Feasibility and initial efficacy of project-based treatment for people with ABI

Background: Communication impairments are common and pervasive for people a long time following acquired brain injury (ABI). These impairments have a significant impact on a person's quality of life (QOL) post‐injury. Project‐based treatment is a treatment approach that could have an impact on communication skills and QOL for people with ABI a long‐term post‐injury. This treatment is embedded in a context of meaningful activities chosen by people with ABI, whereby, as a group, they work collaboratively to achieve a tangible end product. Aims: To evaluate the feasibility and initial efficacy of project‐based treatment on improving the communication skills and QOL for people with ABI. Methods & Procedures: An exploratory controlled trial with alternate allocation of groups, and follow‐up at 6–8 weeks, was completed. Twenty‐one people with chronic ABI were recruited in groups of two to three from community settings, allocated to either a TREATMENT (n = 11) or WAITLIST group (n = 10). Participants attended a 20‐h group‐based treatment over 6 weeks where they worked towards achieving a project that helped others. To determine feasibility, four criteria were used: demand, implementation, practicality and acceptability. A range of communication and QOL outcomes was used to determine a fifth feasibility criterion, initial efficacy. Some of these criteria were additionally used to evaluate the feasibility of the outcomes. Outcomes & Results: All participants received the treatment as allocated with high attendance and no dropouts. The treatment was feasible to deliver as intended and was highly acceptable to participants. Medium and large effect sizes were found from pre‐ to post‐treatment, and from pre‐treatment to follow‐up for measures of conversation, perceived communicative ability and QOL. Conclusions & Implications: Project‐based treatment is feasible with indications of initial efficacy for both communication skills and QOL. The treatment provides a promising new approach for improving communication skills and QOL in people with chronic acquired brain injuries in the community setting

Patterns of dairy food intake, body composition and markers of metabolic health in Ireland:results from the National Adult Nutrition Survey

Background: Studies examining the association between dairy consumption and metabolic health have shown mixed results. This may be due, in part, to the use of different definitions of dairy, and to single types of dairy foods examined in isolation. Objective: The objective of the study was to examine associations between dairy food intake and metabolic health, identify patterns of dairy food consumption and determine whether dairy dietary patterns are associated with outcomes of metabolic health, in a cross-sectional survey. Design: A 4-day food diary was used to assess food and beverage consumption, including dairy (defined as milk, cheese, yogurt, cream and butter) in free-living, healthy Irish adults aged 18–90 years (n=1500). Fasting blood samples (n=897) were collected, and anthropometric measurements taken. Differences in metabolic health markers across patterns and tertiles of dairy consumption were tested via analysis of covariance. Patterns of dairy food consumption, of different fat contents, were identified using cluster analysis. Results: Higher (total) dairy was associated with lower body mass index, %body fat, waist circumference and waist-to-hip ratio (P<0.001), and lower systolic (P=0.02) and diastolic (P<0.001) blood pressure. Similar trends were observed when milk and yogurt intakes were considered separately. Higher cheese consumption was associated with higher C-peptide (P<0.001). Dietary pattern analysis identified three patterns (clusters) of dairy consumption; 'Whole milk', 'Reduced fat milks and yogurt' and 'Butter and cream'. The 'Reduced fat milks and yogurt' cluster had the highest scores on a Healthy Eating Index, and lower-fat and saturated fat intakes, but greater triglyceride levels (P=0.028) and total cholesterol (P=0.015). conclusion: Overall, these results suggest that while milk and yogurt consumption is associated with a favourable body phenotype, the blood lipid profiles are less favourable when eaten as part of a low-fat high-carbohydrate dietary pattern. More research is needed to better understand this association. Conclusion: Overall, these results suggest that although milk and yogurt consumption is associated with a favourable body phenotype, the blood lipid profiles are less favourable when eaten as part of a low-fat high-carbohydrate dietary pattern. More research is needed to better understand this association

Seshat: The Global History Databank

The vast amount of knowledge about past human societies has not been systematically organized and, therefore, remains inaccessible for empirically testing theories about cultural evolution and historical dynamics. For example, what evolutionary mechanisms were involved in the transition from the small-scale, uncentralized societies, in which humans lived 10,000 years ago, to the large-scale societies with an extensive division of labor, great differentials in wealth and power, and elaborate governance structures of today? Why do modern states sometimes fail to meet the basic needs of their populations? Why do economies decline, or fail to grow? In this article, we describe the structure and uses of a massive databank of historical and archaeological information, Seshat: The Global History Databank. The data that we are currently entering in Seshat will allow us and others to test theories explaining how modern societies evolved from ancestral ones, and why modern societies vary so much in their capacity to satisfy their members’ basic human needsPeer reviewedFinal Published versio

Domestication via the commensal pathway in a fish-invertebrate mutualism.

Domesticator-domesticate relationships are specialized mutualisms where one species provides multigenerational support to another in exchange for a resource or service, and through which both partners gain an advantage over individuals outside the relationship. While this ecological innovation has profoundly reshaped the world's landscapes and biodiversity, the ecological circumstances that facilitate domestication remain uncertain. Here, we show that longfin damselfish (Stegastes diencaeus) aggressively defend algae farms on which they feed, and this protective refuge selects a domesticator-domesticate relationship with planktonic mysid shrimps (Mysidium integrum). Mysids passively excrete nutrients onto farms, which is associated with enriched algal composition, and damselfish that host mysids exhibit better body condition compared to those without. Our results suggest that the refuge damselfish create as a byproduct of algal tending and the mutual habituation that damselfish and mysids exhibit towards one another were instrumental in subsequent mysid domestication. These results are consistent with domestication via the commensal pathway, by which many common examples of animal domestication are hypothesized to have evolved

Variation in TAS2R receptor genes explains differential bitterness of two common antibiotics

For pharmaceuticals to deliver their full benefits with maximum efficacy, patients need to follow recommended dosing schedules, in terms of amount and frequency. Unfortunately, the aversive taste of many drugs, especially bitterness, can reduce patient compliance in oral liquid formulations. Given common genetic differences in bitter taste receptor genes (TAS2Rs), some individuals may be at increased risk for poor compliance due to heightened bitterness that becomes a barrier to proper use. Here we report on the sensory profile of two antibiotics, chloramphenicol and ofloxacin, investigating whether bitterness intensity associates with nominally functional TAS2R variants. Participants (n = 143) rated suprathreshold intensity on a general Labeled Magnitude Scale (gLMS) for chloramphenicol and ofloxacin; propylthiouracil (PROP) was included as a control, given robust prior associations with TAS2R38 variants. The dominant sensation from chloramphenicol and ofloxacin was bitterness, falling just below “moderate” on a gLMS. TAS2R38 diplotype associated with variable bitterness of chloramphenicol and PROP, but not ofloxacin. The bitterness of ofloxacin associated with a TAS2R9 SNP (V187A). This pilot study provides novel evidence on differences in the bitterness from two antibiotics, which are associated with TAS2R variants. Improved understanding of individualized barriers to patient compliance, especially for oral formulations, can guide future efforts to optimize delivery systems for improved compliance

Clinical disease course and survival outcomes following disease recurrence in adenoid cystic carcinoma with and without NOTCH signaling pathway activation.

BACKGROUND: Adenoid cystic carcinoma (ACC) is a rare salivary cancer. The highest rates of disease recurrence are in patients with NOTCH pathway activation, reported in up to 20%. Novel drugs targeting NOTCH signaling are under investigation in the recurrent/metastatic (R/M) setting. To understand their clinical utility, there is an urgent need to better characterize the disease course and outcomes following current standard of care treatment. METHODS: 120 patients with R/M ACC underwent clinical review at a single UK Cancer Centre. Patients were retrospectively assessed for tumor NOTCH pathway activation using next generation sequencing (NGS) targeting NOTCH1/2/3 genes and/or NOTCH1 intra-cellular domain (NICD1) immunohistochemistry. Demographic and treatment data were extracted from the clinical notes. Kaplan-Meier survival analysis was performed using log rank test. RESULTS: NOTCH pathway activation was identified in 13/120 patients (11 %). In 12/101 patients analyzed by NGS, NOTCH1/3 activating somatic mutations were identified, and a further patient was identified with NICD1 diffuse nuclear staining in whom NGS testing was not possible. Patients with NOTCH pathway activation had shorter median RFS (1.1 vs 3.4 years, p = 0.2032) and significantly reduced median OS from diagnosis (4.0 vs 16.3 years, p < 0.0001). There was significantly reduced median OS from time of disease recurrence/metastasis (1.9 vs 9.6 years, p < 0.0001). CONCLUSION: This study clearly demonstrates a reduction in OS from time of first confirmed disease recurrence/metastasis for patients with NOTCH pathway activated ACC. This provides support for developing new drugs for this sub-group of patients, for whom clinical outcomes are significantly worse and effective treatments are lacking

ICON 9-an international phase III randomized study to evaluate the efficacy of maintenance therapy with olaparib and cediranib or olaparib alone in patients with relapsed platinum-sensitive ovarian cancer following a response to platinum-based chemotherapy

BACKGROUND: Two novel biological agents-cediranib targeting angiogenesis, and olaparib targeting DNA repair processes-have individually led to an improvement in ovarian cancer control. The aim of ICON9 is to investigate the combination of cediranib and olaparib maintenance in recurrent ovarian cancer following platinum-based therapy. PRIMARY OBJECTIVE: To assess the efficacy of maintenance treatment with olaparib in combination with cediranib compared with olaparib alone following a response to platinum-based chemotherapy in women with platinum-sensitive ovarian, fallopian tube or peritoneal cancer during first relapse. STUDY HYPOTHESIS: Maintenance therapy with cediranib and olaparib in combination is associated with improved patient outcomes compared with olaparib alone. TRIAL DESIGN: International phase III randomized controlled trial. Following a response to platinum-based chemotherapy patients are randomized 1:1 to either oral olaparib and cediranib (intervention arm) or oral olaparib alone (control arm). MAJOR INCLUSION CRITERIA: Patients with a known diagnosis of high grade serous or endometrioid carcinoma of the ovary, fallopian tube or peritoneum, progressing more than 6 months after first-line platinum-based chemotherapy, who have responded to second-line platinum-based chemotherapy. PRIMARY ENDPOINTS: Progression-free and overall survival. Co-primary endpoints to be assessed using a fixed-sequence gatekeeping approach: (1) progression-free survival, all patients; (2) progression-free survival, BRCA wild type; (3) overall survival, all patients; (4) overall survival, BRCA wild type. SAMPLE SIZE: 618 patients will be recruited. ESTIMATED DATES FOR COMPLETING ACCRUAL AND PRESENTING RESULTS: Accrual is expected to be completed in 2024 with presentation of results in 2025. TRIAL REGISTRATION: ClinicalTrials.gov: NCT03278717

Liesegang patterns: Effect of dissociation of the invading electrolyte

The effect of dissociation of the invading electrolyte on the formation of Liesegang bands is investigated. We find, using organic compounds with known dissociation constants, that the spacing coefficient, 1+p, that characterizes the position of the n-th band as x_n ~ (1+p)^n, decreases with increasing dissociation constant, K_d. Theoretical arguments are developed to explain these experimental findings and to calculate explicitly the K_d dependence of 1+p.Comment: RevTex, 8 pages, 3 eps figure

A perspective on the landscape problem

I discuss the historical roots of the landscape problem and propose criteria for its successful resolution. This provides a perspective to evaluate the possibility to solve it in several of the speculative cosmological scenarios under study including eternal inflation, cosmological natural selection and cyclic cosmologies.Comment: Invited contribution for a special issue of Foundations of Physics titled: Forty Years Of String Theory: Reflecting On the Foundations. 31 pages, no figure