs of sequencing. The CSER consortium has established a shared community of research sites by using diverse approaches to pursue the evidence-based development of best practices in genomic medicine

Critical water needs to sustain freshwater ecosystems and aquatic biodiversity in Queensland’s Mitchell River

Critical water needs to sustain freshwater ecosystems and aquatic biodiversity in Queensland’s Mitchell River The Australian Government has identified water-resource development in the north of Australia as a priority for the coming years and Queensland’s Mitchell River is a focus of this interest. The Queensland Government currently regulates small amounts of extraction from the Mitchell River meaning that the flow regime is largely unregulated. In its current condition, the catchment supports existing water users, including Traditional Owners, and significant ecological assets, including wetlands of national significance, threatened species, traditional harvests, and commercial and recreational fisheries. Information is needed on the water needs of freshwater ecosystems and their associated biodiversity to guide decision-making around water planning and development. This project examined the links between freshwater flow and floodplain inundation, aquatic plant biomass accumulation, floodplain subsidies to freshwater food webs, fish movement and fisheries production. This project had five major objectives to understand the flow requirements of freshwater assets: 1. Identify the dependence of floodplain inundation and aquatic plant biomass accumulation on river flow 2. Map key ‘hotspots’ of freshwater primary productivity within the floodplain 3. Quantify riverine and floodplain connectivity to assess the likely impact of varying wet seasons and water-resource development on aquatic food webs, and the movement of fish between river channels and floodplain wetlands 4. Quantify the importance of river flows to estuaries by examining the flow dependence of barramundi growth, population dynamics and habitat use 5. Assess the implications of flow alteration on freshwater ecological communities, including movement of fish throughout the catchment

Biomarker-guided preemption of steroid-refractory graft-versus-host disease with α-1-antitrypsin

Steroid-refractory (SR) acute graft-versus-host disease (GVHD) remains a major cause of nonrelapse mortality (NRM) after allogeneic hematopoietic cell transplantation (HCT), but its occurrence is not accurately predicted by pre-HCT clinical risk factors. The Mount Sinai Acute GVHD International Consortium (MAGIC) algorithm probability (MAP) identifies patients who are at high risk for developing SR GVHD as early as 7 days after HCT based on the extent of intestinal crypt damage as measured by the concentrations of 2 serum biomarkers, suppressor of tumorigenesis 2 and regenerating islet-derived 3 alpha. We conducted a multicenter proof-of-concept "preemptive" treatment trial of alpha-1-antitrypsin (AAT), a serine protease inhibitor with demonstrated activity against GVHD, in patients at high risk for developing SR GVHD. Patients were eligible if they possessed a high-risk MAP on day 7 after HCT or, if initially low risk, became high risk on repeat testing at day 14. Thirty high-risk patients were treated with twice-weekly infusions of AAT for a total of 16 doses, and their outcomes were compared with 90 high-risk near-contemporaneous MAGIC control patients. AAT treatment was well tolerated with few toxicities, but it did not lower the incidence of SR GVHD compared with controls (20% vs 14%, P = 5.56). We conclude that real-time biomarker-based risk assignment is feasible early after allogeneic HCT but that this dose and schedule of AAT did not change the incidence of SR acute GVHD. This trial was registered at www.clinicaltrials.gov as #NCT03459040

The MAGIC algorithm probability is a validated response biomarker of treatment of acute graft-versus-host disease

The Mount Sinai Acute GVHD International Consortium (MAGIC) algorithm probability (MAP), derived from 2 serum biomarkers, measures damage to crypts in the gastrointestinal tract during graft-versus-host disease (GVHD). We hypothesized that changes in MAP after treatment could validate it as a response biomarker. We prospectively collected serum samples and clinical stages of acute GVHD from 615 patients receiving hematopoietic cell transplantation in 20 centers at initiation of first-line systemic treatment and 4 weeks later. We computed MAPs and clinical responses and compared their abilities to predict 6-month nonrelapse mortality (NRM) in the validation cohort (n = 367). After 4 weeks of treatment, MAPs predicted NRM better than the change in clinical symptoms in all patients and identified 2 groups with significantly different NRM in both clinical responders (40% vs 12%, P < .0001) and nonresponders (65% vs 25%, P < .0001). MAPs successfully reclassified patients for NRM risk within every clinical grade of acute GVHD after 4 weeks of treatment. At the beginning of treatment, patients with a low MAP that rose above the threshold of 0.290 after 4 weeks of treatment had a significant increase in NRM, whereas patients with a high MAP at onset that fell below that threshold after treatment had a striking decrease in NRM that translated into clear differences in overall survival. We conclude that a MAP measured before and after treatment of acute GVHD is a response biomarker that predicts long-term outcomes more accurately than change in clinical symptoms. MAPs have the potential to guide therapy for acute GVHD and may function as a useful end point in clinical trials

Robotic versus laparoscopic liver resection in various settings: an international multicenter propensity score matched study of 10.075 patients

Objective: the aim of this study was to compare the perioperative outcomes of robotic liver surgery (RLS) and laparoscopic liver surgery (LLS) in various settings.Summary background data: clear advantages of RLS over LLS have rarely been demonstrated, and the associated costs of robotic surgery are generally higher than those of laparoscopic surgery. Therefore, the exact role of the robotic approach in minimally invasive liver surgery remains to be defined.Methods: in this international retrospective cohort study, the outcomes of patients who underwent RLS and LLS for all indications between 2009 and 2021 in 34 hepatobiliary referral centers were compared. Subgroup analyses were performed to compare both approaches across several types of procedures: minor resections in the anterolateral (2, 3, 4b, 5, and 6) or posterosuperior segments (1, 4a, 7, 8), and major resections (≥3 contiguous segments). Propensity score matching (PSM) was used to mitigate the influence of selection bias. The primary outcome was textbook outcome in liver surgery (TOLS), previously defined as the absence of intraoperative incidents ≥grade 2, postoperative bile leak ≥grade B, severe morbidity, readmission, and 90-day or in-hospital mortality with the presence of an R0 resection margin in case of malignancy. The absence of a prolonged length of stay was added to define TOLS+.Results: among the 10.075 included patients, 1.507 underwent RLS and 8.568 LLS. After PSM, both groups constituted 1.505 patients. RLS was associated with higher rates of TOLS (78.3% vs. 71.8%, P&lt;0.001) and TOLS+ (55% vs. 50.4%, P=0.026), less Pringle usage (39.1% vs. 47.1%, P&lt;0.001), blood loss (100 vs. 200 milliliters, P&lt;0.001), transfusions (4.9% vs. 7.9%, P=0.003), conversions (2.7% vs 8.8%, P&lt;0.001), overall morbidity (19.3% vs. 25.7%, P&lt;0.001) and R0 resection margins (89.8% vs. 86%, P=0.015), but longer operative times (190 vs. 210 min, P=0.015). In the subgroups, RLS tended to have higher TOLS rates, compared to LLS, for minor resections in the posterosuperior segments (n=431 per group, 75.9% vs. 71.2%, P=0.184) and major resections (n=321 per group, 72.9% vs. 67.5%, P=0.086), although these differences did not reach statistical significance.Conclusions: while both producing excellent outcomes, RLS might facilitate slightly higher TOLS rates than LLS.</p

Nanosatellites: Space and Ground Technologies, Operations and Economics

Nanosatellites: Space and Ground Technologies, Operations and Economics comprehensively presents the latest research on the fast-developing area of nanosatellites. Divided into three distinct sections, the book begins with a brief history of nanosatellites and introduces nanosatellites technologies and payloads, also explaining how these are deployed into space. The second section provides an overview of the ground segment and operations, and the third section focuses on the regulations, policies, economics, and future trends. Key features: Payloads for nanosatellites Nanosatellites components design Examines the cost of development of nanosatellites. Covers the latest policies and regulations. Considers future trends for nanosatellites. Nanosatellites: Space and Ground Technologies, Operations and Economics is a comprehensive reference for researchers and practitioners working with nanosatellites in the aerospace industry