Development of Prognosis in Palliative care Study (PiPS) predictor models to improve prognostication in advanced cancer: prospective cohort study

OBJECTIVE: To develop a novel prognostic indicator for use in patients with advanced cancer that is significantly better than clinicians' estimates of survival. DESIGN: Prospective multicentre observational cohort study. SETTING: 18 palliative care services in the UK (including hospices, hospital support teams, and community teams). PARTICIPANTS: 1018 patients with locally advanced or metastatic cancer, no longer being treated for cancer, and recently referred to palliative care services. MAIN OUTCOME MEASURES: Performance of a composite model to predict whether patients were likely to survive for "days" (0-13 days), "weeks" (14-55 days), or "months+" (>55 days), compared with actual survival and clinicians' predictions. RESULTS: On multivariate analysis, 11 core variables (pulse rate, general health status, mental test score, performance status, presence of anorexia, presence of any site of metastatic disease, presence of liver metastases, C reactive protein, white blood count, platelet count, and urea) independently predicted both two week and two month survival. Four variables had prognostic significance only for two week survival (dyspnoea, dysphagia, bone metastases, and alanine transaminase), and eight variables had prognostic significance only for two month survival (primary breast cancer, male genital cancer, tiredness, loss of weight, lymphocyte count, neutrophil count, alkaline phosphatase, and albumin). Separate prognostic models were created for patients without (PiPS-A) or with (PiPS-B) blood results. The area under the curve for all models varied between 0.79 and 0.86. Absolute agreement between actual survival and PiPS predictions was 57.3% (after correction for over-optimism). The median survival across the PiPS-A categories was 5, 33, and 92 days and survival across PiPS-B categories was 7, 32, and 100.5 days. All models performed as well as, or better than, clinicians' estimates of survival. CONCLUSIONS: In patients with advanced cancer no longer being treated, a combination of clinical and laboratory variables can reliably predict two week and two month survival

Seed production of barnyardgrass (Echinochloa crus-galli) in response to time of emergence in cotton and rice

The spread of herbicide resistance in barnyardgrass (Echinochloa crus-galli (L.) Beauv.) poses a serious threat to crop production in the southern United States. A thorough knowledge of the biology of barnyardgrass is fundamental for designing effective resistance-management programmes. In the present study, seed production of barnyardgrass in response to time of emergence was investigated in cotton and rice, respectively, in Fayetteville and Rohwer, Arkansas, over a 2-year period (2008–09). Barnyardgrass seed production was greater when seedlings emerged with the crop, but some seed production was observed even if seedlings emerged several weeks after crop emergence. Moreover, barnyardgrass seed production was highly variable across environments. When emerging with the crop (0 weeks after crop emergence (WAE)), barnyardgrass produced c. 35 500 and 16 500 seeds/plant in cotton, and c. 39 000 and 2900 seeds/plant in rice, in 2008 and 2009, respectively. Seed production was observed when seedlings emerged up to 5 WAE (2008) or 7 WAE (2009) in cotton and up to 5 WAE (2008, 2009) in rice; corresponding seed production was c. 2500 and 1500 seeds/plant in cotton, and c. 14 700 and 110 seeds/plant in rice, in 2008 and 2009, respectively. The results suggest that cultural approaches that delay the emergence of barnyardgrass or approaches that make the associated crop more competitive will be useful in integrated management programmes. In the context of herbicide resistance management, it may be valuable to prevent seed return to the seedbank, irrespective of cohorts. The findings are vital for parameterizing herbicide resistance simulation models for barnyardgrass

A global synthesis of fire effects on pollinators

Understanding fire effects on pollinators is critical in the context of fire regime changes and the global pollination crisis. Through a systematic and quantitative review of the literature, we provide the first global assessment of pollinator responses to fire. We hypothesize that pollinators increase after fire and during the early postfire succession stages; however, high fire frequency has the opposite effect, decreasing pollinators. Location: Terrestrial ecosystems, excluding Antarctica. Time period: Data collected from 1973 to 2017. Major taxa studied: Insects (Coleoptera, Diptera, Hymenoptera and Lepidoptera) and a few bird species. Methods: We first compiled available studies across the globe that assessed fire effects on pollinator communities. Then, by means of hierarchical meta-analyses, we evaluated how different fire regime parameters (fire frequency, postfire time and fire type) and habitat characteristics affect the abundance and richness of animals that act as pollinators. We also explored to what extent the responses vary among taxa groups and life history traits of pollinators (sociality system, nest location and feeding specialization), and among biomes. The overall effect size of fire on pollinator abundance and richness across all studies was positive. Fire effect was especially clear and significant in early postfire communities, after wildfires, and for Hymenoptera. Taxonomic resolution influenced fire effects, where only studies at the species/genus and family levels showed significant effects. The main exceptions were recurrent fires that showed a negative effect, and especially wildfire effects on Lepidoptera abundance that showed a significant negative response. Main conclusions: Pollinators tend to be promoted after a wildfire event. However, short fire intervals may threat pollinators, and especially lepidopterans. Given the current fire regime changes at the global scale, it is imperative to monitor postfire pollinators across many ecosystems, as our results suggest that fire regime is critical in determining the dynamics of pollinator communities.Fil: Carbone, Lucas Manuel. Universidad Nacional de Córdoba; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto Multidisciplinario de Biología Vegetal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto Multidisciplinario de Biología Vegetal; ArgentinaFil: Tavella, Julia Rita. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto Multidisciplinario de Biología Vegetal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto Multidisciplinario de Biología Vegetal; ArgentinaFil: Pausas, Juli G.. Universidad de Valencia; EspañaFil: Aguilar, Ramiro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto Multidisciplinario de Biología Vegetal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto Multidisciplinario de Biología Vegetal; Argentin

Did we do everything we could have? Nurses’ contributions to medicines optimisation: a mixed method study

Aim To explore UK professionals’ interpretations of medicines optimization and expansion of nurses’ roles. Design This mixed‐methods study sought professionals’ views on nurses’ involvement, competency and engagement in monitoring patients for adverse effects of medicines, monitoring adherence, prescribing and patient education. Method An online survey and interviews were undertaken with nurses, doctors and pharmacists in Wales and England, May 2018 to July 2019. Results In all, 220 nurses, 17 doctors and 62 pharmacists responded to the online survey, and 24 professionals were interviewed. Nurses were divided over extending their roles, with 123/220 (55.9%) wishing to extend roles in monitoring patients for possible adverse drug reactions (ADRs), 111/220 (50.5%) in adherence monitoring, 121/220 (55.0%) in prescribing and 122/220 (55.4%) in patient education. The best‐qualified nurses were the most willing to increase involvement in monitoring patients for ADRs (aOR 13.00, 1.56–108.01). Interviews revealed that both nurses and doctors assumed the other profession was undertaking this monitoring. Respondents agreed that increasing nurses’ involvement in medicines optimization would improve patient care, but expressed reservations about nurses’ competencies. Collaboration between nurses and doctors was suboptimal (rated 7/10 at best) and between nurses and pharmacists even more so (6/10 at best). Conclusion Juxtaposition of datasets identified problems with medicines optimization: although most respondents agreed that increasing nurses’ involvement would positively impact practice, their educational preparation was a barrier. Only ~50% of nurses were willing to expand their roles to fill the hiatus in care identified and ensure that at least one profession was taking responsibility for ADR monitoring. Impact To improve multiprofessional team working and promote patient safety, nurse leaders should ensure patients are monitored for possible ADRs by at least one profession. Initiatives expanding nurses’ roles in medicines optimization and prescribing might be best targeted towards the more educated nurses, who have multidisciplinary support

Structure of unbound neutron-rich 9^{9}He studied using single-neutron transfer

The 8He(d,p) reaction was studied in inverse kinematics at 15.4A MeV using the MUST2 Si-CsI array in order to shed light on the level structure of 9He. The well known 16O(d,p)17O reaction, performed here in reverse kinematics, was used as a test to validate the experimental methods. The 9He missing mass spectrum was deduced from the kinetic energies and emission angles of the recoiling protons. Several structures were observed above the neutron-emission threshold and the angular distributions were used to deduce the multipolarity of the transitions. This work confirms that the ground state of 9He is located very close to the neutron threshold of 8He and supports the occurrence of parity inversion in 9He.Comment: Exp\'erience GANIL/SPIRAL1/MUST

Algorithms for Olfactory Search across Species

Localizing the sources of stimuli is essential. Most organisms cannot eat, mate, or escape without knowing where the relevant stimuli originate. For many, if not most, animals, olfaction plays an essential role in search. While microorganismal chemotaxis is relatively well understood, in larger animals the algorithms and mechanisms of olfactory search remain mysterious. In this symposium, we will present recent advances in our understanding of olfactory search in flies and rodents. Despite their different sizes and behaviors, both species must solve similar problems, including meeting the challenges of turbulent airflow, sampling the environment to optimize olfactory information, and incorporating odor information into broader navigational systems

Low-lying states and structure of the exotic 8^8He via direct reactions on the proton

International audienceThe structure of the light exotic nucleus 8He was investigated using direct reactions of the 8He SPIRAL beam on a proton-rich target. The (p,p') scattering to the Click to view the MathML source state, the (p,d)7He and (p,t)6He transfer reactions, were measured at the energy Elab=15.7 A.MeV. The light charged particles (p,d,t) were detected in the MUST Si-strip telescope array. The excitation spectrum of 8He was extracted from the (p,p') reaction. Above the known Click to view the MathML source excited state at 3.6 MeV, a second resonance was found around 5.4 MeV. The cross sections were analyzed within the coupled-reaction channels framework, using microscopic potentials. It is inferred that the 8He ground state has a more complex neutron-skin structure than suggested by previous α+4n models assuming a pure (1p3/2)4 configuration