A millennial-scale record of Arctic Ocean sea ice variability and the demise of the Ellesmere Island ice shelves

Sea-ice ice shelves, at the apex of North America (>80N), constitute the oldest sea ice in the Northern Hemisphere. We document the establishment and subsequent stability of the Ward Hunt Ice Shelf, and multiyear landfast sea ice in adjacent fiords, using 69 radiocarbon dates obtained on Holocene driftwood deposited prior to coastal blockage. These dates (47 of which are new) record a hiatus in driftwood deposition beginning 5500 cal yr BP, marking the inception of widespread multiyear landfast sea ice across northern Ellesmere Island. This chronology, together with historical observations of ice shelf breakup (1950 to present), provides the only millennial-scale record of Arctic Ocean sea ice variability to which the past three decades of satellite surveillance can be compared. Removal of the remaining ice shelves would be unprecedented in the last 5500 years. This highlights the impact of ongoing 20th and 21st century climate warming that continues to break up the remaining ice shelves and soon may cause historically ice-filled fiords nearby to open seasonally

Palliative pelvic exenteration: A systematic review of patient-centered outcomes

Objective: Palliative pelvic exenteration (PPE) is a technically complex operation with high morbidity and mortality rates, considered in patients with limited life expectancy. There is little evidence to guide practice. We performed a systematic review to evaluate the impact of PPE on symptom relief and quality of life (QoL). Methods: A systematic review was conducted according to the PRISMA guidelines using Ovid MEDLINE, EMBASe, and PubMed databases for studies reporting on outcomes of PPE for symptom relief or QoL. Descriptive statistics were used on pooled patient cohorts. Results: Twenty-three historical cohorts and case series were included, comprising 509 patients. No comparative studies were found. Most malignancies were of colorectal, gynaecological and urological origin. Common indications for PPE were pain, symptomatic fistula, bleeding, malodour, obstruction and pelvic sepsis. The pooled median postoperative morbidity rate was 53.6% (13\u2013100%), the median in-hospital mortality was 6.3% (0\u201366.7%), and median OS was 14 months (4\u201340 months). Some symptom relief was reported in a median of 79% (50\u2013100%) of the patients, although the magnitude of effect was poorly measured. Data for QoL measures were inconclusive. Five studies discouraged performing PPE in any patient, while 18 studies concluded that the procedure can be considered in highly selected patients. Conclusion: Available evidence on PPE is of low-quality. Morbidity and mortality rates are high with a short median OS interval. While some symptom relief may be afforded by this procedure, evidence for improvement in QoL is limited. A highly selective individualised approach is required to optimise the risk:benefit equation

Guidelines for the use and interpretation of assays for monitoring autophagy (3rd edition)

[[sponsorship]]生物化學研究所[[note]]已出版;[SCI];有審查制度;具代表性[[note]]http://gateway.isiknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=Drexel&SrcApp=hagerty_opac&KeyRecord=1554-8627&DestApp=JCR&RQ=IF_CAT_BOXPLO

Predicting outcomes of pelvic exenteration using machine learning

Aim: We aim to compare machine learning with neural network performance in predicting R0 resection (R0), length of stay > 14 days (LOS), major complication rates at 30 days postoperatively (COMP) and survival greater than 1 year (SURV) for patients having pelvic exenteration for locally advanced and recurrent rectal cancer. Method: A deep learning computer was built and the programming environment was established. The PelvEx Collaborative database was used which contains anonymized data on patients who underwent pelvic exenteration for locally advanced or locally recurrent colorectal cancer between 2004 and 2014. Logistic regression, a support vector machine and an artificial neural network (ANN) were trained. Twenty per cent of the data were used as a test set for calculating prediction accuracy for R0, LOS, COMP and SURV. Model performance was measured by plotting receiver operating characteristic (ROC) curves and calculating the area under the ROC curve (AUROC). Results: Machine learning models and ANNs were trained on 1147 cases. The AUROC for all outcome predictions ranged from 0.608 to 0.793 indicating modest to moderate predictive ability. The models performed best at predicting LOS > 14 days with an AUROC of 0.793 using preoperative and operative data. Visualized logistic regression model weights indicate a varying impact of variables on the outcome in question. Conclusion: This paper highlights the potential for predictive modelling of large international databases. Current data allow moderate predictive ability of both complex ANNs and more classic methods