Therapy preferences of patients with lung and colon cancer: A discrete choice experiment

Objectives: There is increasing interest in studies that examine patient preferences to measure health-related outcomes. Understanding patients’ preferences can improve the treatment process and is particularly relevant for oncology. In this study, we aimed to identify the subgroup-specific treatment preferences of German patients with lung cancer (LC) or colorectal cancer (CRC). Methods: Six discrete choice experiment (DCE) attributes were established on the basis of a systematic literature review and qualitative interviews. The DCE analyses comprised generalized linear mixed-effects model and latent class mixed logit model. Results: The study cohort comprised 310 patients (194 with LC, 108 with CRC, 8 with both types of cancer) with a median age of 63 (SD =10.66) years. The generalized linear mixed-effects model showed a significant (P<0.05) degree of association for all of the tested attributes. “Strongly increased life expectancy” was the attribute given the greatest weight by all patient groups. Using latent class mixed logit model analysis, we identified three classes of patients. Patients who were better informed tended to prefer a more balanced relationship between length and health-related quality of life (HRQoL) than those who were less informed. Class 2 (LC patients with low HRQoL who had undergone surgery) gave a very strong weighting to increased length of life. We deduced from Class 3 patients that those with a relatively good life expectancy (CRC compared with LC) gave a greater weight to moderate effects on HRQoL than to a longer life. Conclusion: Overall survival was the most important attribute of therapy for patients with LC or CRC. Differences in treatment preferences between subgroups should be considered in regard to treatment and development of guidelines. Patients’ preferences were not affected by sex or age, but were affected by the cancer type, HRQoL, surgery status, and the main source of information on the disease

Human ankle joint movements during walking are probably not determined by talar morphology.

Knowledge about the orientation of a representative ankle joint axis is limited to studies of tarsal morphology and of quasistatic movements. The aim of our study was therefore to determine the development of the axis orientation during walking. Intracortical bone pins were used to monitor the kinematics of the talus and tibia of five healthy volunteers. The finite helical axis was determined for moving windows of 10% stance phase and its orientation reported if the rotation about the axis was more than 2°. A representative axis for ankle dorsi- and plantarflexion was also estimated based on tarsal morphology. As reported by literature, the morphology-based axis was inclined more medially upwards for dorsiflexion than for plantarflexion. However, when a mean of the finite helical axis orientations was calculated for each walking trial for dorsiflexion (stance phase 15-25%) and for plantarflexion (stance phase 85-95%), the inclination was less medially upwards in dorsiflexion than in plantarflexion in four out of five participants. Thus, it appears that the inclination of a representative ankle joint axis for dynamic loading situations cannot be estimated from either morphology or quasi-static experiments. Future studies assessing muscle activity, ligament behaviour and articulating surfaces may help to identify the determining factors for the orientation of a representative ankle joint axis

Tremendous bleeding complication after vacuum-assisted sternal closure

Vacuum-assisted closure (VAC) of complex infected wounds has recently gained popularity among various surgical specialties. The system is based on the application of negative pressure by controlled suction to the wound surface. The effectiveness of the VAC System on microcirculation and the promotion of granulation tissue proliferation are proved. No contraindications for the use in deep sternal wounds in cardiac surgery are described. In our case report we illustrate a scenario were a patient developed severe bleeding from the ascending aorta by penetration of wire fragments in the vessel. We conclude that all free particles in the sternum have to be removed completely before negative pressure is used

Superconductivity in Ce- and U-based "122" heavy-fermion compounds

This review discusses the heavy-fermion superconductivity in Ce- and U-based compounds crystallizing in the body-centered tetragonal ThCr2Si2 structure. Special attention will be paid to the theoretical background of these systems which are located close to a magnetic instability.Comment: 12 pages, 9 figures. Invited topical review (special issue on "Recent Developments in Superconductivity") Metadata and references update

Geothermal heat flux in the Amundsen Sea sector of West Antarctica: New insights from temperature measurements, depth to the bottom of the magnetic source estimation, and thermal modeling

Focused research on the Pine Island and Thwaites glaciers, which drain the West Antarctic Ice Shelf (WAIS) into the Amundsen Sea Embayment (ASE), revealed strong signs of instability in recent decades that result from variety of reasons, such as inflow of warmer ocean currents and reverse bedrock topogra- phy, and has been established as the Marine Ice Sheet Instability hypothesis. Geothermal heat flux (GHF) is a poorly constrained parameter in Antarctica and suspected to affect basal conditions of ice sheets, i.e., basal melting and subglacial hydrology. Thermomechanical models demonstrate the influential boundary condition of geothermal heat flux for (paleo) ice sheet stability. Due to a complex tectonic and magmatic history of West Antarctica, the region is suspected to exhibit strong heterogeneous geothermal heat flux variations. We present an approach to investigate ranges of realistic heat fluxes in the ASE by different methods, discuss direct observations, and 3-D numerical models that incorporate boundary conditions derived from various geophysical studies, including our new Depth to the Bottom of the Magnetic Source (DBMS) estimates. Our in situ temperature measurements at 26 sites in the ASE more than triples the number of direct GHF observations in West Antarctica. We demonstrate by our numerical 3-D models that GHF spatially varies from 68 up to 110 mW m-2

Author Correction: The FLUXNET2015 dataset and the ONEFlux processing pipeline for eddy covariance data

The following authors were omitted from the original version of this Data Descriptor: Markus Reichstein and Nicolas Vuichard. Both contributed to the code development and N. Vuichard contributed to the processing of the ERA-Interim data downscaling. Furthermore, the contribution of the co-author Frank Tiedemann was re-evaluated relative to the colleague Corinna Rebmann, both working at the same sites, and based on this re-evaluation a substitution in the co-author list is implemented (with Rebmann replacing Tiedemann). Finally, two affiliations were listed incorrectly and are corrected here (entries 190 and 193). The author list and affiliations have been amended to address these omissions in both the HTML and PDF versions