108 research outputs found
Enhancing Next-Generation Sequencing-Guided Cancer Care Through Cognitive Computing
Background: Using next-generation sequencing (NGS) to guide cancer therapy has created challenges in analyzing and reporting large volumes of genomic data to patients and caregivers. Specifically, providing current, accurate information on newly approved therapies and open clinical trials requires considerable manual curation performed mainly by human âmolecular tumor boardsâ (MTBs). The purpose of this study was to determine the utility of cognitive computing as performed by Watson for Genomics (WfG) compared with a human MTB. Materials and Methods: One thousand eighteen patient cases that previously underwent targeted exon sequencing at the University of North Carolina (UNC) and subsequent analysis by the UNCseq informatics pipeline and the UNC MTB between November 7, 2011, and May 12, 2015, were analyzed with WfG, a cognitive computing technology for genomic analysis. Results: Using a WfG-curated actionable gene list, we identified additional genomic events of potential significance (not discovered by traditional MTB curation) in 323 (32%) patients. The majority of these additional genomic events were considered actionable based upon their ability to qualify patients for biomarker-selected clinical trials. Indeed, the opening of a relevant clinical trial within 1 month prior to WfG analysis provided the rationale for identification of a new actionable event in nearly a quarter of the 323 patients. This automated analysis took <3 minutes per case. Conclusion: These results demonstrate that the interpretation and actionability of somatic NGS results are evolving too rapidly to rely solely on human curation. Molecular tumor boards empowered by cognitive computing could potentially improve patient care by providing a rapid, comprehensive approach for data analysis and consideration of up-to-date availability of clinical trials. Implications for Practice: The results of this study demonstrate that the interpretation and actionability of somatic next-generation sequencing results are evolving too rapidly to rely solely on human curation. Molecular tumor boards empowered by cognitive computing can significantly improve patient care by providing a fast, cost-effective, and comprehensive approach for data analysis in the delivery of precision medicine. Patients and physicians who are considering enrollment in clinical trials may benefit from the support of such tools applied to genomic data
Modeling the Subsurface Structure of Sunspots
While sunspots are easily observed at the solar surface, determining their
subsurface structure is not trivial. There are two main hypotheses for the
subsurface structure of sunspots: the monolithic model and the cluster model.
Local helioseismology is the only means by which we can investigate
subphotospheric structure. However, as current linear inversion techniques do
not yet allow helioseismology to probe the internal structure with sufficient
confidence to distinguish between the monolith and cluster models, the
development of physically realistic sunspot models are a priority for
helioseismologists. This is because they are not only important indicators of
the variety of physical effects that may influence helioseismic inferences in
active regions, but they also enable detailed assessments of the validity of
helioseismic interpretations through numerical forward modeling. In this paper,
we provide a critical review of the existing sunspot models and an overview of
numerical methods employed to model wave propagation through model sunspots. We
then carry out an helioseismic analysis of the sunspot in Active Region 9787
and address the serious inconsistencies uncovered by
\citeauthor{gizonetal2009}~(\citeyear{gizonetal2009,gizonetal2009a}). We find
that this sunspot is most probably associated with a shallow, positive
wave-speed perturbation (unlike the traditional two-layer model) and that
travel-time measurements are consistent with a horizontal outflow in the
surrounding moat.Comment: 73 pages, 19 figures, accepted by Solar Physic
Noncommutative Fluids
We review the connection between noncommutative gauge theory, matrix models
and fluid mechanical systems. The noncommutative Chern-Simons description of
the quantum Hall effect and bosonization of collective fermion states are used
as specific examples.Comment: To appear in "Seminaire Poincare X", Institut Henri Poincare, Paris;
references adde
Recent sarcopenia definitionsâprevalence, agreement and mortality associations among men: findings from populationâbased cohorts
Background
The 2019 European Working Group on Sarcopenia in Older People (EWGSOP2) and the Sarcopenia Definitions and Outcomes Consortium (SDOC) have recently proposed sarcopenia definitions. However, comparisons of the performance of these approaches in terms of thresholds employed, concordance in individuals and prediction of important health-related outcomes such as death are limited. We addressed this in a large multinational assembly of cohort studies that included information on lean mass, muscle strength, physical performance and health outcomes.
Methods
White men from the Health Aging and Body Composition (Health ABC) Study, Osteoporotic Fractures in Men (MrOS) Study cohorts (Sweden, USA), the Hertfordshire Cohort Study (HCS) and the Sarcopenia and Physical impairment with advancing Age (SarcoPhAge) Study were analysed. Appendicular lean mass (ALM) was ascertained using DXA; muscle strength by grip dynamometry; and usual gait speed over courses of 2.4â6 m. Deaths were recorded and verified. Definitions of sarcopenia were as follows: EWGSOP2 (grip strength <27 kg and ALM index <7.0 kg/m2), SDOC (grip strength <35.5 kg and gait speed <0.8 m/s) and Modified SDOC (grip strength <35.5 kg and gait speed <1.0 m/s). Cohen's kappa statistic was used to assess agreement between original definitions (EWGSOP2 and SDOC). Presence versus absence of sarcopenia according to each definition in relation to mortality risk was examined using Cox regression with adjustment for age and weight; estimates were combined across cohorts using random-effects meta-analysis.
Results
Mean (SD) age of participants (n = 9170) was 74.3 (4.9) years; 5929 participants died during a mean (SD) follow-up of 12.1 (5.5) years. The proportion with sarcopenia according to each definition was EWGSOP2 (1.1%), SDOC (1.7%) and Modified SDOC (5.3%). Agreement was weak between EWGSOP2 and SDOC (Îș = 0.17). Pooled hazard ratios (95% CI) for mortality for presence versus absence of each definition were EWGSOP2 [1.76 (1.42, 2.18), I2: 0.0%]; SDOC [2.75 (2.28, 3.31), I2: 0.0%]; and Modified SDOC [1.93 (1.54, 2.41), I2: 58.3%].
Conclusions
There was low prevalence and poor agreement among recent sarcopenia definitions in community-dwelling cohorts of older white men. All indices of sarcopenia were associated with mortality. The strong relationship between sarcopenia and mortality, regardless of the definition, illustrates that identification of appropriate management and lifecourse intervention strategies for this condition is of paramount importance
Interaction of inflammatory cytokines and erythropoeitin in iron metabolism and erythropoiesis in anaemia of chronic disease
In chronic inflammatory conditions increased endogenous release of specific cytokines (TNFα, IL-1, IL-6, IFNγ and others) is presumed. It has been shown that those of monocyte lineage play a key role in cytokine expression and synthesis. This may be associated with changes in iron metabolism and impaired erythropoiesis and may lead to development of anaemia in patients with rheumatoid arthritis. Firstly, increased synthesis of acute phase proteins, like ferritin, during chronic inflammation is proposed as the way by which the toxic effect of iron and thereby the synthesis of free oxy-radicals causing the damage on the affected joints, may be reduced. This is associated with a shift of iron towards the mononuclear phagocyte system which may participate in the development of anaemia of chronic disease. Secondly, an inhibitory action of inflammatory cytokines (TNFα, IL-1), on proliferation and differentiation of erythroid progenitors as well as on synthesis of erythropoietin has been shown, thereby also contributing to anaemia. Finally, chronic inflammation causes multiple, complex disturbances in the delicate physiologic equilibrium of interaction between cytokines and cells (erythroid progenitors, cells of mononuclear phagocyte system and erythropoietin producing cells) leading to development of anaemia of chronic disease (Fig. 1)
Local Helioseismology of Sunspots: Current Status and Perspectives (Invited Review)
Mechanisms of the formation and stability of sunspots are among the
longest-standing and intriguing puzzles of solar physics and astrophysics.
Sunspots are controlled by subsurface dynamics hidden from direct observations.
Recently, substantial progress in our understanding of the physics of the
turbulent magnetized plasma in strong-field regions has been made by using
numerical simulations and local helioseismology. Both the simulations and
helioseismic measurements are extremely challenging, but it becomes clear that
the key to understanding the enigma of sunspots is a synergy between models and
observations. Recent observations and radiative MHD numerical models have
provided a convincing explanation to the Evershed flows in sunspot penumbrae.
Also, they lead to the understanding of sunspots as self-organized magnetic
structures in the turbulent plasma of the upper convection zone, which are
maintained by a large-scale dynamics. Local helioseismic diagnostics of
sunspots still have many uncertainties, some of which are discussed in this
review. However, there have been significant achievements in resolving these
uncertainties, verifying the basic results by new high-resolution observations,
testing the helioseismic techniques by numerical simulations, and comparing
results obtained by different methods. For instance, a recent analysis of
helioseismology data from the Hinode space mission has successfully resolved
several uncertainties and concerns (such as the inclined-field and phase-speed
filtering effects) that might affect the inferences of the subsurface
wave-speed structure of sunspots and the flow pattern. It becomes clear that
for the understanding of the phenomenon of sunspots it is important to further
improve the helioseismology methods and investigate the whole life cycle of
active regions, from magnetic-flux emergence to dissipation.Comment: 34 pages, 18 figures, submitted to Solar Physic
The current state of the use of large wood in river restoration and management
Trees fall naturally into rivers generating flow heterogeneity, inducing geomorphological features, and creating habitats for biota. Wood is increasingly used in restoration projects and the potential of wood acting as leaky barriers to deliver natural flood management by âslowing the flowâ is recognised. However, wood in rivers can pose a risk to infrastructure and locally increase flood hazards. The aim of this paper is to provide an up-to-date summary of the benefits and risks associated with using wood to promote geomorphological processes to restore and manage rivers. This summary was developed through a workshop that brought together academics, river managers, restoration practitioners and consultants in the UK to share science and best-practice on wood in rivers. A consensus was developed on four key issues: (i) hydro-geomorphological effects, (ii) current use in restoration and management, (iii) uncertainties and risks, and (iv) tools and guidance required to inform process-based restoration and management
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