Organizational guidance for the care of patients with head-and-neck cancer in Ontario.

Background: At the request of the Head and Neck Cancers Advisory Committee of Ontario Health (Cancer Care Ontario), a working group and expert panel of clinicians with expertise in the management of head-and-neck cancer developed the present guideline. The purpose of the guideline is to provide advice about the organization and delivery of health care services for adult patients with head-and-neck cancer. Methods: This document updates the recommendations published in the Ontario Health (Cancer Care Ontario) 2009 organizational guideline Results: To ensure that all patients have access to the highest standard of care available in Ontario, the guideline establishes the minimum requirements to maintain a head-and-neck disease site program. Recommendations are made about the membership of core and extended provider teams, minimum skill sets and experience of practitioners, cancer centre-specific and practitioner-specific volumes, multidisciplinary care requirements, and unique infrastructure demands. Conclusions: The recommendations contained in this document offer guidance for clinicians and institutions providing care for patients with head-and-neck cancer in Ontario, and for policymakers and other stakeholders involved in the delivery of health care services for head-and-neck cancer

Age structure, dispersion and diet of a population of stoats (Mustela erminea) in southern Fiordland during the decline phase of the beechmast cycle

The dispersion, age structure and diet of stoats (Mustela erminea) in beech forest in the Borland and Grebe Valleys, Fiordland National Park, were examined during December and January 2000/01, 20 months after a heavy seed-fall in 1999. Thirty trap stations were set along a 38-km transect through almost continuous beech forest, at least 1 km apart. Mice were very scarce (nights, C/100TN) along two standard index lines placed at either end of the transect, compared with November 1999 (>60/100TN), but mice were detected (from footprints in stoat tunnels) along an 8 km central section of the transect (stations 14-22). Live trapping with one trap per station (total 317.5 trap nights) in December 2000 caught 2 female and 23 male stoats, of which 10 (including both females) were radio collared. The minimum range lengths of the two females along the transect represented by the trap line were 2.2 and 6.0 km; those of eight radio-tracked males averaged 2.9 ± 1.7 km. Stations 14-22 tended to be visited more often, by more marked individual stoats, than the other 21 stations. Fenn trapping at the same 30 sites, but with multiple traps per station (1333.5 trap nights), in late January 2001 collected carcasses of 35 males and 28 females (including 12 of the marked live-trapped ones). Another two marked males were recovered dead. The stoat population showed no sign of chronic nutritional stress (average fat reserve index = 2.8 on a scale of 1-4 where 4 = highest fat content); and only one of 63 guts analysed was empty. Nevertheless, all 76 stoats handled were adults with 1-3 cementum annuli in their teeth, showing that reproduction had failed that season. Prey categories recorded in descending frequency of occurrence were birds, carabid beetle (ground beetle), weta, possum, rat, and mouse. The frequencies of occurrence of mice and birds in the diet of these stoats (10% and 48%, respectively) were quite different from those in stoats collected in Pig Creek, a tributary of the Borland River (87%, 5%), 12 months previously when mice were still abundant. Five of the six stoat guts containing mice were collected within 1 km of stations 14-22

The Ealing Intensive Therapeutic and Short Breaks Service: an update five years on

The purpose of this paper is to present an update on the Ealing Intensive Therapeutic and Short Breaks Service (ITSBS). Design/methodology/approach– Thechallengestheservicehasfacedarereviewed,includingtheservice’s response to those challenges. Also provided is a more detailed analysis of the outcomes of the service. Findings – The ITSBS continues to succeed in supporting young people with intellectual disabilities and challenging behaviour to stay at home with their families. Originality/value – Despite considerable challenges and adaptations to the model, the ITSBS is still achieving successful outcomes for vulnerable young people and is considered nationally to be a bestpracticemodel.Fewpriorarticleshaveprovidedanaccountofhowinnovativeservicemodelsaremaintained and evolve over time

Observation of Beam Spin Asymmetries in the Process ep → e\u27π⁺π⁻ X with CLAS 12

The observation of beam spin asymmetries in two-pion production in semi-inclusive deep inelastic scattering off an unpolarized proton target is reported. The data presented here were taken in the fall of 2018 with the CLAS12 spectrometer using a 10.6 GeV longitudinally spin-polarized electron beam delivered by CEBAF at JLab. The measured asymmetries provide the first opportunity to extract the parton distribution function e(x), which provides information about the interaction between gluons and quarks, in a collinear framework that offers cleaner access than previous measurements. The asymmetries also constitute the first ever signal sensitive to the helicity-dependent two-pion fragmentation function G⊥1. A clear sign change is observed around the ρ mass that appears in model calculations and is indicative of the dependence of the produced pions on the helicity of the fragmenting quark

Sensitivity of fluvial sediment source apportionment to mixing model assumptions: A Bayesian model comparison

Mixing models have become increasingly common tools for apportioning fluvial sediment load to various sediment sources across catchments using a wide variety of Bayesian and frequentist modeling approaches. In this study, we demonstrate how different model setups can impact upon resulting source apportionment estimates in a Bayesian framework via a one-factor-at-a-time (OFAT) sensitivity analysis. We formulate 13 versions of a mixing model, each with different error assumptions and model structural choices, and apply them to sediment geochemistry data from the River Blackwater, Norfolk, UK, to apportion suspended particulate matter (SPM) contributions from three sources (arable topsoils, road verges, and subsurface material) under base flow conditions between August 2012 and August 2013. Whilst all 13 models estimate subsurface sources to be the largest contributor of SPM (median ∼76%), comparison of apportionment estimates reveal varying degrees of sensitivity to changing priors, inclusion of covariance terms, incorporation of time-variant distributions, and methods of proportion characterization. We also demonstrate differences in apportionment results between a full and an empirical Bayesian setup, and between a Bayesian and a frequentist optimization approach. This OFAT sensitivity analysis reveals that mixing model structural choices and error assumptions can significantly impact upon sediment source apportionment results, with estimated median contributions in this study varying by up to 21% between model versions. Users of mixing models are therefore strongly advised to carefully consider and justify their choice of model structure prior to conducting sediment source apportionment investigations

Regulatory Polymorphisms in the Cyclophilin A Gene, PPIA, Accelerate Progression to AIDS

Human cyclophilin A, or CypA, encoded by the gene peptidyl prolyl isomerase A (PPIA), is incorporated into the HIV type 1 (HIV-1) virion and promotes HIV-1 infectivity by facilitating virus uncoating. We examined the effect of single nucleotide polymorphisms (SNPs) and haplotypes within the PPIA gene on HIV-1 infection and disease progression in five HIV-1 longitudinal history cohorts. Kaplan-Meier survival statistics and Cox proportional hazards model were used to assess time to AIDS outcomes. Among eight SNPs tested, two promoter SNPs (SNP3 and SNP4) in perfect linkage disequilibrium were associated with more rapid CD4+ T-cell loss (relative hazard = 3.7, p = 0.003) in African Americans. Among European Americans, these alleles were also associated with a significant trend to more rapid progression to AIDS in a multi-point categorical analysis (p = 0.005). Both SNPs showed differential nuclear protein-binding efficiencies in a gel shift assay. In addition, one SNP (SNP5) located in the 5′ UTR previously shown to be associated with higher ex vivo HIV-1 replication was found to be more frequent in HIV-1-positive individuals than in those highly exposed uninfected individuals. These results implicate regulatory PPIA polymorphisms as a component of genetic susceptibility to HIV-1 infection or disease progression, affirming the important role of PPIA in HIV-1 pathogenesis