MaskDensity14: an R package for the density approximant of a univariate based on noise multiplied data

Lin (2014) developed a framework of the method of the sample-moment-based density approximant, for estimating the probability density function of microdata based on noise multiplied data. Theoretically, it provides a promising method for data users in generating the synthetic data of the original data without accessing the original data; however, technical issues can cause problems implementing the method. In this paper, we describe a software package called MaskDensity14, written in the R language, that uses a computational approach to solve the technical issues and makes the method of the sample-moment-based density approximant feasible. MaskDensity14 has applications in many areas, such as sharing clinical trial data and survey data without releasing the original data

A new varve sequence from Windermere, UK, records rapid ice retreat prior to the Lateglacial Interstadial (GI-1)

Annually laminated sediments (varves) provide excellent temporal resolution to study rapid environmental change, but are rare in the early part of the Last Termination (∼19–∼11.7 ka BP). We present a new >400 varve year (vyr) varve sequence in two floating parts from Windermere, a lake at the southern margin of the mountains of northwest England. This sequence records the final retreat of the Windermere glacier at the southern edge of the Lake District Ice Cap during the transition from Heinrich Stadial 1 (∼18–∼14.7 ka BP) into the Lateglacial Interstadial (∼14.7–∼12.9 ka BP). Laminated sediments from four lake cores from Windermere's northern and southern basins were investigated and shown to be varved. These sequences are integrated with seismic reflection evidence to reconstruct south-to-north deglaciation. Seismic and sedimentological evidence is consistent with gradual stepped ice retreat along the entire southern basin and into the northern basin between 255 and 700 vyr prior to the appearance of significant biota in the sediment that heralded the Lateglacial Interstadial, and had retreated past a recessional moraine (RM8) in the northern basin by 121 vyr prior to the interstadial. The Lateglacial Interstadial age of this biota-bearing unit was confirmed by 14C-dating, including one date from the northernmost core of ∼13.5 cal ka BP. A change in mineralogy in all four cores as the glacier retreated north of the Dent Group (the northernmost source of calcareous bedrock) and a decrease in coarse grains in the varves shows that the ice had retreated along the entire North Basin at ∼70 vyr prior to the Lateglacial Interstadial. The estimated retreat rate is 70–114 m yr−1 although buried De Geer moraines, if annual, may indicate retreat of 120 m yr−1 with a ≥3 year stillstand at a recessional moraine halfway along the basin. The glacier then retreated north of the lake basin, becoming land-terminating and retreating at 92.5–49 m yr−1. The northernmost core has a varve sequence ending at least 111 vyr after the other core chronologies, due to the increased proximity to remnant ice in the catchment uplands into the early Lateglacial Interstadial. We show that almost all of the glacier retreat in the Windermere catchment occurred before the abrupt warming at the onset of the Lateglacial Interstadial, in keeping with similar findings from around the Irish Sea Basin, and suggesting a similar retreat timescale for other radial valley glaciers of the Lake District Ice Cap. The seismic and core evidence also show the potential for a much longer varve chronology extending at least 400 and potentially over 1000 vyr further back into Heinrich Stadial 1 (18–14.7 ka BP), suggesting that glacier retreat in the Windermere valley initiated at least before 15.5 ka BP and perhaps 16 ka BP

Diagnosis, treatment, and survival from kidney cancer: real‐world National Health Service England data between 2013 and 2019

Objectives: To report the NHS Digital (NHSD) data for patients diagnosed with kidney cancer (KC) in England. We explore the incidence, route to diagnosis (RTD), treatment, and survival patterns from 2013 to 2019. Materials and Methods: Data was extracted from the Cancer Data NHSD portal for International Classification of Diseases, 10th edition coded KC; this included Cancer Registry data, Hospital Episode Statistics, and cancer waiting times data. Results: Registrations included 66 696 individuals with KC. Incidence of new KC diagnoses increased (8998 in 2013, to 10 232 in 2019), but the age‐standardised rates were stable (18.7–19.4/100 000 population). Almost half of patients (30 340 [45.5%]) were aged 0–70 years and the cohort were most frequently diagnosed with Stage 1–2 KC (n = 26 297 [39.4%]). Most patients were diagnosed through non‐urgent general practitioner referrals (n = 16 814 [30.4%]), followed by 2‐week‐wait (n = 15 472 [28.0%]) and emergency routes (n = 11 796 [21.3%]), with older patients (aged ≥70 years), Stage 4 KCs, and patients with non‐specified renal cell carcinoma being significantly more likely to present through the emergency route (all P < 0.001). Invasive treatment (surgery or ablation), radiotherapy, or systemic anti‐cancer therapy use varied with disease stage, patient factors, and treatment network (Cancer Alliance). Survival outcomes differed by Stage, histological subtype, and social deprivation class (P < 0.001). Age‐standardised mortality rates did not change over the study duration, although immunotherapy usage is likely not captured in this study timeline. Conclusion: The NHSD resource provides useful insight about the incidence, diagnostic pathways, treatment, and survival of patients with KC in England and a useful benchmark for the upcoming commissioned National Kidney Cancer Audit. The RTD data may be limited by incidental diagnoses, which could confound the high proportion of ‘emergency’ diagnoses. Importantly, survival outcomes remained relatively unchanged

Religiousness as tourist performances: a case study of Greek Orthodox pilgrimage

The aim of this paper is to decipher ways of experiencing religiousness through tourist performances, intersecting textual approaches with the essential embodiment and materiality of the tourist world. Exploring the diversity of religious tourists’ practices within the Greek Orthodox context, two dimensions underpinning religious tourist experience are highlighted: institutional performances and unconventional performances. Focussing on the embodied experience and drawing upon theories of performance, the paper critiques the interplays of body and place to re-conceptualise current understanding of the pilgrimage/tourism relationship. In doing so, the paper proposes that tourism and religion are not separate entities but linked through embodied notions of godliness sensed through touristic performances

Distribution and determinants of patient satisfaction in oncology with a focus on health related quality of life

<p>Abstract</p> <p>Background</p> <p>Cancer patients usually undergo extensive and debilitating treatments, which make quality of life (QoL) and patient satisfaction important health care assessment measures. However, very few studies have evaluated the relationship between QoL and patient satisfaction in oncology. We investigated the clinical, demographic and QoL factors associated with patient satisfaction in a large heterogeneous sample of cancer patients.</p> <p>Methods</p> <p>A cohort of 538 cancer patients treated at Cancer Treatment Centers of America^®(CTCA) was assessed. A patient satisfaction questionnaire developed in-house by CTCA was used. It covered the following dimensions of patient satisfaction: hospital operations and services, physicians and staff, and patient endorsements for themselves and others. QoL was assessed using the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (QLQ-C30). The clinical, demographic and QoL factors were evaluated for predictive significance using univariate and multivariate logistic regression.</p> <p>Results</p> <p>The mean age of our patient population was 54.1 years (SD = 10.5, range 17-86), with a slight preponderance of females (57.2%). Breast cancer (n = 124) and lung cancer (n = 101) were the most frequent cancer types. 481 (89.4%) patients were "very satisfied" with their overall experience. Age and several QoL function and symptom scales were predictive of overall patient satisfaction upon univariate analysis. In the multivariate modeling, only those with a score above the median on the fatigue measure (i.e. worse fatigue) had reduced odds of 0.28 of being very satisfied (p = 0.03).</p> <p>Conclusion</p> <p>Patient fatigue, as reported by the QoL fatigue scale, was an independent significant predictor of overall patient satisfaction. This finding argues for special attention and programs for cancer patients who report higher levels of fatigue given that fatigue is the most frequently reported symptom in cancer patients.</p

Understanding the circumgalactic medium is critical for understanding galaxy evolution

Galaxies evolve under the influence of gas flows between their interstellar medium and their surrounding gaseous halos known as the circumgalactic medium (CGM). The CGM is a major reservoir of galactic baryons and metals, and plays a key role in the long cycles of accretion, feedback, and recycling of gas that drive star formation. In order to fully understand the physical processes at work within galaxies, it is therefore essential to have a firm understanding of the composition, structure, kinematics, thermodynamics, and evolution of the CGM. In this white paper we outline connections between the CGM and galactic star formation histories, internal kinematics, chemical evolution, quenching, satellite evolution, dark matter halo occupation, and the reionization of the larger-scale intergalactic medium in light of the advances that will be made on these topics in the 2020s. We argue that, in the next decade, fundamental progress on all of these major issues depends critically on improved empirical characterization and theoretical understanding of the CGM. In particular, we discuss how future advances in spatially-resolved CGM observations at high spectral resolution, broader characterization of the CGM across galaxy mass and redshift, and expected breakthroughs in cosmological hydrodynamic simulations will help resolve these major problems in galaxy evolution.Comment: Astro2020 Decadal Science White Pape

Designing protected area networks that translate international conservation commitments into national action

Most countries have committed to protect 17% of their terrestrial area by 2020 through Aichi Target 11 of the Convention on Biological Diversity, with a focus on protecting areas of particular importance for biodiversity. This means national-scale spatial conservation prioritisations are needed to help meet this target and guide broader conservation and land-use policy development. However, to ensure these assessments are adopted by policy makers, they must also consider national priorities. This situation is exemplified by Guyana, a corner of Amazonia that couples high biodiversity with low economic development. In recent years activities that threaten biodiversity conservation have increased, and consequently, protected areas are evermore critical to achieving the Aichi targets. Here we undertake a cost-effective approach to protected area planning in Guyana that accounts for in-country conditions. To do this we conducted a stakeholder-led spatial conservation prioritisation based on meeting targets for 17 vegetation types and 329 vertebrate species, while minimising opportunity costs for forestry, mining, agriculture and urbanisation. Our analysis identifies 3 millio

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat