Formal Definitions of Unbounded Evolution and Innovation Reveal Universal Mechanisms for Open-Ended Evolution in Dynamical Systems

Open-ended evolution (OEE) is relevant to a variety of biological, artificial and technological systems, but has been challenging to reproduce in silico. Most theoretical efforts focus on key aspects of open-ended evolution as it appears in biology. We recast the problem as a more general one in dynamical systems theory, providing simple criteria for open-ended evolution based on two hallmark features: unbounded evolution and innovation. We define unbounded evolution as patterns that are non-repeating within the expected Poincare recurrence time of an equivalent isolated system, and innovation as trajectories not observed in isolated systems. As a case study, we implement novel variants of cellular automata (CA) in which the update rules are allowed to vary with time in three alternative ways. Each is capable of generating conditions for open-ended evolution, but vary in their ability to do so. We find that state-dependent dynamics, widely regarded as a hallmark of life, statistically out-performs other candidate mechanisms, and is the only mechanism to produce open-ended evolution in a scalable manner, essential to the notion of ongoing evolution. This analysis suggests a new framework for unifying mechanisms for generating OEE with features distinctive to life and its artifacts, with broad applicability to biological and artificial systems.Comment: Main document: 17 pages, Supplement: 21 pages Presented at OEE2: The Second Workshop on Open-Ended Evolution, 15th International Conference on the Synthesis and Simulation of Living Systems (ALIFE XV), Canc\'un, Mexico, 4-8 July 2016 (http://www.tim-taylor.com/oee2/

Development of A “PharmaComm” Serious Game for Teaching Pharmacist Communication and Drug Administration in a Virtual Hospital Setting

Practical experience is crucial in pharmacy education, but it can be difficult to provide pharmacy students with a sufficient level of experience during their education due to a number of challenges. Video games might provide a platform where students can gain positive learning experience in a virtual environment. Serious games have been used successfully across many industries, which suggest that a well-designed serious game can have positive learning outcomes. Increased engagement and motivation are mentioned by experts as some of the main benefits of serious games. Being able to practise skills before utilising them in real-world scenarios is another advantage identified. In this paper, we present a virtual patient simulator which is designed specifically teaching pharmacy students patient communication and administration of drugs. A pilot study and an expert review were carried out to evaluate the effectiveness of the application and its findings are presented

Ultrafiltration for acute decompensated cardiac failure: A systematic review and meta-analysis

Background Ultrafiltration is a method used to achieve diuresis in acute decompensated heart failure (ADHF) when there is diuretic resistance, but its efficacy in other settings is unclear. We therefore conducted a systematic review and meta-analysis to evaluate the use of ultrafiltration in ADHF. Methods We searched MEDLINE and EMBASE for studies that evaluated outcomes following filtration compared to diuretic therapy in ADHF. The outcomes of interest were body weight change, change in renal function, length of stay, frequency of rehospitalization, mortality and dependence on dialysis. We performed random effects meta-analyses to pool studies that evaluated the desired outcomes and assessed statistical heterogeneity using the I2 statistic. Results A total of 10 trials with 857 participants (mean age 68 years, 71% male) compared filtration to usual diuretic care in ADHF. Nine studies evaluated weight change following filtration and the pooled results suggest a decline in mean body weight − 1.8; 95% CI, − 4.68 to 0.97 kg. Pooled results showed no difference between the filtration and diuretic group in change in creatinine or estimated glomerular filtration rate. The pooled results suggest longer hospital stay with filtration (mean difference, 3.70; 95% CI, − 3.39 to 10.80 days) and a reduction in heart failure hospitalization (RR, 0.71; 95% CI, 0.51–1.00) and all-cause rehospitalization (RR, 0.89; 95% CI, 0.43–1.86) compared to the diuretic group. Filtration was associated with a non-significant greater risk of death compared to diuretic use (RR, 1.08; 95% CI, 0.77–1.52)

Management of Septated Malignant Pleural Effusions

Purpose of Review: We review recent studies of patients with septated malignant pleural effusions, to understand what the clinical implications for patients are and what evidence-based methods should be used to manage these effusions. Recent Findings: Fibrinolytics improve effusion size assessed radiologically in patients with a chest drain inserted for septated malignant pleural effusions but this does not translate into an improvement in breathlessness relief or pleurodesis success. Fibrinolytics have also been used in patients with septated effusions associated with indwelling pleural catheters, but dyspnoea relief has not been assessed in this population. Patients with septated effusions or extensive adhesions appear to have a worse prognosis. Summary: Patients with septated malignant pleural effusions have a poor prognosis and do not gain clinical benefit from fibrinolytics via chest drain. The role of fibrinolytics for septated effusions associated with indwelling pleural catheters requires further study

Quality of life after curative gastrectomy for gastric cancer in a randomised controlled trial

Quality of life (QOL) was studied in gastric cancer patients treated on a randomised, controlled trial comparing D1 (level 1) with D3 (levels 1, 2 and 3) lymphadenectomy. A total of 221 patients were randomly assigned to D1 (n=110) and D3 (n=111) surgery. Quality-of-life assessments included functional outcomes (a 14-item survey about treatment-specific symptoms) and health perception (Spitzer QOL Index) was performed before and after surgery at disease-free status. Patients suffered from irrelative events such as loss of partners was excluded thereafter. Main analyses were done by intention-to-treat. Thus, 214 D1 (106/110=96.4%) and D3 (108/111=97.3%) R0 patients were assessed. Longitudinal analysis showed that functional outcomes decreased at 6 months after surgery and increased over time thereafter, while health perceptions increased over time in general. On the basis of linear mixed model analyses, patients having total gastrectomy, advanced cancer and hemipancreaticosplenectomy, but not complications had poorer QOL than those without. D1 and D3 patients showed no significant difference in QOL. The results suggest that changes of QOL were largely due to scope of gastric resection, disease status and distal pancreaticosplenectomy, rather than the extent of lymph node dissection. This indicates that nodal dissection can be performed for a potentially curable gastric cancer

Hand-grip strength is a simple and effective outcome predictor in esophageal cancer following esophagectomy with reconstruction: a prospective study

<p>Abstract</p> <p>Background</p> <p>Surgery for esophageal cancer usually carries considerable complication and mortality rate. Adequate preoperative evaluation is mandatory to decrease complication rate. Hand-grip strength is a useful measure to assess the extent of aging, nutrition and patient's overall condition. Because preoperative nutrition state and physiologic aging process play important roles in postoperative recovery, we would like to know if hand-grip strength is an adequate tool for such evaluation.</p> <p>Material and methods</p> <p>From January 1st, 2007 to December 31, 2008, there was 68 cases underwent esophagectomy with reconstruction due to esophageal cancer in our hospital. After excluding 7 patients of incomplete data and loss of follow-up, there were 61 patients included in the study.</p> <p>Results</p> <p>There were 54 men and 7 women. The mean age is 60.7. Most of patients had squamous cell carcinoma. Patient with weak hand-grip strength prior to operation had exceedingly high rates of complication and mortality within 6 months after operation. Compared to other risk factors, low grip strength has highest relative risks for both mortality and morbidity.</p> <p>Conclusion</p> <p>Because test for hand-grip strength is cheap, not time-consuming and has high predictive value, it may be included in routine preoperative evaluation.</p

A Spatial Analysis of Rift Valley Fever Virus Seropositivity in Domestic Ruminants in Tanzania

Rift Valley fever (RVF) is an acute arthropod-borne viral zoonotic disease primarily occurring in Africa. Since RVF-like disease was reported in Tanzania in 1930, outbreaks of the disease have been reported mainly from the eastern ecosystem of the Great Rift Valley. This cross-sectional study was carried out to describe the variation in RVF virus (RVFV) seropositivity in domestic ruminants between selected villages in the eastern and western Rift Valley ecosystems in Tanzania, and identify potential risk factors. Three study villages were purposively selected from each of the two Rift Valley ecosystems. Serum samples from randomly selected domestic ruminants (n = 1,435) were tested for the presence of specific immunoglobulin G (IgG) and M (IgM), using RVF enzyme-linked immunosorbent assay methods. Mixed effects logistic regression modelling was used to investigate the association between potential risk factors and RVFV seropositivity. The overall RVFV seroprevalence (n = 1,435) in domestic ruminants was 25.8% and species specific seroprevalence was 29.7%, 27.7% and 22.0% in sheep (n = 148), cattle (n = 756) and goats (n = 531), respectively. The odds of seropositivity were significantly higher in animals sampled from the villages in the eastern than those in the western Rift Valley ecosystem (OR = 1.88, CI: 1.41, 2.51; p<0.001), in animals sampled from villages with soils of good than those with soils of poor water holding capacity (OR = 1.97; 95% CI: 1.58, 3.02; p< 0.001), and in animals which had been introduced than in animals born within the herd (OR = 5.08, CI: 2.74, 9.44; p< 0.001). Compared with animals aged 1-2 years, those aged 3 and 4-5 years had 3.40 (CI: 2.49, 4.64; p< 0.001) and 3.31 (CI: 2.27, 4.82, p< 0.001) times the odds of seropositivity. The findings confirm exposure to RVFV in all the study villages, but with a higher prevalence in the study villages from the eastern Rift Valley ecosystem

Informing the design of a national screening and treatment programme for chronic viral hepatitis in primary care: qualitative study of at-risk immigrant communities and healthcare professionals

n Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise statedThis paper presents independent research funded by the National Institute for Health Research (NIHR) under the Programme Grants for Applied Research programme (RP-PG-1209-10038).

Thymosin β10 Expression Driven by the Human TERT Promoter Induces Ovarian Cancer-Specific Apoptosis through ROS Production

Thymosin β10 (Tβ10) regulates actin dynamics as a cytoplasm G-actin sequestering protein. Previously, we have shown that Tβ10 diminishes tumor growth, angiogenesis, and proliferation by disrupting actin and by inhibiting Ras. However, little is known about its mechanism of action and biological function. In the present study, we establish a new gene therapy model using a genetically modified adenovirus, referred to as Ad.TERT.Tβ10, that can overexpress the Tβ10 gene in cancer cells. This was accomplished by replacing the native Tβ10 gene promoter with the human TERT promoter in Ad.TERT.Tβ10. We investigated the cancer suppression activity of Tβ10 and found that Ad.TERT.Tβ10 strikingly induced cancer-specific expression of Tβ10 as well as apoptosis in a co-culture model of human primary ovarian cancer cells and normal fibroblasts. Additionally, Ad.TERT.Tβ10 decreased mitochondrial membrane potential and increased reactive oxygen species (ROS) production. These effects were amplified by co-treatment with anticancer drugs, such as paclitaxel and cisplatin. These findings indicate that the rise in ROS production due to actin disruption by Tβ10 overexpression increases apoptosis of human ovarian cancer cells. Indeed, the cancer-specific overexpression of Tβ10 by Ad.TERT.Tβ10 could be a valuable anti-cancer therapeutic for the treatment of ovarian cancer without toxicity to normal cells