Reliability and Validity of the Monitored Functional Task Evaluation (MFTE) for Patients with Chronic Obstructive Pulmonary Disease (COPD)

This article describes the development of a new functional measure — the Monitored Functional Task Evaluation (MFTE) — a symptom-limited evaluation that is used to measure the functional performance of an individual with chronic obstructive pulmonary disease (COPD), and to document a client's physiological changes through repeated testing. Stage I of the study included developing the content validity of the instrument. Stage II consisted of establishing the performance profile, test-retest and inter-rater reliability using a convenience sample of 27 inpatients and outpatients who had COPD. In stage III, the criterion-related and discriminative validity of the instrument was verified in a retrospective sample of 124 inpatients and day patients who had COPD. Results indicated that there was high intra- and inter-rater reliability for the total score of MFTE. Significant correlation of the MFTE was found with parameters such as Moser's Activities of Daily Living (ADL) class, COPD disability class, 6-minute walking distance, work capacity in terms the ratio of the metabolic rate associated with a given activity to the resting metabolic rate, and the fatigue dimension of the Chronic Respiratory Disease Questionnaire. In addition, prediction of group membership to Moser's ADL class revealed that 52.4% of the original grouped cases could be correctly classified by the MFTE alone. In conclusion, the MFTE is a useful measure to evaluate functional performance as well as document physiological changes in patients with moderate-to-severe COPD from both conceptual and empirical perspectives

The Resilient Organization: A Meta-Analysis of the Effect of Communication on Team Diversity and Team Performance

The Input-Process-Output framework is adopted to examine the impact of diversity attributes (the input) on communication (the process) and their influence on performance (the output), to understand the internal group/team working mechanisms of organizational resilience. A meta-analysis of 174 correlations from 35 empirical studies undertaken over 35 years (1982-2017) showed that members of a team who have different experiences are more likely to share information and communicate openly when they deal with a task that requires collaboration outside the team. This supports the view that organizations are more resilient by being more closely connected with the external environment. Differences in social categories tend to favor openness of communication, especially in the case of age diversity and race/ethnicity diversity. An increase in openness of communication is likely to enhance team performance, particularly for small and medium sized teams operating in manufacturing industries, while frequency of communication can be beneficial for both large and medium sized teams working in the high technology industry. The positive workings of these associations form the resilient organization

Improving phenotyping in winter barley cultivars towards waterlogging tolerance by combining field trials under natural conditions with controlled growth condition experiments

Additional rainfall in Northern Europe due to global climate change is increasing the incidences of field flooding. Flooding causes hypoxic stress that results in a reduced capacity for photosynthesis, reduction in nutrient availability and uptake, increased production of toxic metabolites by anaerobic bacteria in the soil, and ultimately yield losses and crop death. To overcome hypoxic environmental conditions, new cultivars need to be bred and tested for waterlogging tolerance. We scored 403 winter barley cultivars from the ‘Association Genetics of UK Elite Barley’ (AGOUEB) population, taking advantage of the phenotypic changes associated with hypoxic stress. This enabled us to identify an initial set of waterlogging sensitive and tolerant cultivars. Comparative analysis of a subset of 65 cultivars exposed to waterlogging stress under field and growth cabinet environments showed variability in scores due to varying sensitivity to waterlogging over multi-season field trials. In field trials, we observed waterlogging damage resulting in reductions in biomass, grain yield and crop height. However, the effects varied between seasons and the severity of waterlogging due to differences in the topography of the field and the amount of rainfall. To overcome the seasonal variations in environmental conditions in multi-season field trials, we developed in parallel, an enhanced phenotyping method by complementing field experiments with phenotyping under controlled growth conditions. The phenotyping scoring method allows for the grouping of cultivars by sensitivity and tolerance to waterlogging, with limited variance between cultivars scored in the field and controlled conditions. Together, these two complementary approaches maximise the data available to breeders, allowing for the reliable selection of more tolerant cultivars able to grow under flooding conditions

Diagnosis of Cystic Echinococcosis, Central Peruvian Highlands

High prevalence was confirmed by ultrasonography, radiography, and 2 serologic tests, although usefulness of serologic testing in the field was limited

Genomic insights into rapid speciation within the world’s largest tree genus Syzygium

Species radiations, despite immense phenotypic variation, can be difficult to resolve phylogenetically when genetic change poorly matches the rapidity of diversification. Genomic potential furnished by palaeopolyploidy, and relative roles for adaptation, random drift and hybridisation in the apportionment of genetic variation, remain poorly understood factors. Here, we study these aspects in a model radiation, Syzygium, the most species-rich tree genus worldwide. Genomes of 182 distinct species and 58 unidentified taxa are compared against a chromosome-level reference genome of the sea apple, Syzygium grande. We show that while Syzygium shares an ancient genome doubling event with other Myrtales, little evidence exists for recent polyploidy events. Phylogenomics confirms that Syzygium originated in Australia-New Guinea and diversified in multiple migrations, eastward to the Pacific and westward to India and Africa, in bursts of speciation visible as poorly resolved branches on phylogenies. Furthermore, some sublineages demonstrate genomic clines that recapitulate cladogenetic events, suggesting that stepwise geographic speciation, a neutral process, has been important in Syzygium diversification

Assessment of variation in immunosuppressive pathway genes reveals TGFBR2 to be associated with prognosis of estrogen receptor-negative breast cancer after chemotherapy

Introduction: Tumor lymphocyte infiltration is associated with clinical response to chemotherapy in estrogen receptor (ER) negative breast cancer. To identify variants in immunosuppressive pathway genes associated with prognosis after adjuvant chemotherapy for ER-negative patients, we studied stage I-III invasive breast cancer patients of European ancestry, including 9,334 ER-positive (3,151 treated with chemotherapy) and 2,334 ER-negative patients (1,499 treated with chemotherapy). Methods: We pooled data from sixteen studies from the Breast Cancer Association Consortium (BCAC), and employed two independent studies for replications. Overall 3,610 single nucleotide polymorphisms (SNPs) in 133 genes were genotyped as part of the Collaborative Oncological Gene-environment Study, in which phenotype and clinical data were collected and harmonized. Multivariable Cox proportional hazard regression was used to assess genetic associations with overall survival (OS) and breast

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries