Baseline Variations Research Articles

P16 status or response to induction chemotherapy, which predicts survival outcomes in Chinese oropharyngeal cancer treated with definitive radiotherapy?

PurposeTo identify whether p16 status or response to induction chemotherapy (IC) predicts the radiotherapy (RT) response and survival outcomes in Chinese oropharyngeal squamous cell carcinoma (OPSCC). MethodsA total of 211 patients, including 128 p16-positive and 83 p16-negative were analyzed. All patients underwent IC followed by definitive RT or concurrent chemoradiotherapy (CCRT). Propensity score matching (PSM) was used to eliminate the baseline variations. ResultsAge, sex, smoking history, alcohol history, and primary site were unbalanced between different p16 status subgroups. Before PSM, the objective response rates to IC between p16-positive and p16-negative groups were 80.5 % and 85.5 % (p = 0.344). After RT, the complete response (CR) rates were 73.4 % and 66.3 %, respectively (p = 0.264). IC-sensitive (IC-s) subgroups had a higher percentage of RT-CR rate than the IC-resistant (IC-r) subgroups in both p16-positive and p16-negative patients. IC-s showed significant improvement in cancer-specific survival (CSS) (92.9 % vs. 53.6 %, p < 0.0001), progression-free survival (PFS) (p < 0.0001), locoregional relapse-free survival (LRFS) (p < 0.0001) and distant metastasis-free survival (DMFS) (p = 0.025). After PSM, the CR rates among different p16 groups remained comparable following RT (71.2 % vs. 65.8 %, p = 0.476). Before or after PSM, CSS, PFS, LRFS, and DMFS were similar between different p16 status either in IC-s or IC-r subgroups (p > 0.05). IC-r was independently associated with shorter PFS (HR = 2.661, p = 0.002) and LRFS (HR = 2.876, p = 0.002; HR = 2.78, p = 0.018). ConclusionsResponse to IC is an important predictor of prognosis in Chinese OPSCC treated with definitive RT. Poor response to IC is associated with unsatisfactory outcomes either in p16-positive or p16-negative OPSCC.

Efficacy of a Four-Week Diagonal Pattern Exercise Program on Trunk and Lower Limb Function in Patients With Stroke-Induced Hemiplegia.

Objective The intended effect of this investigation is to quantifythe efficacy of a four-week program of diagonal pattern exercises in managing trunk impairments and improving gait difficulties in hemiplegic stroke subjects. The study aims to measure changes in trunk stability and gait parameters post-intervention, providing insights into the potential therapeutic benefits of these exercises for stroke rehabilitation. Methodology Thisexperimentation approach encompassing before and the follow-up test evaluations was implemented in this investigation. It was conducted at Madha College of Physiotherapy, Chennai, using convenience sampling to recruit 20 stroke subjects meeting specific inclusion criteria. Participants underwent pre-test evaluations for trunk control and gait. They were then divided equally into two groups for a four-week intervention comprising diagonal pattern exercises or single-plane training. Treatment sessions were administered five days per week for 45 minutes each. Posttest evaluations assessed changes in trunk control using the Trunk Impairment Scale (TIS) and gait parameters via the Timed Up and Go (TUG) test. Results Pretest analysis indicated no substantial baseline variations amongthe experimental and control groups, affirming their suitability for comparison. Posttest analysis of intervention at a 5% significance level revealed that the experimental group demonstrated a statistically significant improvement in trunk control, as measured by the TIS and TUG test, compared to the control group. The paired t-testresults showed significant differences in pre- and posttest values within each group, while the unpaired t-test confirmed the superiority of the experimental group's outcomes, with a P-value < 0.05. This improvement is likely due to the effectiveness of the diagonal pattern exercise in enhancing trunk muscle activity and coordination. Conclusions This study concludes that diagonal pattern training is more beneficial for improving trunk musculature control and locomotory ability in chronic cerebrovascular accident subjects. The exercise program's simplicity, minimal risks, and ease of home application after initial therapist supervision make it a promising therapeutic approach.

MRI analysis of neurodevelopmental anatomy in myelomeningocele: prenatal vs postnatal repair.

Compared with postnatal repair, prenatal myelomeningocele (MMC) repair is associated with improved motor function and decreased need for cerebrospinal fluid (CSF) diversion. It is unknown how prenatal surgery alters neuroanatomical structures identifiable on magnetic resonance imaging (MRI). The purpose of this study was to use MRI to compare neurodevelopmental anatomy in patients undergoing fetal MMC repair compared with those undergoing postnatal repair. This was a retrospective review of neonates who underwent prenatal or postnatal MMC repair at our institution between 2016 and 2021. Imaging data, including prenatal ultrasound and pre- and postnatal MRI examinations, if available, were retrieved. We analyzed anatomical findings characteristically seen on MRI of the neuroaxis in patients with MMC and compared imaging findings between patients with prenatal vs postnatal MMC repair. The study population included 61 patients who underwent surgical repair for MMC during the 6-year study period, of whom 25 underwent prenatal repair and 36 postnatal repair. CSF diversion was required in 24% of the prenatally repaired cohort vs 67% of the postnatally repaired cohort (P = 0.001). On postnatal MRI, a syrinx was present in 13% of the prenatally repaired cohort vs 42% in the postnatally repaired cohort (P = 0.02). Postnatal corpus callosal (CC) morphology was abnormal in 54% of the prenatally repaired cohort vs 53% of the postnatally repaired cohort (P = 0.92), while falx morphology was normal in 92% of the prenatally repaired cohort vs 34% of the postnatally repaired cohort (P < 0.001). On postnatal MRI, patients in the prenatally repaired cohort had a shorter tentorium-to-foramen-magnum distance compared with those in the postnatally repaired cohort (mean, 18.43 mm vs 22.42 mm; P = 0.01), a larger foramen magnum diameter (mean, 22.87 mm vs 18.94 mm; P < 0.001) and a smaller degree of hindbrain herniation (mean, 1.53 mm vs 8.72 mm; P < 0.001). The cerebral aqueduct was patent in 79% of the prenatally repaired cohort vs 100% of the postnatally repaired cohort on postnatal MRI (P = 0.008). Between the two cohorts, at postnatal MRI there was no significant difference in the presence of gray-matter heterotopia, presence of the septum pellucidum or size of the massa intermedia. We report variations in developmental neuroanatomy in patients with MMC, including rates of CC dysgenesis, gray-matter heterotopia and additional cranial and spinal MRI findings. Compared to postnatal surgery, prenatal surgery is associated with changes to infratentorial anatomy, with minimal effect on supratentorial brain development. This information will be useful in counseling parents affected by fetal MMC and in understanding how prenatal repair of MMC affects brain development. © 2024 International Society of Ultrasound in Obstetrics and Gynecology.

Mid-infrared Fine Structure Lines from the Galactic Warm Ionized Medium

The Warm Ionized Medium (WIM) hosts most of the ionized gas in the Galaxy and occupies perhaps a quarter of the volume of the Galactic disk. Decoding the spectrum of the Galactic diffuse ionizing field is of fundamental interest. This can be done via direct measurements of ionization fractions of various elements. Based on current physical models for the WIM we predicted that mid-IR fine structure lines of Ne, Ar and S would be within the grasp of the Mid-Infrared Imager-Medium Resolution Spectrometer (MIRI-MRS), an Integral Field Unit (IFU) spectrograph, aboard the James Webb Space Telescope (JWST). Motivated thus we analyzed a pair of commissioning data sets and detected [Ne ii] 12.81 μm, [S iii] 18.71 μm and possibly [S iv] 10.51 μm. The inferred emission measure for these detections is about 10 cm−6 pc, typical of the WIM. These detections are broadly consistent with expectations of physical models for the WIM. The current detections are limited by uncorrected fringing (and to a lesser extent by baseline variations). In due course, we expect, as with other IFUs, the calibration pipeline to deliver photon-noise-limited spectra. The detections reported here bode well for the study of the WIM. Along most lines-of-sight hour-long MIRI-MRS observations should detect line emission from the WIM. When combined with optical observations by modern IFUs with high spectral resolution on large ground-based telescopes, the ionization fraction and temperature of neon and sulfur can be robustly inferred. Separately, the ionization of helium in the WIM can be probed by NIRspec. Finally, joint JWST and optical IFU studies will open up a new cottage industry of studying the WIM on arcsecond scales.

Glucose breath test for the detection of small intestine bacterial overgrowth: Impact of diet prior to the test.

Glucose breath test (GBT) is used for the diagnosis of small intestine bacterial overgrowth. A restrictive diet without fibers and/or fermentable food is recommended on the day before the test. The aim of our retrospective study was to evaluate the impact of two different restrictive diets on the results of GBT. A change of the pretest restrictive diet was applied in our lab on September 1, 2020. The recommended diet was a fiber-free diet before this date, and a fiber-free diet plus restriction of all fermentable food afterward. We thus compared the results of GBT performed before (group A) and after (group B) this pretest diet modification. Demographics, reasons to perform GBT, digestive symptoms, and hydrogen and methane baseline values and variations after glucose ingestion were compared between the two groups. 269 patients underwent GBT in group A, and 316 patients in group B. The two groups were comparable in terms of demographics. Methane and hydrogen baseline values were significantly higher in group A (respectively 14 [18] vs. 8 [14] ppm, p < 0.01 and 11 [14] vs. 6 [8] ppm, p < 0.01). The percentage of positive tests was higher in group A for methane (43% vs. 28%, p < 0.05), and for hydrogen (18% vs. 12%, p = 0.03). This retrospective study suggests the importance of the restrictive diet prior to GBT. A strict limitation of fibers and fermentable food decreased hydrogen and methane baseline values, and the prevalence of positive GBT. Thus a strict restrictive diet should be recommended on the day before the test, in order to limit the impact of food on hydrogen and methane breath levels, and possibly improve the diagnosis quality of GBT.

Performance of Radiological and Biochemical Biomarkers in Predicting Radio-Symptomatic Knee Osteoarthritis Progression.

Imaging biomarkers permit improved approaches to identify the most at-risk patients encountering knee osteoarthritis (KOA) progression. This study aimed to investigate the utility of trabecular bone texture (TBT) extracted from plain radiographs, associated with a set of clinical, biochemical, and radiographic data, as a predictor of long-term radiographic KOA progression. We used data from the Foundation for the National Institutes of Health (FNIH) Biomarkers Consortium dataset. The reference model made use of baseline TBT parameters adjusted for clinical covariates and radiological scores. Several models based on a combination of baseline and 24-month TBT variations (TBT∆TBT) were developed using logistic regression and compared to those based on baseline-only TBT parameters. All models were adjusted for baseline clinical covariates, radiological scores, and biochemical descriptors. The best overall performances for the prediction of radio-symptomatic, radiographic, and symptomatic progression were achieved using TBT∆TBT parameters solely, with area under the ROC curve values of 0.658 (95% CI: 0.612-0.705), 0.752 (95% CI: 0.700-0.804), and 0.698 (95% CI: 0.641-0.756), respectively. Adding biochemical markers did not significantly improve the performance of the TBT∆TBT-based model. Additionally, when TBT values were taken from the entire subchondral bone rather than just the medial, lateral, or central compartments, better results were obtained.

LIBS combined with SG-SPXY spectral data pre-processing for cement raw meal composition analysis.

Rapid testing of cement raw meal plays a crucial role in the cement production process, so there is an urgent need for a fast and accurate testing method. In this paper, a method based on the Savitzky-Golay (SG) smoothing and sample set partitioning based on joint x-y distance (SPXY) spectral data pre-processing is proposed to improve the accuracy of the laser-induced breakdown spectroscopy (LIBS) technique for quantitative analysis of cement raw meal components. Firstly, the spectral data is denoised by SG smoothing, which effectively reduces the noise and baseline variations in the spectra. Then, the denoised data is divided into sample sets by combining the SPXY sample division method, which improves the efficiency of data analysis. Finally, the delineated data set is modeled for quantitative analysis by a back-propagation (BP) neural network. Compared to the modeling effect of the four oxide contents of CaO, S i O 2, A l 2 O 3, and F e 2 O 3 in the Hold-Out method, the correlation coefficient (R) was improved by 26%, 10%, 17%, and 4%, respectively. The root mean square error (RMSE) was reduced by 47%, 33%, 43%, and 21%, respectively. The mean absolute percentage error (MAPE) was reduced by 63%, 60%, 36%, and 51%, respectively. The results show that there is a significant improvement in the model effect, which can effectively improve the accuracy of quantitative analysis of cement raw meal composition by LIBS. This is of great significance for the real-time detection of cement raw meal composition analysis.

Aortic Valve Replacement: Totally Endoscopic versus Mini-Sternotomy

(1) Background: The development of totally endoscopic aortic valve replacement has the potential to enhance clinical results compared to mini-sternotomy. To our knowledge, no comparison between these two techniques has been conducted before. Therefore, the objective of this retrospective study is to examine the results after both totally endoscopic and mini-sternotomy approaches. (2) Methods: This study covered all elective patients who underwent isolated aortic valve replacement, either totally endoscopically (n = 392) or through a mini-sternotomy (n = 323), between 2013 and 2021. Multivariable analysis was used to account for baseline variations between the two groups. All data were retrospectively gathered and analysed. The primary objective of this study was the one-year mortality rate. (3) Results: The mean aortic cross-clamping and cardiopulmonary bypass times were significantly longer in the totally endoscopic approach (cross-clamping: 43.73 ± 13.71 min and 61.93 ± 16.76 min, p-value &lt; 0.001; CPB time: 64.86 ± 23.02 min and 93.23 ± 23.67 min, p-value &lt; 0.001). However, perioperative bleeding was lower (706.40 ± 542.77 mL and 444.50 ± 515.84 mL, p-value &lt; 0.001). The primary objective, one-year survival, did not significantly differ between both groups (Mini-AVR: 94.5% vs TEAVR: 93.3%, p-value = 0.520). (4) Conclusions: Our results show that totally endoscopic aortic valve replacement has comparable clinical results compared to aortic valve replacement through mini-sternotomy.

Geographic, seasonal and ontogenetic variations of δ15N and δ13C of Japanese sardine explained by baseline variations and diverse fish movements

Understanding and predicting variability in the stable isotope ratios of nitrogen and carbon (δ15N and δ13C, respectively) of small pelagic fish is crucial to enable isotopic studies of a variety of marine predators that feed on them. However, because the isotope ratios reflect plastic feeding habits and fish migration in addition to baseline variation, their predictions require a mechanistic understanding of how each factor contributes. Here, we investigated the habitat-wide variability of δ15N and δ13C of the Japanese sardine Sardinops melanostictus in the western North Pacific and its marginal seas (the East China Sea and the Sea of Japan). By combining this with the archived particulate organic matter (POM) dataset as a baseline, we aimed to understand how ecological processes and baseline fluctuations affect isotope ratios of the sardine. Both δ15N and δ13C of sardine showed significant geographical and seasonal trends, with higher values in southern nearshore areas, including the Seto Inland Sea, intermediate values in marginal seas and lower values in Pacific offshore areas. As the variations were largely consistent with the geographic trend and the temporally integrated seasonal trend of isotope ratios of POM, respectively, the baseline variations are the main determinant of sardine isotope composition. The trophic positions of sardine are therefore not significantly different between regions, with possible minor increases in the southern nearshore area. Adults showed less geographic variation than larvae and juveniles, likely due to slower turnover periods and wider migration ranges. Although larval and juvenile isotope ratios in marginal seas mostly reflected the local baseline, those in the Pacific offshore often reflected the baseline in the neighbouring southern region, suggesting contrasting juvenile movements between regions. Our results suggest that the δ15N and δ13C of Japanese sardine strongly reflect baseline variations, but can also be influenced by life-stage- and region-dependent fish movements, thereby demonstrating both the possibility and difficulty of mechanistically modelling the isoscapes of lower trophic position species.

Multicomponent Training Improves the Quality of Life of Older Adults at Risk of Frailty.

Achieving a high quality of life in older adults can be difficult if they have limited physical function. The aims of this study were to evaluate the relationship between baseline values and variations in body composition, fitness, and nutritional status on health-related quality of life (HRQoL) and to describe the effects of a 6-month multicomponent training (MCT) programme and a 4-month detraining period on HRQoL. A total of 106 participants with limited physical function were included in this study (age: 80.8 ± 5.9 years; 74 females) and were divided into two groups: control (CON) and intervention (TRAIN). HRQoL was measured using the EQ-5D-3L questionnaire and a visual analogue scale (EQ-VAS). Information on body composition, physical fitness, Mediterranean diet adherence, and nutritional status were obtained. Healthier baseline values for body composition, fitness and nutritional status were associated with better HRQoL (explaining 23.7-55.4%). The TRAIN group showed increased HRQoL during this 6-month MCT, showing group-by-time interaction (p < 0.05) and a deleterious effect of detraining. Changes in weight, arm strength, and aerobic capacity contributed to explaining 36% of the HRQoL changes obtained with MCT (all p < 0.05). This MCT improved HRQoL in older adults with limited physical function. However, HRQoL returned to baseline values after detraining. This study highlights the importance of performing ongoing programs in this population.

Comment on "Dying in the Sun: Direct evidence for elevated UV-B radiation at the end-Permian mass extinction".

Liu etal. present evidence of increased abundance of UV-B-absorbing compounds in fossilized sporomorphs at the end-Permian mass extinction based on Fourier transform infrared (FTIR) spectroscopy. Their approach assumes that UV-B-absorbing compounds are present in the fossilized sporomorphs spanning the extinction interval and that they can be quantified using FTIR. However, further analysis reveals that the signal that they aim to focus on is weak and poorly resolved against nonrandom background interference most likely associated with water vapor. We also show that the peak detection methods that they use are inappropriate for use on these fossil sporomorphs because their methods select only 3.9% of the spectra at the target waveband of interest. The reconstruction that they present is based on baseline variations in the spectra and cannot be confidently attributed to variations in UV-B-absorbing compounds. "Direct" evidence for UV-B radiation at the end-Permian mass extinction cannot be claimed to have been observed in this record.

Baseline innate and T cell populations are correlates of protection against symptomatic influenza virus infection independent of serology.

Evidence suggests that innate and adaptive cellular responses mediate resistance to the influenza virus and confer protection after vaccination. However, few studies have resolved the contribution of cellular responses within the context of preexisting antibody titers. Here, we measured the peripheral immune profiles of 206 vaccinated or unvaccinated adults to determine how baseline variations in the cellular and humoral immune compartments contribute independently or synergistically to the risk of developing symptomatic influenza. Protection correlated with diverse and polyfunctional CD4+ and CD8+ T, circulating T follicular helper, T helper type 17, myeloid dendritic and CD16+ natural killer (NK) cell subsets. Conversely, increased susceptibility was predominantly attributed to nonspecific inflammatory populations, including γδ T cells and activated CD16- NK cells, as well as TNFα+ single-cytokine-producing CD8+ T cells. Multivariate and predictive modeling indicated that cellular subsets (1) work synergistically with humoral immunity to confer protection, (2) improve model performance over demographic and serologic factors alone and (3) comprise the most important predictive covariates. Together, these results demonstrate that preinfection peripheral cell composition improves the prediction of symptomatic influenza susceptibility over vaccination, demographics or serology alone.

Longitudinal changes in echocardiographic variables and endothelial function to predict cardiovascular toxicities in patients with multiple myeloma receiving carfilzomib.

e20012 Background: Carfilzomib (CFZ) is a second-generation proteasome inhibitor with activity in multiple myeloma (MM) that is associated with cardiotoxicity and dyspnea. The pathophysiology and risk factors for developing these toxicities are not well described. We are conducting a prospective observational study (NCT04827563) of longitudinal changes in cardiovascular and endothelial function among MM patients receiving CFZ. We hypothesize that baseline and longitudinal variations in cardiovascular and endothelial function correlate with development of cardiotoxicity and dyspnea in MM patients receiving CFZ. Methods: Patients with MM receiving first-time CFZ therapy are prospectively enrolled and undergo the following study procedures prior to CFZ initiation and then every 2 weeks for the first 6 weeks of CFZ therapy (C1D1, C1D15, C2D1, C2D15): 24-hour ambulatory blood pressure monitoring, echocardiography, pulse wave velocity, and EndoPAT endothelial function assessment. Patient-reported outcomes are also collected. Cardiovascular adverse events (CVAEs) and dyspnea are assessed at all timepoints, as well as at 3 and 6 months after enrollment, by CTCAE v5.0 and are adjudicated by a cardio-oncologist. Patients with endothelial dysfunction will be defined as reactive hyperemia index (RHI) &lt;1.67 via EndoPAT. Baseline variables were analyzed with unpaired t-tests and longitudinal variables were analyzed by one-way repeated measures ANOVA. Results: Ten patients have completed 6 months of follow-up. Demographic data is summarized in the table. Four patients (40%) developed dyspnea, 2 with grade 1 and 2 with grade 3 at maximum, with most patients developing dyspnea by C1D15. Two patients had ongoing grade 1 dyspnea at follow-up. Four patients (40%) developed grade 3 or higher CVAEs, most of which were grade 3 hypertension and/or grade 3 HFpEF. Baseline left ventricular mass was significantly higher in patients who developed dyspnea compared to those who did not (p=0.040). EndoPAT values were significantly different between C1D1 and C1D15 in those with CVAEs (2.28 vs 1.74, p=0.0223). NTproBNP values were also significantly different between C1D1 and C1D15 in those with dyspnea (74.5 vs 129.3, p=0.006). Conclusions: MM patients that developed dyspnea during treatment with CFZ had a higher baseline LV mass and were more likely to develop increases in NTproBNP despite preserved ejection fraction, consistent with HFpEF. This group also had a greater change in EndoPAT values suggesting that short-term alterations in endothelial function may have a role in the development of dyspnea in those who may have the anatomic substrate for HFpEF. Clinical trial information: NCT04827563 . [Table: see text]

Prognostic value of von Willebrand factor levels in patients with metastatic melanoma treated by immune checkpoint inhibitors

BackgroundAn increased incidence of thrombotic complications associated with an increased mortality rate has been observed under immune checkpoint inhibition (ICI). Recent investigations on the coagulation pathways have highlighted the direct...

The impact of policy and model uncertainties on emissions projections of the Paris Agreement pledges

Tracking progress towards the Paris Agreement climate goal requires understanding the 2030 emission levels implied by countries’ National Determined Contributions (NDCs). However, key uncertainties and assumptions impact greenhouse gas (GHG) emission projections implied by the NDCs. This study analyses this impact, both globally and for major emitting countries. We find that the assessed uncertainties markedly affect global GHG emission projections. Full achievement of NDC targets is estimated to result in a range of 46–60 GtCO2eq by 2030 (median estimate: 53 GtCO2eq). The uncertainty in measuring historical emissions, including land-use, as reflected by different datasets is the most important contributing factor. This is followed by two equally important factors globally: socio-economic baseline uncertainty and uncertainty about the emissions implied by current policies in case NDCs are less ambitious than these. Overall, the impact of policy uncertainty (i.e. uncertainty resulting from conditionality of or ranges in NDC targets and uncertainty in emissions resulting from current policies) is about equally important as model/technical uncertainty (i.e. uncertainty in historical emissions and socio-economic baseline variations). This new insight is important for decision makers and researchers because a larger share of the total uncertainty is now attributable to aspects that can be influenced by policy decisions compared to previous analyses of NDC uncertainty.

Techno-economic evaluation of a hybrid photovoltaic system with hot/cold water storage for poly-generation in a residential building

There is a growing effort towards the application of solar technologies to meet electrical and thermal demand. However, substantial energy is used in buildings around the world for electricity and thermal comfort. Here we evaluate a novel hybrid solar-powered system for reducing the load on the direct expansion and heat pump unit of a combined heating and air conditioning system while generating electricity. The system combines rooftop photovoltaic (PV) and building-integrated photovoltaic thermal (BIPV/T) systems for electricity generation, while any excess electricity is used to drive a hot and cold water storage system. A residential building in Tehran is used as a case study, and the results are computed via MATLAB, TRNSYS, and Carrier HAP software. The system is shown to outperform both rooftop PV and BIPV/T systems alone, generating at least 50% more electricity while reducing the heating and cooling loads on the machinery by at least 60%. The system also enjoys a payback time of 2.87 years. The impact of thermal comfort setpoints, in addition to inflation and discount rates, are also evaluated via a sensitivity analysis involving several key performance metrics, namely the hot and cold water storage volumes, the size of the desiccant wheel, and the payback time. The cooling load is found to have the greatest influence on the cold water storage volume and the desiccant size, with 80.1% and 41.2% variations for baseline variations of ±20%. With a 57.7% increase, the heating load is found to have the biggest influence on the hot water storage volume. With a 27.1% variation, inflation has the strongest effect on the payback time.

Compound-specific stable isotope analysis of amino acid nitrogen reveals detrital support of microphytobenthos in the Dutch Wadden Sea benthic food web

The Wadden Sea is the world’s largest intertidal ecosystem and provides vital food resources for a large number of migratory bird and fish species during seasonal stopovers. Previous work using bulk stable isotope analysis of carbon found that microphytobenthos (MPB) was the dominant resource fueling the food web with particulate organic matter making up the remainder. However, this work was unable to account for the trophic structure of the food web or the considerable increase in δ15N values of bulk tissue throughout the benthic food web occurring in the Eastern regions of the Dutch Wadden Sea. Here, we combine compound-specific and bulk analytical stable isotope techniques to further resolve the trophic structure and resource use throughout the benthic food web in the Wadden Sea. Analysis of δ15N for trophic and source amino acids allowed for better identification of trophic relationships due to the integration of underlying variation in the nitrogen resources supporting the food web. Baseline-integrated trophic position estimates using glutamic acid (Glu) and phenylalanine (Phe) allow for disentanglement of baseline variations in underlying δ15N sources supporting the ecosystem and trophic shifts resulting from changes in ecological relationships. Through this application, we further confirmed the dominant ecosystem support by MPB-derived resources, although to a lesser extent than previously estimated. In addition to phytoplankton-derived particulate, organic matter and MPB supported from nutrients from the overlying water column there appears to be an additional resource supporting the benthic community. From the stable isotope mixing models, a subset of species appears to focus on MPB supported off recycled (porewater) N and/or detrital organic matter mainly driven by increased phenylalanine δ15N values. This additional resource within MPB may play a role in subsidizing the exceptional benthic productivity observed within the Wadden Sea ecosystem and reflect division in MPB support along green (herbivory) and brown (recycled/detrital) food web pathways.

A Study on Non-coplanar Baseline Effects for Mingantu Spectral Radioheliograph

As a dedicated solar radioheliograph, the MingantU SpEctral RadioHeliograph (MUSER) has a maximum baseline of more than 3000 m and a frequency range of 400 MHz–15 GHz. According to the classical radio interferometry theory, the non-coplanar baseline effect (i.e., w-term effect) would be considered and calibrated for such a radio instrument. However, little previous literature made the qualitative or quantitative analyses on w-term effects of solar radioheliograph in-depth. This study proposes a complete quantitative analysis of w-term effects for the MUSER. After a brief introduction of the MUSER, we systematically investigate the baseline variations over a year and analyze the corresponding variations of w-term. We further studied the effects of the w-term in the imaging for the specified extended source, i.e., the Sun. We discussed the possible effects of the w-term, such as image distortion and so on. The simulated results show that the w-term is an essential and unavoidable issue for solar radio imaging with high spatial resolution.

The prognostic value of baseline and early variations of peripheral blood inflammatory ratios and their cellular components in patients with metastatic renal cell carcinoma treated with nivolumab: The Δ-Meet-URO analysis.

BackgroundTreatment choice for metastatic renal cell carcinoma (mRCC) patients is still based on baseline clinical and laboratory factors.MethodsBy a pre-specified analysis of the Meet-URO 15 multicentric retrospective study enrolling 571 pretreated mRCC patients receiving nivolumab, baseline and early dynamic variations (Δ) of neutrophil, lymphocyte, and platelet absolute cell counts (ACC) and their inflammatory ratios (IR) were evaluated alongside their association with the best disease response and overall (OS) and progression-free survival (PFS). Multivariable analyses on OS and PFS between baseline and Δ ACC and IR values were investigated with receiving operating curves-based cut-offs.ResultsThe analysis included 422 mRCC patients. Neutrophil-to-lymphocyte ratio (NLR) increased over time due to consistent neutrophil increase (p < 0.001). Higher baseline platelets (p = 0.044) and lower lymphocytes (p = 0.018), increasing neutrophil Δ (p for time-group interaction <0.001), higher baseline IR values (NLR: p = 0.012, SII: p = 0.003, PLR: p = 0.003), increasing NLR and systemic immune-inflammatory index (SII) (i.e., NLR x platelets) Δ (p for interaction time-group = 0.0053 and 0.0435, respectively) were associated with disease progression. OS and PFS were significantly shorter in patients with baseline lower lymphocytes (p < 0.001 for both) and higher platelets (p = 0.004 and p < 0.001, respectively) alongside early neutrophils Δ (p = 0.046 and p = 0.033, respectively). Early neutrophils and NLR Δ were independent prognostic factors for both OS (p = 0.014 and p = 0.011, respectively) and PFS (p = 0.023 and p = 0.001, respectively), alongside baseline NLR (p < 0.001 for both) and other known prognostic variables.ConclusionsEarly neutrophils and NLR Δ may represent new dynamic prognostic factors with clinical utility for on-treatment decisions.

The kinetics of isotonic and hypertonic resuscitation fluids is dependent on the sizes of the body fluid volumes.

The extracellular and intracellular fluid volumes (ECV and ICV) vary not only with age, gender, and body weight but also with the habitual intake of water. The present study examines whether the baseline variations in the ECV and ICV change the distribution and elimination of subsequently given infusion fluids. Twenty healthy male volunteers underwent 50 infusion experiments with crystalloid fluid for which the fluid volume kinetics was calculated based on frequent measurements of the hemodilution using mixed-effects modeling software. The results were compared with the ECV and ICV measured with multifrequency bioimpedance analysis before each infusion started. The fluids were given over 30 minutes and comprised 25 mL/kg Ringer's acetate (N = 20), Ringer's lactate, 5 mL/kg 7.5% saline, and 3 mL/kg 7.5% saline in 6% dextran 70 (these fluids, N = 10). A large ICV was associated with a small extravascular accumulation of infused fluid, which increased the plasma volume expansion and the urinary excretion. With hypertonic fluid, a large ECV greatly accelerated urinary excretion. The body weight did not serve as a covariate in the kinetic models. Albumin was recruited to the plasma during infusion of both types of fluid. The hypertonic fluids served as diuretics. The infused excess sodium and osmolality were distributed over a 35% larger space than the sum of the ECV and ICV. A large ICV reduced the rate of distribution of Ringer's solution, whereas a large ECV accelerated the excretion of hypertonic saline.